Why Breakthrough Research Sits On The Shelf, And What To Do About It

By Sonia Hassan Duggan, M.D.

In the United States, it has typically taken 10 to 15 years for breakthrough research to be adopted in real-world clinical settings: a decade or more between proving something saves lives and actually using it to save lives.

That’s not acceptable. 

I've lived on both sides of this divide, as a researcher who's published breakthrough findings and as a clinician who's watched those same findings collect dust for years. When we built the SOS Maternity Network in Michigan, bringing together 20 healthcare systems, universities, and community partners to implement evidence-based protocols across the state, we didn't just want to move faster. We wanted to understand what keeps good research from reaching patients and how to dismantle those barriers permanently.

The Real Barriers

The obstacles aren't dramatic, they're mundane, varied, and deeply embedded in how healthcare operates.

Start with the most basic: knowledge. Providers don't know the treatment exists or what it accomplishes. Administrators don't understand the evidence. Patients have never heard it's an option. Insurance companies haven't updated their coverage policies. You can have the best research in the world, but if nobody knows about it, it doesn't matter.

Then there's what I call organizational inertia — the institutional molasses that slows everything down. I've watched administrators take years to evaluate something that should take months. One of Michigan's largest health systems took nearly two years to join our network, even though their providers desperately wanted to participate. The administrative barriers seemed insurmountable until they finally got approved just a month ago.

And then there are the access barriers people often overlook. I'll never forget a phone call from a patient in the hospital, at risk for preterm birth, calling our team for help getting medication. Not because the medication wasn't available — it was. Not because her insurance wouldn't cover it — they would. She was calling because even though she was inside a hospital, the system itself couldn't figure out how to get her the treatment.

Transportation is also huge. In Michigan, Medicaid pays for transportation for pregnant women to prenatal appointments, but the companies often don't show up, arrive late, or can't accommodate patients with disabilities. We've worked with women facing homelessness, women who needed help paying their electric bill, women who couldn't get to a clinic because the nearest hospital was hours away.

What Has To Change

Understanding these barriers is one thing. Building around them is another.

When you pilot research, you're working in a controlled environment with people who know how to collect data and implement protocols meticulously. When you build for scale in the real world, everything has to be different. Simpler. More sustainable. More human.

Most importantly, you need champions, providers and administrators who believe in what you're doing as much as you do. I learned early on: Don't waste time on people who don't want to do it. Find the ones who do.

When we launched the SOS Maternity Network, whose aim is to implement statewide best practices to prevent preterm birth and maternal mortality, we focused our resources on the health systems and providers who were ready to move. We didn't wait for the stragglers, but we didn't kick them out either because their patients also deserve this care. The result? We now have 20 partners moving strong, and the stragglers are finally coming around.

The Non-Negotiables

After building this network and watching what works and what doesn't, I can tell you exactly what it takes to replicate this model in another domain, whether that's cardiology, diabetes, or ophthalmology.

First, find your champions and set your ego aside. Let them own it at their sites. Let them take credit. Your goal is changing practice, not building a monument to yourself.

Second, understand the financial reality. These are health systems, not charities. Whatever you're proposing needs to be revenue-neutral or generate revenue. Have an ROI ready. We were fortunate that data existed showing our interventions could save money long-term.

Third, build trust through structure. We made Wayne State University the coordinating center, but we stayed neutral; we're not competing with our partners for patients. That trust came from years of prior relationships, and you can't manufacture that overnight.

Fourth, remember you're solving for patients. When you hit resistance, ask yourself: are the patients at this site getting what they need? If not, find a way to change that. Sometimes that means hiring people to help a struggling site. Sometimes it means working around administrative barriers. But never lose sight of why you're doing this.

A Fundamentally Different Operating Model

Here's the critical insight: we didn't just move faster through the traditional research-to-practice pipeline, we built a completely different model.

Traditional approaches assume a linear path: study to publication to guidelines to adoption. We threw that out and, instead, built an implementation infrastructure with coordinated funding, standardized protocols, patient navigation, transportation support, provider training, data systems — all at once, across multiple organizations simultaneously.

Our state government was also critical. Michigan cares deeply about maternal health, and we had bipartisan support. That's rare and we were lucky. The funding let us move fast. But the governance structure, letting each site own their implementation while coordinating centrally, made it sustainable.

For investors or health systems considering similar efforts, here's what you need to understand: This only works if you're solving a problem where the stakes are high enough that everyone wants it to work. Patients’ health need to be on the line.

I think about where this approach could work next, and the opportunities are everywhere: because the research exists, and the evidence exists. What's missing is the infrastructure, the champions, and the will to implement what we already know works.

About The Author:

Dr. Sonia S. Hassan, M.D., MBA is Associate Vice-President at Wayne State University (WSU), a Professor of Obstetrics and Gynecology and Maternal-Fetal Medicine, and the Founding Director of the Office of Women’s Health at WSU. She leads the SOS Maternity Network in Michigan, a statewide implementation science program to reduce preeclampsia and preterm birth, the leading causes of maternal and infant mortality.