From Patient to Participant:
The Evolving Role of
Consumers in Research
Natasha F. Bonhomme
Genetic Alliance Network
• Disease Advocacy Orgs
• General Support Orgs
• Universities
• Government
• Companies
• Labs
• Hospitals
• Health Centers
• Professional Societies
• Think tanks/policy
groups
Network of Resources
Maturing Patient Advocacy
• 1950s-1960s – Medical Models
‣ Voluntary Health Agencies
• 1970s – Nascent Patient Movement – Missing Services
‣ Self-organized Disease Specific Organizations
• 1980s – Maturing Patient Movement – IS & IT Technology
‣ New Alliances and New Strategies Emerge
• 1990s – Powerful Momentum “Patient Power” – Websites & Email
‣ Institutionalized Advocacy Coalitions
‣ Patient Organized Networked Research Organizations
‣ Effecting Broad Change of Public Policy
• 2000s – Successful Models “ResearchAdvocacy” – BioBanks
‣ Active Engagement in the Research Enterprise
‣ Breaking Conventional Boundaries of the Medical Model
‣ Demand for Quality, Services, Choice, & Personalized Delivery
‣ Patient Rights Public Policy – Changing the Status-Quo
• 2010s – Networks in the Commons – Translation & Delivery
What Do Groups Do in Research?
• Set research initiatives
• Raise funds for investigators
– Becoming investigators
• Sponsor projects
– Academic and Biotech
• IRB
• Collect data (registries and biobanks)
• Recruit
• Communicate out messages
• Disseminate findings
What do personal data collection tools look like in 2015?
iPhone App
iPhone App
Wireless Scale
Twitter
Facebook
What does it mean?
• Self aggregation
• Label =/= experience
• Data and experience even more intertwine
• Can’t have the specimen without the other
“Stuff”
Educate  Communicate
Because people seek out what they want
to know…
In other industries:
• Co-design
• Consumer testing
• Consumer preference
analysis
• Responsiveness
• Self-reported clinical data
“Enables individuals to set their own
sharing, privacy and data access
preferences, in a granular and dynamic
manner.”
• Community-based guides
• “White label” version
(“Open Consent”)
(similarto Portable LegalConsent)
(similarto HIPAA/CommonRule)
(“Dynamic Consent” model)
(Effectively an Opt-out)
Platformfor EngagingEveryoneResponsibly
(PEER)
...Adjustdynamicandgranularsettingsasvalues
and prioritieschangeover time
PEER Deployed
• PCORnet PPRN
– 11 Disease Advocacy Organizations
• Robert Wood Johnson Foundation Project
– 30 Communities/collectives (employers, churches, gyms)
• Campaigns
– Free the Data: https://www.free-the-data.org
– Patient Focused Drug Development (Sickle cell, IBD, IPF)
– Patient Preference Study (CDHR – Obesity)
• Advocacy Initiated
– United Mitochondrial Disease Foundation
– Pancreatic Cancer Action Network
– …
• General Public
– Registries for All: https://www.reg4all.org
– TrialsFinder: https://www.trialsfinder.org
Mosaic: crowd-sourced research
• Bullet
14
Advocacy owned and managed data
repositoryand samples
Clinical Information Medical Records
DNA/RNA Self-reported Data
Cell Lines Tissue / Organs
30,000 samples + 20,000 clinicalrecords
BioBank.org
Components of a network-based Learning
Health System*
1. Focus on outcome
2. Build community
3. Effective use of technology
4. Learning system
– System science, QI, qualitative
research, clinical research
*Collective creativity (Swarm Creativity; Peter Gloor)
Lead User innovation (Democratizing Innovation; Eric von Hippel)
New economic models (The Wealth of Networks; Yochai Benkler)
Actor-oriented organizational architecture (Configuring value for competitive advantage;
Charles Stabell and Oystein Fjelstad
Courtesy of Peter Margolis, ImproveCareNow PPRN, PCORnet
Biggest Ah-ha(s)!
• Not research “subjects” and are often not
just “patients”
• This is about relationships, not
transactions
• Relationships are messy
• This will be challengingAND fun
It’s about trust
(more so than privacy)
But privacy is a surrogate marker for trust
…it reflects a level of care and if these are not present, people
feel it …which undermines trust
Resources
• Community Campus Partnership for Health:
https://ccph.memberclicks.net/
• PCORI Patient and Family Engagement Rubric:
http://www.pcori.org/sites/default/files/PCORI-
Patient-and-Family-Engagement-Rubric.pdf
• The Center for Information and Study on Clinical
Research Participation: https://www.ciscrp.org/
• Research On Medical Practices (ROMP):
https://rompethics.iths.org/
• Clinical Trials Transformation Inititiative:
http://www.ctti-clinicaltrials.org/
• Community Engagement Studio:
https://www.aamc.org/initiatives/rocc/363090/vand
erbiltuniversityprojectdescription.html
Thanks!
20
Natasha F, Bonhomme, Sharon F. Terry, MA
nbonhomme@geneticalliance.org
peerplatform.org
geneticalliance.org/PEER
mosaic.ucsf.edu
@geneticalliance
• How do we create a culture of openness and
sharing?
• Where can we take friction out of our systems (or
lack thereof)?
• How do we animate the American public to get in
the game?
• How do we know what is working and what is
not?
• How to get complete data on individuals and
respect their desire to participate?
• How to get oversight that is flexible enough to
deal with these sorts of
engagements/development?

Natasha Bonhomme, "From Patient to Participant: The Evolving Role of Consumers in Biospecimen Research"

  • 1.
    From Patient toParticipant: The Evolving Role of Consumers in Research Natasha F. Bonhomme
  • 2.
    Genetic Alliance Network •Disease Advocacy Orgs • General Support Orgs • Universities • Government • Companies • Labs • Hospitals • Health Centers • Professional Societies • Think tanks/policy groups
  • 3.
  • 4.
    Maturing Patient Advocacy •1950s-1960s – Medical Models ‣ Voluntary Health Agencies • 1970s – Nascent Patient Movement – Missing Services ‣ Self-organized Disease Specific Organizations • 1980s – Maturing Patient Movement – IS & IT Technology ‣ New Alliances and New Strategies Emerge • 1990s – Powerful Momentum “Patient Power” – Websites & Email ‣ Institutionalized Advocacy Coalitions ‣ Patient Organized Networked Research Organizations ‣ Effecting Broad Change of Public Policy • 2000s – Successful Models “ResearchAdvocacy” – BioBanks ‣ Active Engagement in the Research Enterprise ‣ Breaking Conventional Boundaries of the Medical Model ‣ Demand for Quality, Services, Choice, & Personalized Delivery ‣ Patient Rights Public Policy – Changing the Status-Quo • 2010s – Networks in the Commons – Translation & Delivery
  • 5.
    What Do GroupsDo in Research? • Set research initiatives • Raise funds for investigators – Becoming investigators • Sponsor projects – Academic and Biotech • IRB • Collect data (registries and biobanks) • Recruit • Communicate out messages • Disseminate findings
  • 6.
    What do personaldata collection tools look like in 2015? iPhone App iPhone App Wireless Scale Twitter Facebook
  • 7.
    What does itmean? • Self aggregation • Label =/= experience • Data and experience even more intertwine • Can’t have the specimen without the other “Stuff”
  • 8.
    Educate  Communicate Becausepeople seek out what they want to know…
  • 9.
    In other industries: •Co-design • Consumer testing • Consumer preference analysis • Responsiveness
  • 11.
    • Self-reported clinicaldata “Enables individuals to set their own sharing, privacy and data access preferences, in a granular and dynamic manner.” • Community-based guides • “White label” version
  • 12.
    (“Open Consent”) (similarto PortableLegalConsent) (similarto HIPAA/CommonRule) (“Dynamic Consent” model) (Effectively an Opt-out) Platformfor EngagingEveryoneResponsibly (PEER) ...Adjustdynamicandgranularsettingsasvalues and prioritieschangeover time
  • 13.
    PEER Deployed • PCORnetPPRN – 11 Disease Advocacy Organizations • Robert Wood Johnson Foundation Project – 30 Communities/collectives (employers, churches, gyms) • Campaigns – Free the Data: https://www.free-the-data.org – Patient Focused Drug Development (Sickle cell, IBD, IPF) – Patient Preference Study (CDHR – Obesity) • Advocacy Initiated – United Mitochondrial Disease Foundation – Pancreatic Cancer Action Network – … • General Public – Registries for All: https://www.reg4all.org – TrialsFinder: https://www.trialsfinder.org
  • 14.
  • 15.
    Advocacy owned andmanaged data repositoryand samples Clinical Information Medical Records DNA/RNA Self-reported Data Cell Lines Tissue / Organs 30,000 samples + 20,000 clinicalrecords BioBank.org
  • 16.
    Components of anetwork-based Learning Health System* 1. Focus on outcome 2. Build community 3. Effective use of technology 4. Learning system – System science, QI, qualitative research, clinical research *Collective creativity (Swarm Creativity; Peter Gloor) Lead User innovation (Democratizing Innovation; Eric von Hippel) New economic models (The Wealth of Networks; Yochai Benkler) Actor-oriented organizational architecture (Configuring value for competitive advantage; Charles Stabell and Oystein Fjelstad Courtesy of Peter Margolis, ImproveCareNow PPRN, PCORnet
  • 17.
    Biggest Ah-ha(s)! • Notresearch “subjects” and are often not just “patients” • This is about relationships, not transactions • Relationships are messy • This will be challengingAND fun
  • 18.
    It’s about trust (moreso than privacy) But privacy is a surrogate marker for trust …it reflects a level of care and if these are not present, people feel it …which undermines trust
  • 19.
    Resources • Community CampusPartnership for Health: https://ccph.memberclicks.net/ • PCORI Patient and Family Engagement Rubric: http://www.pcori.org/sites/default/files/PCORI- Patient-and-Family-Engagement-Rubric.pdf • The Center for Information and Study on Clinical Research Participation: https://www.ciscrp.org/ • Research On Medical Practices (ROMP): https://rompethics.iths.org/ • Clinical Trials Transformation Inititiative: http://www.ctti-clinicaltrials.org/ • Community Engagement Studio: https://www.aamc.org/initiatives/rocc/363090/vand erbiltuniversityprojectdescription.html
  • 20.
    Thanks! 20 Natasha F, Bonhomme,Sharon F. Terry, MA nbonhomme@geneticalliance.org peerplatform.org geneticalliance.org/PEER mosaic.ucsf.edu @geneticalliance
  • 21.
    • How dowe create a culture of openness and sharing? • Where can we take friction out of our systems (or lack thereof)? • How do we animate the American public to get in the game? • How do we know what is working and what is not? • How to get complete data on individuals and respect their desire to participate? • How to get oversight that is flexible enough to deal with these sorts of engagements/development?