The UCSF/Stanford Collaborative Research Network (CRN) has a long and rich history of conducting high quality practice-based research. However, the network has been limited by an inability to implement or standardize electronic data acquisition in our diverse practices, and by an inability to address the health care needs of underserved and underrepresented minorities. The recent addition of the Community Health Network (CHN) practices to the CRN provides the opportunity to overcome both of these limitations, as well as providing a cadre of collaborating researchers with expertise in health services research and TRIP. The CHN consists of nine community clinics and three clinics located at San Francisco General Hospital. All 12 clinics use a single electronic medical record system in providing care to vulnerable patients. This application requests funds for two studies to be conducted within the CHN. In the homeless study, we will develop a series of validated questions to collect standardized data on patients' housing status for incorporation within the CHN's electronic medical record, providing prevalence data on homelessness and housing instability. Subsequently, the questions will be used in other CRN practices to address the prevalence of rural homelessness, and to develop a cohort of homeless patients for health interventions and future research. In the IDEALL Study, we will develop and test two forms of disease management to overcome communication barriers and promote self-management in diabetic patients with low language and literacy levels. Patients will be randomized to three groups: 1) automated telephone disease management; (2) group medical visits; or (3) usual care. AHRQ funds will be used to examine the feasibility of rigorously evaluating this quality improvement initiative among diverse, underserved patients, to standardize the interventions, to assess the quality of existing evaluation methods, to enhance these methods in targeted areas, and to estimate the size of the effects across subgroups of patients. As a result of both studies, the CRN will have accomplished four aims: 1) use of an electronic data acquisition technology to systematically collect data for a CRN project and for patient care purposes; (2) completion of a TRIP project by critically evaluating disease management strategies using a RCT design; (3) conducting research within the CHN on vulnerable patients; and (4) collaborating with new investigators to broaden our expertise.
| Handley, Margaret A; Hammer, Hali; Schillinger, Dean (2006) Navigating the terrain between research and practice: a Collaborative Research Network (CRN) case study in diabetes research. J Am Board Fam Med 19:85-92 |
