Aim: To enhance the computerized information and communications infrastructure of our emerging primary care practice-based research network (PBRN). This is a Category I application. Background: The Kentucky Ambulatory Network (KAN) was established in the fall of 2000, using grant support from HRSA. Its missions are to advance knowledge and promote best practices in primary care, through the study of common health problems in appropriate settings. In so doing, KAN seeks to broadly represent primary care practices in Kentucky; most of which are small, independent, and widely dispersed in rural communities. To date, KAN has 102 community-based clinician members (74 percent family physicians) at 56 sites, plus 48 university-based faculty members. KAN has completed data collection on 3100 patient visits in its replication of the National Ambulatory Medical Care Survey. Three other funded studies will begin within the next 6 months. KAN is administered through the University of Kentucky, in cooperation with the University of Louisville and the Kentucky Academy of Family Physicians. Needs: KAN has no informatics infrastructure beyond a rudimentary website. More technologically sophisticated information/communication systems are needed in order for KAN to realize its potential beyond completing relatively simple studies that require very limited data collection at the point of care. Opportunities: KAN has identified experts in medical informatics who are anxious to work with us. Over 90 percent of our practitioners already use computerized billing and the Internet. We have funding for 50 palm-top computers, not yet in use. Local Area Health Education Centers (AHECs) wish to partner with KAN, at no extra cost, to promote the electronic medical library and decision support portions of a network-wide informatics infrastructure. Methods: We propose a planning , through which we will: 1) Complete an assessment of our members' current capabilities, needs, desires, and barriers related to the adoption and implementation of computerized information and communication technologies that would be useful for individual practitioners and for our PBRN. 2) Construct a realistic plan for building a network-ride computerized data and communications system, with evidence-adaptive decision support components. Evaluation: Non-native and summative evaluations of our assessments and plans will be completed, measuring success against a priori qualifications for: completeness of our assessments, valid planning processes that incorporate appropriate data and stakeholder inputs, and finally, production of a viable, realistic and detailed plan for a network-wide informatics infrastructure. CATEGORY I
