alliance of chicago community health services ehrs-enabled pbrn of safety net health centers fred...
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Alliance of Chicago Community Health
ServicesEHRS-enabled PBRN of safety net
health centers
Fred Rachman, MDErin Kaleba, MPH
Alliance Overview• HRSA-funded network of 4 independent,
federally qualified Health Centers located on the Near North Side of Chicago
• Target populations:– Latino, African American, Gay and Lesbian, and
Immigrant and Homeless
• Services encompass comprehensive Primary Care, Dental, Mental Health and Social Services, Health Education, and Research
Role of HIT“To utilize a fully-functioning EHR as a tool to improve the
quality and safety of health care delivered at the individual patient level and population level”
2004-2007 EQUIP Project (AHRQ-funded)• Enhanced availability of Information• Decision support (active and passive)• Performance measurement • Reporting (individual and population)• Support of clinical translational science, research
Alliance Research Infrastructure
Alliance Research Infrastructure
• Community-driven research platform• Infrastructure to link urban and rural
community sites through common technology platform
04/19/23
OverviewAlliance: PBRN Characteristics:• 23 safety net health centers across 9
states– 91 unique clinical sites– 294,000 patients; underserved minority
populations
• Shared technology platform (same EHRS, centralized data warehouse)
Current Research ProjectsProject Title Funder Time Period Study Partners
Improving HIV/AIDS quality through HIT
AHRQ 2007-2009 •Alliance (HB, HHO)•HRET
A Partnership for Clinician EHR Use and Quality of Care
AHRQ 2007-2010 •Alliance (HB, HHO, Erie)•MPHI - Inst for Nursing Ctrs•University of Michigan•3 nurse-managed centers
Validating national HIV performance measures with a commercial EHR in the safety net
AMA 2008-2009 •Alliance (HB, HHO)•American Medical Association
UPQUAL AHRQ 2008-2010 •Alliance (Erie, Near North)•Northwestern University
Health Information Exchange (HIE) Planning Grant
HRSA 2008-2009 •Alliance (Erie, Near North)•NMH/NU
REACH Network Grants NU CTSA grant 2008 - ongoing •Alliance (HIHC, Erie) •Northwestern University
Components of Research Infrastructure
Technical infrastructure to include:• Enhanced data extraction, analytic capability
to capture research data from central HER•
• Videoconferencing capability to: 1) link sites for research project communications; 2) potentially be used for patient recruitment; and 3) remotely deliver interventions
• Mobile device technology for data collection and unique interventions at patient level.
Components of Research Infrastructure
Administrative infrastructure would include:
• Research advisory board - foundation for involving academic researchers, community clinicians in planning/carrying out research
• Data use policy, procedure, and agreement• Templates for patient recruitment, consent • Centralized IRB • Informatics staff
Survey Results
• Survey sent to ~20 end user health centers to gauge interest in participating in an infrastructure that supports network-wide research
• Respondents: n=16
• 100% of respondents indicated interest in participating in a research network
Survey Results• HIGHLIGHTS:
What benefits would your health center hope to gain by participating in a research network? n=16
Enhance knowledge about how to improve quality of care delivered
94%
Access to infrastructure funding 88%
Access to larger populations with which to pool your health center data for research
69%
Access to research opportunities to enhance staff recruitment and retention
63%
Ability to work with other research institutions 44%
Increased involvement in setting research agendas 38%
Survey ResultsHIGHLIGHTS:
Currently involved in research? n=15Yes – 60%No – 40%
Major sources of research funding? n=8Government Agency (eg, AHRQ, CDC) – 63%Private National Foundation – 50%Private Local Foundation – 50%
Research relationship with academic center? n=14Yes – 57%No – 43%
Survey ResultsHIGHLIGHTS:
Does your health center have a federally negotiated indirect rate? n=14Yes – 14% No – 86%
Does your health center's notice of privacy practices (eg, HIPAA notice) include language about the use of data for research purposes? n=14Yes – 71% No – 29%
SUMMARY• Commitment to HIT-enabled, community-driven
research
• Areas of Interest:– Health Disparities
– Cost Effectiveness
– Testing New Devices
– Organizational Process Research
– Clinical Effectiveness
– Secondary Analysis of Existing Data
• Seeking NIH funding to strengthen infrastructure for research
• Eager to collaborate with other PBRNs
Thank You
Fred Rachman, MD
Erin Kaleba