Research Projects

NEW RESEARCH PROJECTS: Improving Performance in Practice This project, funded by the American Board of Medical Specialties (primary: Robert Wood Johnson), is a national initiative supported by the primary care specialty societies and boards to develop, test, and deploy a sustainable, state-based approach that can support efforts by primary care providers, including internists, family physicians, and pediatricians and their care teams, to improve the way chronic illness and preventive care is provided to patients. ASPREE (Aspirin in Reducing Events in the Elderly) This study will examine whether the benefits of low dose aspirin therapy outweighs the risks in healthy adults, age 70 plus. Participants will be followed over the course of 5 years and assessed regularly for changes in physical ability, cognitive ability, bleeding tendencies and cardiovascular events. This study is being conducted in Australia and is getting started in a variety of research networks in the United States. Funding comes from the National Institute on Aging.    Trial Net MAFPRN will be added as an affiliate site to the Natural History Study of  Development  of Type 1 Diabetes sponsored by the NIDDK. .  We will be participating in Phase 1 which involves screening for the presence of three autoantibodies (anti-GAD 65, anti-ICA512 or IAA) associated with type 1 diabetes in persons with a close relative with Type 1 diabetes. Eligible patients may have their blood samples collected at any clinical site with coordination from the University of Minnesota and MAFPRN. Implementing Practice Coaching and the Chronic Care Model in Practices serving vulnerable populations (AHRQ Task Order 13)In collaboration with LA Net,  this study will evaluate the implementation and replication of the AHRQ Toolkit and Practice Coaching intervention in 20 safety net practices in California.  The study will examine variation in process, costs, and satisfaction in small, medium and large practices.  The study will also assess capacity for sustained change, quality of care, and provider and patient satisfaction. Finally, it will look at variation in these outcomes by practice size, location, and baseline measures. Assessing the Impact of the Patient-centered Medical Home (PCMH) (AHRQ Task Order 15) In collaboration with Health Partners Research Foundation, MAFPRN is participating in this important assessment. The primary goal is to inform policy by evaluating the economic and quality outcomes of mature primary care patient-centered medical home (PCMH) clinics. This will include analyzing existing data from the 21 primary care clinics of HealthPartners Medical Group (HPMG). The central hypothesis is that a clinic’s degree of PCMH is significantly associated with higher quality, increased patient satisfaction, and reduced resource use. Existing electronic medical record (EMR) and HPMG administrative data will be used to correlate the quality, patient satisfaction, and medical resource use within these clinics with their scores on the instrument used to accredit clinics for National Committee of Quality Assurance as medical homes.  Trends in these factors within HPMG clinics over the years 2004-2008 will be studied and determined if they significantly differ from the general secular trend occurring across Minnesota-based medical groups. This information will help inform the U.S. as to the value of medical homes and HPMG as to what practice systems are most important. CONTINUING RESEARCH PROJECT UPDATES: Minnesota Complexity Assessment Method in Diabetes Patient Funded by UCare Minnesota, this project examined the validity of the Minnesota Complexity Assessment Method in a sample of clinic patients with poorly controlled diabetes. Physicians and diabetes care coordinators in 4 clinics were asked to assess their patients with poorly controlled diabetes. The complexity tool is a method to help plan additional assistance for patients. Data collection is complete and analysis has begun. Resource Center for Primary Care Practice Based Research Network The MAFPRN is in its second year of operating and managing the National Practice Based Research Network (PBRN) Resource Center. Funded by the Agency for Healthcare Research and Quality (AHRQ), the Resource Center serves as the major Federal source of infrastructure support to primary care PBRNs, especially new and emerging networks. It provides resources and assistance to primary care PBRNs engaged in clinical and health services research. The staff provides support to registered PBRNs through a series of web-based seminars and the provision of technical research expertise. The PBRN resource center also helps plan and manage the annual AHRQ PBRN Research Conference held in June (www.pbrn.ahrq.gov). The Minnesota Academy of Family Physicians Research Network (MAFPRN) In 2007, the MAFPRN was awarded a task order contract by the DHHS Agency for Healthcare Research and Quality (AHRQ) for Primary Care Practice Based Research Networks (PBRNs). All work required under this contract will be performed through the issuance of task orders. Competitive (or justified sole source) requests for task orders (RFTOs) will be sent throughout the fiscal year. To date the MAFPRN has received funding for one task order: Participation by Primary Care Practices in Health Information Exchange. Atherothrombosis Intervention in Metabolic Syndrome (AIM-HIGH) This study began in 2005 and is being funded by the National Institutes of Health (NHLBI) through a subcontract with the Axio Research. As a clinical center for the AIM-HIGH Trial, testing is being done to determine whether the combination of niacin and simvastatin lowers the risk of heart attacks and strokes more than just taking simvastatin alone. ACCORD Trial The ACCORD trial which began in 2000 is sponsored by the National Heart, Lung, and Blood Institute (NHLBI).Results were published in the New England Journal of Medicine March 14, 2010. Observational follow up will continue through December 2010. ACCORDION, a follow up to ACCORD is currently being planned. Phalen Village Clinic is one of the few Family Medicine Clinics that participated in the ACCORD Study. The findings of ACCORD are producing national changes in health care quality measures. RECENTLY COMPLETED RESEARCH PROJECTS: Participation by Primary Care Practices in Health Information Exchange Funding for this project was awarded by the Agency for Healthcare Research and Quality (AHRQ) to assess factors that influence the participation of primary care practices in electronic health information exchange initiatives including benefits and barriers to participation. Study will involve practices that are comprised of 20 or fewer full-time clinicians. Nine primary care clinics around the state participated in the project.  Two presentations, one publication and an AHRQ Webinar have been completed.   Developing a Distributed Research Network and Cooperative to Conduct Population-based Studies and Safety Surveillance This subcontract, awarded by the Agency for Healthcare Research and Quality (AHRQ), began in 2007. The Distributed Ambulatory Research in Therapeutics Network (DARTNet) is a prototype federated network of electronic health record (EHR) data from eight organizations representing over 200 clinicians and over 350,000 patients. The prototype system captures, codifies and standardizes over 200 unique data elements per patient for up to 24 months of time. It explores how currently available EHR data can be used to supplement data from large administrative datasets in order to answer questions concerning the safety and effectiveness of medications and medical devices. Cancer Central Clinical Database (C3D) Trial The University of Minnesota Department of Family Medicine and Community Health (DFMCH) was awarded a contract from the caBIG, an initiative of the National Cancer Institute, NIH, DHHS to conduct two clinical trials using the C3D. The C3D is a web-based clinical data management solution originally developed for NCI’s intramural research program but is now available to other research organizations in a hosted Application Service Provider model. C3D supports data standardization, reuse, sharing, and interoperability through electronic Case Report Forms based on Common Data Elements maintained in NCICB’s Cancer Data Standards Repository and controlled by terminology from the NCI Enterprise Vocabulary Services. Through participation as an early adopter, the DFMCH used this clinical trial management system to support two studies that are relevant to cancer detection and prevention. The studies used were: Increasing Colorectal Cancer Screening by Primary Care Physicians in Appalachia PA, William J. Curry, MD, MS, Principal Investigator, Penn State University Physical Activity Intervention for Smoking Cessation in Women Aged 50 and Older; Sharon S. Allen, MD, PhD Principal Investigator, University of Minnesota Results of these studies will be presented at future meetings. The electronic Primary Care Research Network (ePCRN) This project, funded by an NIH award to a collaboration of the Federation of Practice-based Research Networks (FPBRN), the MAFPRN, and the University of Minnesota, has been successfully completed and makes it possible for PBRNs to participate in large randomized controlled trials. The ePCRN is designed to support primary care providers in conducting clinical research in their practices and to provide secure, cutting-edge technology along with training, support and technical assistance. This technology enables practices to create disease registries and report quality indicators, and to better communicate and coordinate activities among practices. Project results were presented at the NIH Translation Conference in May, 2008 and were presented at the American Medical Informatics Association Meeting in May, 2009. Survey On Patient Safety Culture (Task Order 11) The purpose of this project was to assess the patient safety culture in family medicine clinics in Minnesota and contribute to a national database using the standardized questionnaire, the Medical Office Survey on Patient Safety, developed by the Agency for Healthcare Research and Quality. 21 clinics in Minnesota participated, receiving results from their clinic staff and comparing them to Minnesota and National benchmarks. Results were presented at the Research Forum earlier this year.

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