Summary

Translating medical discoveries into patient treatments has not always happened quickly. Mayo Clinic is one of the first NIH-funded centers focusing on streamlining that process. Part of the goal is to engage patients and practitioners on a community level for input and exchanges, and to involve a larger and more diverse range of participants in clinical research studies. As Mayo's CTSA explains on its web site, "Everyone can be involved in discovery."

David Warner, M.D.

You can't talk to anyone at Mayo's CTSA - Center for Translational Science Activities - without hearing the phrase "taking research to the people." It sounds a little revolutionary, and from the perspective of the National Institutes of Health, initiator of the CTSA awards, it's supposed to be. The goal of the competitive awards was to create innovative systems for delivering benefits of research discoveries to the people of America. NIH leaders felt there was too much of a gap, sometimes in years, sometimes in effectiveness, in the translation of scientific findings to the practice of medicine. Mayo Clinic's century-plus of patient-centered medical science and its integrated research-education-practice structure made this concept a familiar theme.

"What CTSA brings to Mayo is an opportunity to build and expand our existing model of conducting research to inform patient care," says David Warner, M.D., CTSA associate director and director of community engagement. "What we will be doing now is enhancing and extending that across our enterprise."

The focus is community involvement in research, not only in enhancing participation in clinical trials, but increasing awareness of clinical and translational research in all the communities Mayo serves. The idea is that medical research is a two-way street: researchers need the input and participation of physicians and community members, and those same physicians and patients directly benefit from the results of the research. It really goes back to the Mayo brothers' founding idea that collaboration is far better than someone going it alone. In this aspect, the collaboration is with Mayo's large and diverse populations of patients in both rural and urban areas across five states. CTSA is saying to people, "Help us create the future of medicine - we're all in this together." Americans respond willingly when asked to donate blood. CTSA is trying to establish that same level of interest and involvement when it comes to participating in research. At the same time, Mayo's Office for Diversity in Clinical Research (now part of CTSA) is examining social and cultural factors that create health disparities and contribute to lower levels of minority participation in clinical research.

"Mayo's CTSA has a unique opportunity," says Dr. Warner. "Our clinic has campuses in four cities in three states (Rochester, Minn., Jacksonville, Fla., and Scottsdale and Phoenix, Ariz.), representing diverse geographic and ethnic populations. But additionally, we are establishing a research partnership with Mayo Health System (MHS), comprised of 66 clinics and hospitals that serve many small towns and rural areas (Minnesota, Wisconsin and Iowa). Where we are going is a future where translational research is conducted at all our sites, including key sites within the Mayo Health System, to provide not only a representative population base, but also a strong component of rural America in terms of population, environment and health care delivery. Then, we use those same relationships to expedite the discoveries into the day-to-day medical practice in all those locations. That's a level of synergy and collaboration that brings new meaning to the term 'community involvement'."

Outreach initiatives are already under way:

• Mayo's CTSA is the first to establish a Mobile Clinical Research Unit (CRU). Traditionally these clinical research units are based inside hospitals and other clinical settings, and patients have to travel to the unit. This may not be possible for acutely ill patients in the ICU, or for surgical patients.. Mayo now has a dedicated CRU (its third) that can travel throughout the hospitals to conduct research activities at the bedside of acutely ill patients or even conduct research at off-site locations. Most recently the Mobile CRU went to Winona State University (at the eastern border of Minnesota) to enroll participants in control groups of clinical trials. The mobility offers the potential of conducting clinical research at various remote sites, reaching populations that are unwilling or unable to travel to downtown Rochester.
• Discussions are underway with Mayo colleagues and leaders at all campuses and the MHS about how the CTSA can facilitate clinical research throughout Mayo. For example, in partnership with the MHS Research Committee, chaired by MHS physician Dr. Thomas Grau, planning is underway for a practice-based research network based in MHS that will concentrate on new methods to improve patient care throughout the region.
• Interactions with minority population groups have begun to increase diversity in clinical research
• August 2, 2007 - Rochester's mayor joins Mayo Clinic's CEO and CTSA leaders in a mid-day gathering celebrating the community's involvement in Mayo medical research. That evening, research volunteers are honored at a special reception.

The success of Mayo's CTSA will be marked not simply by improved movement of discoveries to a broader and diverse group of patients; the CTSA also will contribute to Mayo Clinic's ambitious goal of transforming health care.

"What we're looking at is systems science," says Robert Rizza, M.D., director of Mayo's CTSA. "From finding the mechanism of action of a specific potential drug, to seeing that treatment approved and made available as part of standard medical practice - that's what we're talking about -- systems health care delivery." Dr. Rizza says that model itself is mobile and has worldwide potential.

"If we can do this here, from Arizona to Florida to Minnesota and across the Midwest, we can do it anywhere."