Leveraging Electronic Health Information to Advance Precision Medicine (LEAP)

LEAP experts from several VA medical centers and academic institutions harness “Big” electronic health and other national data sources to provide real-world evidence about pressing health issues. LEAP uses novel methods on the Veterans Health Administration’s electronic health data, the longest-running and largest U.S. electronic health records system, to inform population health outcomes, individual precision health, healthcare system management, and quality in clinical practice.

LEAP is a national data initiative and a multi-site collaboration comprised of data scientists, biostatisticians, epidemiologists, informaticians, and clinical leadership partners. The VA’s extensive health information archive offers a rich opportunity to develop Precision Medicine–based strategies that can be implemented in pragmatic and attainable ways. LEAP advances national precision medicine initiatives, which leverages large-scale information to customize medical treatments based on a patient’s genetic history, environment, and lifestyle. LEAP utilizes existing large data sources to augment and support the strategic planning, conduct, generalizability, and impact of multi-site randomized clinical trials. Recent work has included a focus on research related to glycemic dysregulation, cardiometabolic conditions, cancers, and COVID-19.

Objectives of LEAP

• Establishing a quality real-world evidence (RWE) base about health conditions, populations, interventions, and outcomes using VA EHR.
• Augment and support Randomized Clinical Trials (RCTs) to improve individual and population health.

Ongoing Observational Real-World Evidence Exemplars

• Pre-diabetes detection and management
• Longitudinal progression of glycemic dysregulation
• Metformin prescribing patterns in pre-diabetes
• SARS-CoV-2 infection and outcomes in patients with glycemic dysregulation

Key Personnel

Jennifer Lee, MD, PhD & Mei-Chiung Shih, PhD (Co-Chairs, VA Palo Alto Health Care System)

Natalie Fullenkamp, MA (LEAP National Coordinator, VA Palo Alto Health Care System)

Mihaela Aslan, PhD (LEAP Coordinating Center Director (Acting), West Haven CSP Epidemiology Center, VA Connecticut Healthcare System)

Julie Lynch, PhD & Kyung Lee, PhD (Co-Investigators, VA Salt Lake City)

Patricia Crutchfield (Program Manager, VA Connecticut Healthcare System)

Sponsorship

This project is sponsored by the Department of Veterans Affairs Cooperative Studies Program.

Contact

Contact the National Coordinator, Natalie Fullenkamp, for more information.