Table 1.
Identified problems and suggested solutions.
| TM HEALTHCARE | IDENTIFIED PROBLEMS | |
| 1 | Lack of hospital-level quality assessment and feedback makes it impossible to define where the best quality treatment is available. | |
| 2 | Although we know that the multidisciplinary approach is essential to ensure good quality and effective patient care, it is still not applied in many cases. | |
| 3 | Only a narrow area of patient care is involved in scientific activities or clinical research. | |
| 4 | Funding is not sufficient for covering the costs of scientific activities (staffing, consumables, facility development) in many healthcare centers. | |
| SUGGESTED SOLUTIONS | ||
| 1 | The widespread adoption of science in patient-care is needed for improving the quality and cost-effectiveness of healthcare. | |
| 2 | Multidisciplinary teams should be formed everywhere to increase safety and achieve efficiency and added value in patient care. | |
| 3 | Continuous data recording and monitoring are needed for hospital-level assessment of quality and effectiveness to define the necessary changes in the structure of healthcare (treatment centers) or funding. | |
| 4 | Biological sample collection and cooperation of healthcare centers and research centers are necessary to promote scientific activity. | |
| 5 | Tertiary centers may be ideal locations to start implementing the TM Healthcare system | |
| 6 | All healthcare providers and other disciplines should agree on evidence (science)-based patient management and work together in a multidisciplinary approach. | |
| 7 | General patient care should be financed by national and private health insurance. Activities intended to achieve new scientific results should be funded by institutional, national and international grants and funds. Current budgets should be elevated as well. | |
| TM SCIENCE | IDENTIFIED PROBLEMS | |
| 1 | Many discoveries do not reach patient care. | |
| 2 | Clinically relevant questions are not addressed through the arsenal of basic research methodologies. | |
| 3 | The regional differences in funding and opportunities. (In Western Europe, funding of basic science is inadequate in relation to the scientific opportunities that exist. Whereas clinical science is less developed in Eastern Europe). | |
| SUGGESTED SOLUTIONS | ||
| 1 | Close cooperation of healthcare centers and research centers are necessary to promote scientific activity. | |
| 2 | All publications describing new, previously unknown results should be considered as original publications, regardless of whether these analyses are based on newly generated or already existing data | |
| 3 | Funding has to be tailored to research needs. A special emphasis should be put on raising budgets for science in Eastern and Central European countries. | |
| TM KNOWLEDGE | IDENTIFIED PROBLEMS | |
| 1 | Readers, professionals cannot cope with the huge number of publications, knowledge released. | |
| 2 | Many review articles are inaccurate or biased. | |
| 3 | There is a huge gap between the guideline, knowledge and its implementation. | |
| 4 | Summary publication and standardization is not rewarded in the academic carrier, neither in impact factors. | |
| SUGGESTED SOLUTIONS | ||
| 1 | A proper classification of summary publication is needed, our paper recommends one. | |
| 2 | Quality assessment of summary publications is extremely important. Several measure are recommended in the peer review process (consultative peer review, technical innovations, etc.) | |
| 3 | A good critical review should be rewarded with impact factors as well. | |
| 4 | Summary publication, standardization is an important part of the TM cycle, the field should be rewarded in academic progress and in publication impact. | |
| TM COMMUNICATION | IDENTIFIED PROBLEMS | |
| 1 | Often there is a lack of communication between the participants of healthcare (e.g., scientists and insurance policy-makers or scientists and patients). | |
| 2 | Guidelines are often not translated into the local language and not incorporated into insurance policies in many countries, which is an obstacle for implementation. | |
| 3 | Patient organizations and advocacy is underdeveloped in many countries. | |
| 4 | Medical students and nurses has no access to clinical research methodology knowledge as the curricula do not cover them. | |
| SUGGESTED SOLUTIONS | ||
| 1 | Bilateral/multilateral communication need to be developed between participants of healthcare. Feedback has a crucial importance. | |
| 2 | Guidelines need to be translated and incorporated into insurance policies, knowledge publication should be communicated to healthcare professionals in order to be implemented. | |
| 3 | Patient organizations have a critical role as channels for patient educations and advocacy, in most countries patient organizations have to be developed. | |
| 4 | All research methodologies (including clinical research) should be included in the curricula of medical universities and education of nurses. | |
| 5 | Policymakers need guidance to create a balance between ensuring patient access to innovation and maintaining financial sustainability | |
| TM INTERDISCIPLINARY | IDENTIFIED PROBLEMS | |
| 1 | Lack of time, resources for organizing clinical research among clinicians. | |
| 2 | Lack of clinical research methodology knowledge and special knowledge in the fields of biostatistics, IT, communication to policymakers, etc. among clinicians and researchers. | |
| 3 | A dedicated interdisciplinary team for supporting the TM cycle elements is missing from the academic organization in many countries, especially in Central and Eastern Europe. | |
| SUGGESTED SOLUTIONS | ||
| 1 | Providing funds for and establishing interdisciplinary teams in the academic environment supporting TM. | |
| 2 | The interdisciplinary team should cover the fields of biostatistics, IT, data management and patient inclusion coordination, ethical submissions, communication, patient club coordination, implementation coordination, other supporting roles like event coordination, management, administration and training in regulatory science, etc. | |
| TM ACADEMY | IDENTIFIED PROBLEMS | |
| 1 | Universities and academic institutes do not adapt fast enough to the changing environment, concerning the inclusion of new methodologies in their curricula. | |
| 2 | Clinical research nursing is not included in nursing curricula, although they play a critical role in play a role in the maintenance of participant safety, the integrity of protocol implementation and the accuracy of data collection. | |
| 3 | Because of the lack of knowledge in clinical research methodologies among supervisors and interdisciplinary support units, clinical research is not very popular among students. | |
| SUGGESTED SOLUTIONS | ||
| 1 | Medical schools are strongly advised to plan compulsory or at least elective courses for medical students to teach them the basics of TM, scientific methodologies and scientific knowledge supplemented by techniques of effective medical information translation for the different members of the community. | |
| 2 | Nursing curricula should include clinical research nursing. | |
| 3 | New form of education is needed, a ‘learning by doing’ model, which may involve practicing physicians beside student and those seeking PhD. | |