This headline is both accurate and profound, a rarity.

At the core, we need public investment in medical research. As pointed out in the article, almost every randomized controlled trial (RCT) is conducted by the study drug’s manufacturer. This means that those drug companies have some infrastructure for designing and conducting RCTs but they have no interest in using those resources for studying repurposing of drugs like hydroxychloroquine. We–and here I mean the royal, public “we”–need to be investing in investigating drugs and therapeutics ourselves. The National Institutes of Health are well suited to lead this, but they need to get out of Bethesda and into hospitals and clinics around the country.

The article also refers to the ongoing siloed nature of our electronic health records, but I think misses the mark somewhat. The presupposition here is that all data collected as part of a RCT is clinical data that is wholly contained in the EHR. RCTs include a ton of data that is never a part of the medical record. So, we don’t have to have some sort of magical RCT software integrated with all EHRs to conduct meaningful wide-scale RCTs. RCTs and disease-specific registries need ways to extract specific data from EHRs at scale and this can be accomplished through FHIR [1].

Regardless, the bottom line remains the same, we need to be able to do clinical research much fast.

There are, of course, caveats with this statement. FHIR is still quite limited in what data healthcare organizations have available by default. But this could quickly be scaled. ↩