scholarly journals Practice-Based Research Networks: Strategic Opportunities to Advance Implementation Research for Health Equity

2019 ◽  
Vol 29 (Suppl 1) ◽  
pp. 113-118
Author(s):  
John M. Westfall ◽  
Rebecca Roper ◽  
Anne Gaglioti ◽  
Donald E. Nease, Jr.

While the vast majority of people re­ceive their medical care in community primary and specialty care clinics, most clinical research is performed in academic tertiary care hospitals and hospital clin­ics. Practice-based research networks are most commonly collections of primary care practices that work together to ask and answer health questions for their patients and communities and are an integral part of the translational pathway from discovery to practice to community health. Community primary care practices are at the front line of health equity issues; equity in clinical care, equity in community health, equity in social determinants of health, and equity in health outcomes. Practice-based research networks can gather and combine data from dozens of communities, hundreds of prac­tices and thousands of patients to address health equity and disparities across the full spectrum of community and public health to clinical and primary care. This article will briefly outline the history of PBRNs, types of PBRNs, locations, topics, and patient outcomes over the past 25 years. Current PBRN efforts to address health disparities and improve health equity will be described. New PBRN opportunities to address health disparities and approaches to advance implementation research for health equity in the practice and community will be described. Readers will be challenged to consider ways to engage practice-based research networks in their health equity ef­forts.Ethn Dis. 2019;29(Suppl 1):113-118; doi:10.18865/ed.29.S1.113.

2019 ◽  
Vol 29 (Suppl 1) ◽  
pp. 113-118 ◽  
Author(s):  
John M. Westfall ◽  
Rebecca Roper ◽  
Anne Gaglioti ◽  
Donald E. Nease, Jr.

While the vast majority of people re­ceive their medical care in community primary and specialty care clinics, most clinical research is performed in academic tertiary care hospitals and hospital clin­ics. Practice-based research networks are most commonly collections of primary care practices that work together to ask and answer health questions for their patients and communities and are an integral part of the translational pathway from discovery to practice to community health. Community primary care practices are at the front line of health equity issues; equity in clinical care, equity in community health, equity in social determinants of health, and equity in health outcomes. Practice-based research networks can gather and combine data from dozens of communities, hundreds of prac­tices and thousands of patients to address health equity and disparities across the full spectrum of community and public health to clinical and primary care. This article will briefly outline the history of PBRNs, types of PBRNs, locations, topics, and patient outcomes over the past 25 years. Current PBRN efforts to address health disparities and improve health equity will be described. New PBRN opportunities to address health disparities and approaches to advance implementation research for health equity in the practice and community will be described. Readers will be challenged to consider ways to engage practice-based research networks in their health equity ef­forts.Ethn Dis. 2019;29(Suppl 1):113-118; doi:10.18865/ed.29.S1.113.


Medical Care ◽  
2006 ◽  
Vol 44 (7) ◽  
pp. 696-700 ◽  
Author(s):  
Shawna V. Hudson ◽  
Sonja Harris-Haywood ◽  
Kurt C. Stange ◽  
A John Orzano ◽  
Benjamin F. Crabtree

2017 ◽  
Vol 67 (664) ◽  
pp. e764-e774 ◽  
Author(s):  
Jasmine Pawa ◽  
John Robson ◽  
Sally Hull

BackgroundPrimary care practices are increasingly working in larger groups. In 2009, all 36 primary care practices in the London borough of Tower Hamlets were grouped geographically into eight managed practice networks to improve the quality of care they delivered. Quantitative evaluation has shown improved clinical outcomes.AimTo provide insight into the process of network implementation, including the aims, facilitating factors, and barriers, from both the clinical and managerial perspectives.Design and settingA qualitative study of network implementation in the London borough of Tower Hamlets, which serves a socially disadvantaged and ethnically diverse population.MethodNineteen semi-structured interviews were carried out with doctors, nurses, and managers, and were informed by existing literature on integrated care and GP networks. Interviews were recorded and transcribed, and thematic analysis used to analyse emerging themes.ResultsInterviewees agreed that networks improved clinical care and reduced variation in practice performance. Network implementation was facilitated by the balance struck between ‘a given structure’ and network autonomy to adopt local solutions. Improved use of data, including patient recall and peer performance indicators, were viewed as critical key factors. Targeted investment provided the necessary resources to achieve this. Barriers to implementing networks included differences in practice culture, a reluctance to share data, and increased workload.ConclusionCommissioners and providers were positive about the implementation of GP networks as a way to improve the quality of clinical care in Tower Hamlets. The issues that arose may be of relevance to other areas implementing similar quality improvement programmes at scale.


2021 ◽  
pp. emermed-2020-210896
Author(s):  
Margaret Samuels-Kalow ◽  
Todd Jaffe ◽  
Kori Zachrison

The use of telemedicine has grown immensely during the COVID-19 pandemic. Telemedicine provides a means to deliver clinical care while limiting patient and provider exposure to the COVID-19. As such, telemedicine is finding applications in a variety of clinical environments including primary care and the acute care setting and the array of patient populations who use telemedicine continues to grow. Yet as telehealth becomes ubiquitous, it is critical to consider its potential to exacerbate disparities in care. Challenges accessing technology and digital literacy, for example, disproportionately impact older patients and those living in poverty. When implemented with the consideration of health disparities, telemedicine provides an opportunity to address these inequities. This manuscript explores potential mechanisms by which telemedicine may play a role in exacerbating or ameliorating disparities in care. We further describe a framework and suggested strategies with which to implement telemedicine systems to improve health equity.


2017 ◽  
Vol 35 (1) ◽  
pp. 111-116 ◽  
Author(s):  
Natalia Y Loskutova ◽  
Craig Smail ◽  
Kemi Ajayi ◽  
Wilson D Pace ◽  
Chester H Fox

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