The proposed project would entail a one-year planning program for the Virginia Ambulatory Care Outcomes Research Network (ACORN), a practice-based research network designed to collect the prospective data as a platform for observational studies and controlled trials to improve the quality of primary care. The planning would include four Areas of Focus: (a) data management; (b) minority and underserved populations; (c) translation of research into practice; and (d) predictable network funding. Data management planning would seek to improve methods for evaluating practices' disparate information systems, including differences in design and coding systems and their use of electronic medical records; to expand to new sources and streamline the process by which patient data are collected; to better safeguard privacy in data transfer; and to simplify procedures for obtaining instructional review board approval for protocol revisions. Planning around minority and underserved populations will focus on patient recruitment from a sampling perspective to ensure adequate representation of such patients, and/or the practices that serve them, and statistical adjustment and oversampling to account for disparities. Plans for translating research into practice will address an ongoing trial of a reminder system to improve smoking cessation counseling, Web-based feedback to practices of performance data, and the use of the ACORN Web site to direct practices to relevant evidence on topics for which performance is reported. Planning for predictable network funding will include discussions with the major health systems with which ACORN practices are affiliated, to explore potential long- term funding, and the development of five-year business plan.
