Practice-based research network

A practice-based research network (PBRN) is a group of practices devoted principally to the care of patients and affiliated for the purpose of examining the health care processes that occur in practices. PBRNs are characterized by an organizational framework that transcends a single practice or study. They provide a "laboratory" for studying broad populations of patients and care providers in community-based settings.[1]

History of primary care research

Before there were research institutes or networks of practices, there were individual practitioners who studied their patients' problems with scientific rigor. Among these were five general practitioners who have been recognized for their seminal work during the past 125 years. They are James Mackenzie, Will Pickles, John Fry, F.J.A. Huygen and Curtis G. Hames. Each of these pioneers demonstrated that important new knowledge could be discovered by practicing family physicians. And this is far from an accepted principle in the United States. These doctors all wondered about their patients' problems and they developed a means of gathering and recording data on their patients.

Each of these research pioneers provide inspiration for the development of practice-based, primary care research networks because each demonstrated that important new knowledge could be discovered by the practicing family doctor. They each wondered about their patients, developed means of gathering and recording data, and found collaborators and support from their staff and local communities. Unfortunately, they practiced in an era that was over-committed to specialism. Research focused on molecular mechanisms of disease. The rush to specialization by the medical community and the linking of research to specialists resulted in decades of neglect of primary care and virtually no recognition of the need to investigate care in the primary care setting. Instead, the common wisdom viewed primary care practices as relatively boring places that could be potential sites of application of the fruits of research done elsewhere in research laboratories, hospitals and institutes.[1]

Among the early regional networks started in the 1970s were the Family Medicine Information System in Colorado (FMIS)[2] and the Cooperative Information Project.[3] These regional networks learned from each other and succeeded in conducting studies focused on what was happening in primary care. They attracted funding from medical schools, national philanthropic foundations and federal programs such as Health for Underserved Rural Areas. As the 1970s closed, these early networks enjoyed sufficient success to stimulate debate about the next steps in the context of the microcomputer's development. Among them was a small group convened by Gene Farley in Denver in 1978 to consider establishing a national sentinel practice system. It was this idea that lead to the Ambulatory Sentinel Practice Network and provided in retrospect what appears to have been a nidus for the establishment of primary care PBRNs in the United States.

PBRNs are feasible and that represent a useful infrastructure for the scientific discovery of family practice and primary care. Experience to date points out the great advantages enjoyed by those with enduring, core financial support—such as the Dutch with their early national commitment to primary care and their willingness to invest in primary care research. It is also obvious that these networks require collaboration, cooperation and a spirit of sharing and trust.

These networks are now at once both a place and a concept. As a place, they are a laboratory for surveillance and research. As a concept, they express the still unmet need for practicing primary care clinicians to accept responsibility to improve frontline clinical care by understanding what is happening in their practices. Successes to date have been sufficient to incite the Institute of Medicine's 1994 committee studying the future of primary care to recommend support to stabilize and expand practice-based primary care research networks.[4]

Currently active

  1. AAFP NRN – AAFP National Research Network Kansas
  2. AANPNR – American Academy of Nurse Practitioners Network for Research Texas
  3. ACCESSPBRN – ACCESSPBRN Illinois
  4. ACCP PBRN – American College of Clinical Pharmacy Practice-Based Research Network Kansas
  5. ACERN – Ambulatory Care Evaluation and Research Network New York
  6. ACORN – Virginia Ambulatory Care Outcomes Research Network Virginia
  7. ACPNet – ACPNet Pennsylvania
  8. APBRN – Alabama Practice Based Research Network Alabama
  9. APN-ARC – Advanced Practice Nurse-Ambulatory Research Consortium Ohio
  10. APPD LEARN – Association of Pediatric Program Directors Longitudinal Educational Assessment Research Network Virginia
  11. ARCHNAP St. Louis Ambulatory Care Research Consortium for Nurses in Advanced Practice Missouri
  12. AT-PBRN – Athletic Training Practice-Based Research Network Arizona
  13. ATSU SOMA PBRN – A.T. Still University School of Osteopathic Medicine in Arizona PBRN Arizona
  14. AppNET – The Appalachian Research Network Tennessee
  15. ArkPBRN – Arkansas Practice Based Research Network Arkansas
  16. BIGHORN – Building Investigative Practices for Better Health Outcomes Colorado
  17. BWPC PBRN – Brigham and Women's Primary Care Practice-Based Research Network Massachusetts
  18. BraveNet – The Bravewell Integrative Medicine Research Network North Carolina
  19. C-AHEAD PBRN – Center for the Advancement of Healthcare Education and Delivery PBRN Colorado
  20. CAARN - Community-Academic Aging Research Network (UW-Madison)
  21. CAPRICORN – Capital Area Primary Care Research Network District of Columbia
  22. CARinG Network – Cincinnati Area Research Group Network Ohio
  23. CCPC – Connecticut Center for Primary Care Connecticut
  24. CDN – Clinical Directors Network, Inc.[5] New York
  25. COCONet – Colorado Child Outcomes Network Colorado
  26. CORC – CAMHS Outcomes Research Consortium UK
  27. CONCORD-PBRN – Consortium for Collaborative Osteopathic Research Development Practice-Based Research Network Texas
  28. CORNET – Continuity Research Network Virginia
  29. CPNet – Community Physician's Network Georgia
  30. CSPC – Centre for Studies in Primary Care
  31. CSRN – CLEAR Scoliosis Research Network Texas
  32. CaReNet – Colorado Research Network Colorado
  33. Cedars-Sinai PBRN-Cedars-Sinai Medical Delivery Network PBRN California
  34. CenTexNet – Central Texas Primary Care Research Network Texas
  35. DC PrimCare PBRN – District of Columbia Primary Care Practice-Based Research Network District of Columbia
  36. DO-Touch.NET – Doctors of Osteopathic Medicine Treating with OMM: Usefulness in Current Healthcare Missouri
  37. DesertNet – DesertNet Arizona Primary Care Research Network Arizona
  38. E-CARE – Eastern Carolina Association for Research & Education North Carolina
  39. EBD-PBRN – Evidence-Based Decisions in Dentistry Practice-Based Research Network California
  40. EPICnet – Eastern Pennsylvania Inquiry Collaborative Network Pennsylvania
  41. GR-PBRN – Greater Rochester Practice Research Network New York
  42. GRIN – Great Lakes Research Into Practice Network Michigan
  43. HCH PBRN – Health Care for the Homeless Practice Based Research Network Tennessee
  44. HHR – Holistic Healthcare and Research Centre
  45. HPRN – High Plains Research Network Colorado
  46. HamesNet – HamesNet Georgia
  47. Healthy Communities – Physicians of Southwest Washington Foundation for Quality Improvement Washington
  48. ICPA PBRN – International Chiropractic Pediatric Association PBRN Pennsylvania
  49. IDND – Indianapolis Discovery Network for Dementia Indiana
  50. IFHRN – Institute for Family Health Research Network New York
  51. IRENE – Iowa Research Network Iowa
  52. ISRN-RN – Improvement Science Research Network Texas
  53. JCCCR – Jefferson Coordinating Center for Clinical Research Pennsylvania
  54. JDPBRN – Dental PBRN Japan
  55. JHCP-PCRN – Johns Hopkins Community Physicians Primary Care Research Network Maryland
  56. JaxHERO – Jacksonville Health Equity Research Organization Florida
  57. KAN – Kentucky Ambulatory Network Kentucky
  58. LA Net – LA Net Community Health Network California
  59. LAC DHS ACN-R&I – Los Angeles County Department of Health Services, Ambulatory Care Network – Research & Innovation California
  60. La MAISON – Louisiana Medical Home Ambulatory Improvements and Outcomes Network Louisiana
  61. Lutheran Network – Lutheran Family Health Center Network New York
  62. MAFPRN – Minnesota Academy of Family Physicians Research Network Minnesota
  63. MAPPR – Mecklenburg Area Partnership for Primary Care Research North Carolina
  64. MASNRN – Massachusetts School Nurse Research Network Massachusetts
  65. MCHS PBRN – Mayo Clinic Health System Practice Based Research Network Minnesota
  66. MGPC-PBRN – Massachusetts General Primary Care Practice Based Research Network Massachusetts
  67. MPCRN – Military Primary Care Research Network Maryland
  68. MPPBRN – Minnesota Pharmacy Practice-Based Research Network Minnesota
  69. MTN – MO Therapy Network Missouri
  70. MedEdNet – Medical Education Research Network Oregon
  71. Mercy – Sisters of Mercy Health System Network Missouri
  72. MetroNet – Metropolitan Detroit Practice-based Research Network Michigan
  73. NC MARCH – North Carolina Multisite Adolescent Research Consortium for Health North Carolina
  74. NC-FM-RN – North Carolina Family Medicine Research Network North Carolina
  75. NCCHRN – North Carolina Child Health Research Network North Carolina
  76. NCnet - Combined PBRNS founded at UNC-Chapel Hill contains NC-FM-RN, NCCHRN, NC MARCH and RCPCrN
  77. NECF PBRN – New England Clinicians Forum Practice-Based Research Network Connecticut
  78. NEON – Northeastern Ohio Network Ohio
  79. NFPCRN – North Florida Pediatric Community Research Network Florida
  80. NIPC-PBRN – National Interdisciplinary Primary Care PBRN Iowa
  81. NJPCRN – New Jersey Primary Care Research Network New Jersey
  82. NP-PITTNet – NursePractitioner-PITTNet Pennsylvania
  83. NYC RING – New York City Research & Improvement Networking Group New York
  84. NYU-HHC CRA – New York University (NYU)-Health and Hospitals Corporation (HHC) Clinical Research Association (CRA) New York
  85. National Dental PBRN – The National Dental Practice-Based Research Network Alabama
  86. NetHaven at Yale – NetHaven Practice Based Research Network Connecticut
  87. NorTex – North Texas Primary Care Practice Based Research Network Texas
  88. NorthShore PBRN – NorthShore Practice-Based Improvement Research Network Illinois
  89. Northwest PRECEDENT – Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry Washington
  90. OCHRN – Oklahoma Child Health Practice Based Research Network Oklahoma
  91. OKPRN – Oklahoma Physicians Resource/Research Network Oklahoma
  92. ORPRN – Oregon Rural Practice-based Research Network Oregon
  93. OPTI-WestNet – OPTI-West Practice-Based Research Network Colorado
  94. OQUIN – Outpatient Quality Improvement Network South Carolina
  95. OSU-PCPBRN – Ohio State University Primary Care Practice Based Research Network Ohio
  96. PAMFRI – Palo Alto Medical Foundation Research Institute California
  97. PBRN-VA – VA Mental Health Practice-Based Research Network Texas
  98. PCRC – Duke Primary Care Research Consortium North Carolina
  99. PDC PBRN – Pediatric Diagnostic Center PBRN California
  100. PPOC – The Pediatric Physicians' Organization at Children's Massachusetts
  101. PRN – Portland Research Network Oregon
  102. PROS – Pediatric Research in Office Settings Illinois
  103. PSARN – Penn State Ambulatory Research Network Pennsylvania
  104. PeRC – The Pediatric Research Consortium Pennsylvania
  105. Pediatric PittNet – Pediatric PittNet: University of Pittsburgh CTSI PBRN Pennsylvania
  106. RAP – Research Association of Practices of the PBRN Shared Resource Ohio
  107. RCPCrN – Robeson County Primary Care research Network North Carolina
  108. REACH Network – Research and Education for Academic Achievement Network Illinois
  109. RIOS NET – Research Involving Outpatient Settings Network New Mexico
  110. Rx-SafeNet – Medication Safety Research Network of Indiana Indiana
  111. SAFTINet – Scalable Architecture for Federated Translational Inquiries Network Colorado
  112. SALT-Net – The Studying, Acting, Learning, and Teaching Network New York
  113. SAPPHIRE – South Asian Practice Partnership for Health Improvement and Research New York
  114. SCOR Network – Slone Center Office-based Research Network Massachusetts
  115. SCPPRN – South Carolina Pediatric Practice Research Network South Carolina
  116. SERCN – Southeast Regional Clinicians Network Georgia
  117. SF Bay CRN – San Francisco Bay Collaborative Research Network California
  118. SICTRN – Southeastern Integrated Clinical and Translational Research Network Florida
  119. SIPRO – Southern Illinois Practice Research Organization Illinois
  120. SOAR-Net – Southwestern Ohio Ambulatory Research Network Ohio
  121. SPUR-Net – Southern Primary-care Urban Research Network Texas
  122. SRN – ShowMe Research Network Missouri
  123. STARNet – South Texas Ambulatory Research Network Texas
  124. STOHN – South Texas Oral Health Network Texas
  125. STP PBRN – South Texas Psychiatric Practice-Based Research Network Texas
  126. SWIRLNet – South West Innovative Research and Learning Network Colorado
  127. Safety Net West – Safety Net West Oregon
  128. South Asian PBRN – South Asian PBRN
  129. Southeast Wisconsin Alliance for Translating Research into Practice – Southeast Wisconsin Alliance for Translating Research into Practice Wisconsin
  130. TAMHSC-RCHI – Texas A&M Health Science Center Rural and Community Health Institute Texas
  131. The Dartmouth CO-OP Project – Dartmouth-Northern New England CO-OP Project New Hampshire
  132. UCLA PCRN – UCLA Primary Care Research Network California
  133. UMASS-FM-PBRN – UMass Family Medicine PBRN Massachusetts
  134. UNYNET – Upstate New York Practice Based Research Network New York
  135. UT Pharm Net – University of Tennessee Pharmacist Practice Based Research Network Tennessee
  136. UUPCRN – Utah Health Research Network Utah
  137. VCMCDDCP – Ventura County Medical Center Diabetes Data Control Project Practice Based California
  138. WPRN – WWAMI region Practice and Research Network Washington
  139. WREN – Wisconsin Research and Education Network Wisconsin
  140. WU PAARC – Washington University Pediatric and Adolescent Ambulatory Research Consortium Missouri
  141. WesTRN – West Texas Research Network Texas

References

  1. "PBRN's in the 21st Century – The Pearls of Research" (PDF). American Academy of Family Physicians.
  2. Green, LA (1978). "A family medicine information system: the beginning of a network for practicing and residency family physicians". Journal of Family Practice. 7 (3): 567–76.
  3. Nelson, EC (1981). "The cooperative information project, part 1: a sentinel prac – tice network for service and research in primary care". Journal of Family Practice. 13 (5): 641–9.
  4. Donaldson, MS (1996). Primary Care. Washington DC: National Academy Press.
  5. Sardell, A (1996). "Clinical networks and clinician retention: the case of CDN". Journal of Community Health. 21 (6): 437‐451. doi:10.1007/BF01702604. PMID 8912120.
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