Our initial planning grant has supported expansion of the Research Association of Practicing Physicians (RAPP) and shown the feasibility of automated collection of patient data by intemet and computerized telephone interview. This competing continuation application builds on these activities, in response to both portions of RFA HS-01-004, by proposing a network-defining survey and a pilot test of electronic data collection methods. A network-defining survey is planned among pediatricians in the newly expanded network. All 171 members of the Rainbow Office-Based Clinical Research Network, a subsidiary of the University Hospital Health System with which RAPP is expanding, will be encouraged to collect physician-report data on 30 outpatient visits, using the 1999- 2000 National Ambulatory Medical Care (NAMCS) survey and NAMCS-like procedures, as decided upon at the October, 2001 AHRQ PBRN meeting. Based on prior studies, participation by 30% of physicians is anticipated. The NAMCS survey will be integrated with ongoing network characterization activities in the Rainbow Network. Data will be used to answer specific questions proposed by network clinicians, as well as being reported to the centralized AHRQ repository. In the second portion of the application, two new technologies for automated collection of patient report data will be evaluated in our sister PBRN, the NorthEast Ohio Network (NEON). NEON was the first PBRN to characterize its patient population using the NAMCS methodology. Now, 10 years later, 30 NEON family physicians have agreed to repeat this characterization of 30 consecutive outpatient visits using the 1999-2000 NAMCS survey. Each patient will also be asked to characterize the visit, using their choice of two technologies: a web- based version of the NAMCS or a computerized telephone interview of the NAMCS. Patient preference for these technologies will be compared for the entire sample and for patient subgroups, and the concordance of patient report and physician report of visit content will be assessed with the kappa statistic. In addition, specific network clinician questions about the concordance of physician and patient perception of reason for visit and visit diagnoses will be assessed. The proposed continuation project will use the infrastructure and experience of the RAPP network to 1) enhance and characterize a new network developed as part of the initial planning grant efforts, and 2) expand the impact of the AHRQ PBRN initiative through collaboration with an experienced affiliated network to assess new technologies designed to decrease the burden of data collection b bus network clinicians and practice staff.
