,i #aafth ,,congress #b;d ,session ,h4 ,r4 #fjib ,,in ,,the ,,house ,,of ,,representatives ,march #e1 #bjbj,mr4 ,dunn 7for himself and ,mr4 ,cunningham7 introduced the following bill2 which was referred to the ,committee on ,veterans' ,affairs ,a ,,bill ,to direct the ,secretary of ,veterans ,affairs to establish a national clinical pathway for prostate cancer1 access to life-saving extending precision clinical trials and research1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,veteran's ,prostate ,cancer ,treatment and ,research ,act4 #b4 ,findings ,congress makes the following findings3 7#a7 ,prostate cancer is the number one cancer diagnosed in the ,veterans ,health ,administration4 7#b7 ,a #aiif report published by the ,national ,academy of ,sciences1 ,engineering1 and ,medicine established a link between prostate cancer and exposure to herbicides1 such as ,agent ,orange4 7#c7 ,it is essential to acknowledge that due to these circumstances1 certain veterans are made aware that they are high-risk individuals when it comes to the potential to develop prostate cancer4 7#d7 ,in being designated as high risk1 it is essential that veterans are proactive in seeking earlier preventative clinical services for the early detection and successful treatment of prostate cancer1 whether that be through the ,veterans ,health ,administration or through a community provider4 7#e7 ,clinical preventative services and initial detection are some of the most important components in the early detection of prostate cancer for veterans at high risk of prostate cancer4 7#f7 ,for veterans with prostate cancer1 including prostate cancer that has metastasized1 precision oncology1 including biomarker-driven clinical trials and innovations underway through the ,prostate ,cancer ,foundation and ,department of ,veterans ,affairs partnership1 represents one of the most promising areas of interventions1 treatments1 and cures for such veterans and their families4 #c4 ,department of ,veterans ,affairs treatment and research of prostate cancer 7a7 ,establishment of clinical pathway 7#a7 ,in general ,not later than #cfe days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall establish in the ,national ,surgery ,office of the ,department of ,veterans ,affairs a national clinical pathway for all stages of prostate cancer1 from early detection to end-of-life care including recommendations regarding the use of transformative innovations1 research1 and uniform clinical data4 7#b7 ,elements ,the national clinical pathway established under this subsection shall include the following elements3 7,a7 ,a multi-disciplinary plan for the early detection1 diagnosis1 and treatment of prostate cancer that includes1 as appropriate1 both ,department medical facilities and community-based partners and providers and research centers specializing in prostate cancer1 especially such centers that have entered into partnerships with the ,department4 7,b7 ,a suggested1 but not mandatory1 protocol for screening1 diagnosis1 and treatment or care for subpopulations with evidence-based risk factors 7including race1 ethnicity1 socioeconomic status1 geographic location1 exposure risks1 and genetic risks1 including family history74 7,c7 ,a suggested treatment protocol timeframe for each point of care based on severity and stage of cancer4 7#c7 ,public comment period ,upon the establishment of a proposed clinical pathway as required under this subsection1 the ,secretary shall publish the proposed clinical pathway in the ,federal ,register and provide for a #de-;day period for public comments4 ,the ,secretary-- 7,a7 may make any such public comments publicly available2 and 7,b7 make changes to the proposed clinical pathway in response to any such comments received using the same process and criteria used to establish the proposed clinical pathway4 7#d7 ,collaboration and coordination ,in establishing the clinical pathway required under this section1 the ,secretary shall-- 7,a7 provide for consideration of other clinical pathways and research findings of other departments and agencies1 including guidelines that are widely recognized and guidelines that are used as the standard for clinical policy in oncology care1 such as ,national ,comprehensive ,cancer ,network guidelines2 and 7,b7 collaborate and coordinate with-- 7i7 the ,national ,institutes of ,health2 7ii7 the ,national ,cancer ,institute2 7iii7 the ,national ,institute on ,minority ,health and ,health ,disparities2 7iv7 other ,institutes and ,centers as the ,secretary determines necessary2 7v7 the ,centers for ,disease ,control and ,prevention2 7vi7 the ,department of ,defense2 7vii7 the ,centers for ,medicare and ,medicaid ,services2 7viii7 the ,patient-,centered ,outcomes ,research ,institute2 and 7ix7 the ,food and ,drug ,administration4 7#e7 ,publication ,the ,secretary shall-- 7,a7 publish the clinical pathway established under this subsection on a publicly available ,department website2 and 7,b7 regularly update the clinical pathway as needed by review of the medical literature and available evidence-based guidelines at least annually1 in accordance with the criteria under paragraph 7#b74 7b7 ,development of national cancer of the prostate clinical care implementation program 7#a7 ,establishment ,not later than #ij days after the date of the enactment of this ,act1 the ,secretary shall submit to ,congress a plan to establish a comprehensive prostate cancer program4 7#b7 ,program requirements ,the comprehensive prostate cancer program shall-- 7,a7 be multidisciplinary and include the authority to work across clinical care lines1 specialties1 and the organizational divisions of the ,veterans ,health ,administration2 7,b7 receive direct oversight from the ,deputy ,undersecretary for ,health of the ,department of ,veterans ,affairs2 7,c7 include a yearly program implementation evaluation to facilitate replication for other disease states or in other healthcare institutions2 7,d7 be metric driven and include the development of quarterly reports on the quality of prostate cancer care1 which shall be provided to the leadership of the ,department1 medical centers1 and providers and made publicly available in an electronic form2 7,e7 made available as national decision support tools in the electronic medical record2 7,f7 include an education plan for patients and providers2 and 7,g7 be funded appropriately to accomplish the objectives of this ,act4 7#c7 ,program implementation evaluation ,the ,secretary shall establish a program evaluation tool as an integral component to learn best practices of multidisciplinary disease-based implementation and to inform the ,department and ,congress regarding further use of the disease specific model of care delivery4 7#d7 ,prostate cancer research ,the ,secretary shall submit to ,congress a plan that provides for continual funding through the ,office of ,research and ,development of the ,department of ,veterans ,affairs for supporting prostate cancer research designed to position the ,department as a national resource for quality reporting metrics1 practice-based evidence1 comparative effectiveness1 precision oncology1 and clinical trials in prostate cancer4 7#e7 ,prostate cancer real time registry program ,the ,secretary1 in collaboration with data stewards of the ,department of ,veterans ,affairs1 scientists1 and the heads of other ,departments1 agencies1 and non-governmental organizations1 such as foundations and non-profit organizations focused on prostate cancer research and care1 shall establish a real-time1 actionable1 national prostate cancer registry4 ,such registry shall be designed-- 7,a7 to establish a systematic and standardized database that enables intra-agency collaboration by which to track veteran patient progress1 enable population management programs1 facilitate best outcomes1 and encourage future research and further development of clinical pathways1 including patient access to precision resources and treatments and access to life-extending precision clinical trials2 7,b7 to employ novel methods of structuring data1 including natural language processing1 artificial intelligence1 structured data clinical notes1 patient reported outcome instruments1 and other tools1 to ensure that all clinically meaningful data is included2 and 7,c7 to be accessible to-- 7i7 clinicians treating veterans diagnosed with prostate cancer and being treated for prostate cancer in conjunction with ,department medical facilities2 and 7ii7 researchers4 7c7 ,clinical pathway defined ,in this section1 the term clinical pathway means a health care management tool designed around research and evidence-backed practices that provides direction for the clinical care and treatment of a specific episode of a condition or ailment4