With more than 420,000 participants, the Department of Veterans Affairs’ Million Veteran Program is already one of the world’s largest medical databases linking genetic, clinical, lifestyle and military-exposure information.
Part of the Obama administration’s Precision Medicine Initiative, the program operates at more than 50 VA medical centers nationwide enrolling volunteers with the goal of better understanding how genes affect health and illness. By collecting data from at least a million veterans and making it available for use in approved studies, researchers hope to gain insights into post-traumatic stress disorder, schizophrenia, bipolar disorder, substance abuse, as well as heart and kidney disease.
Veterans participating in the program donate blood, from which DNA is extracted, and fill out surveys about their health, health-related behaviors and military experiences. In addition, volunteers consent to allowing researchers to access information in their VA electronic health record.
According to officials, VA’s EHR system provides a “richness of clinical data” that goes back to the 1990s. For research purposes, the information is de-identified with no names, birthdates or Social Security numbers shared.
“You need very large numbers to be able to answer the genomic questions,” says VA Chief Research and Development Officer Timothy O’Leary, M.D., who acknowledges that it has been difficult to recruit participants for the Million Veteran Program. “There are challenges. We’re asking roughly one out of six veterans who use the system to be willing to enroll. We’re enrolling mainly at major medical centers and yet many veterans are not seen at major medical centers but at out-patient clinics throughout the country, or smaller facilities, where we haven’t yet opened up an enrollment site.”
To augment its recruitment efforts currently conducted at VA medical centers, Genomic Medicine Program Manager Suma Muralidhar says the department is “developing a web-based enrollment infrastructure to do online surveys and consenting” with the hope of reaching one million veteran volunteers sooner than the five years currently expected to reach that goal.
O’Leary adds that the VA is also planning to begin to enroll active duty service members in the Million Veteran Program before they actually become veterans. “We’re doing a pilot to bring the DOD data into our Veterans Informatics Computing Infrastructure that will help us to learn to integrate the two data systems,” adds Muralidhar.
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