This application is for both category-I and category-II funding. The long-term aim and objective of this PBRN infrastructure application are to develop a self-sustaining network of committed physicians dedicated to practice-based research in internal medicine. Our category-I application focuses on increasing the QNet membership and developing a self-sustaining infrastructure by: (1) doubling the QNet membership through both national and regional chapter-level initiatives; (2) developing a QNet communications infrastructure with quarterly newsletters, a dedicated QNet website, and Internet discussion groups; (3) developing a QNet organizational structure with a clinical steering committee and by-laws; (4) developing the research capacity of QNet members through educational initiatives; (5) improving study design and reducing costs associated with practice-based research; and (6) becoming active in and collaborating with organizations that foster, support, and advance practice-based research. The category-II application is a type 2 diabetes quality improvement project modeled after QNet's current diabetes quality improvement project.
The specific aims of this project are to improve the design and methodology from the lessons learned from Hanover, expand the pilot nationally and evaluate the impact of the interventions on the quality of diabetes patient care, and the diabetes performance measures promulgated from the AMA, JCAHO, and NCQA. The study will be a randomized evaluation trial with two arms. One arm is a standard manual chart audit-feedback intervention where the physician selects 25 patients and gathers data about performance measures at baseline, six months, and 12 months. After each data gathering cycle, the physicians will receive a confidential performance report. The second arm is the """"""""intervention"""""""" arm. This group will use an electronic diabetes registry developed for data gathering and reporting. In addition, after baseline data gathering, these physicians will have access to an innovative new 13-chapter web-based physician's diabetes education program with management tools, """"""""how-to"""""""" sections, treatment algorithms, and self-assessment. Assessments of physician-level performance measures including blood pressure, HbA1C, lipid profiles, foot and opthalmic exams, and urinalysis will be done at six months and 12-months post educational intervention.
