Practice-based Research Networks (PBRNs) in the Era of Integrated Delivery Systems.
Practice-based research networks (PBRNs) have been in existence for several decades, and they provide one mechanism to conduct research outside of academic research centers. Two transformative changes to the practice environment pose significant challenges to the manner in which PBRNs have functioned in the past and require changes to their current activities. The widespread introduction of electronic health records and the organization of practices into often hospital-dominated integrated delivery systems change the manner in which medicine is practiced, administered, and financed. Research funders are committed to extending research into communities, although we have yet to learn how to conduct these activities efficiently. We describe a number of operational challenges to this transformation, and we also propose ways to address these challenges and improve the quality and efficiency through which research is conducted. PBRNs can ensure their relevance in the research environment by adapting to this new era.
From the Cecil G Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, NC (TSC, JRH, KED, SC); the Division of General Medicine and Clinical Epidemiology, University of North Carolina, Chapel Hill (TSC, SC); the Department of Family Medicine, University of North Carolina, Chapel Hill (JRH, KED); and the North Carolina Area Health Education Centers, Chapel Hill (SC). tim_carey@unc.edu.
Timothy S
TS
Carey
From the Cecil G Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, NC (TSC, JRH, KED, SC); the Division of General Medicine and Clinical Epidemiology, University of North Carolina, Chapel Hill (TSC, SC); the Department of Family Medicine, University of North Carolina, Chapel Hill (JRH, KED); and the North Carolina Area Health Education Centers, Chapel Hill (SC).
Jacqueline R
JR
Halladay
From the Cecil G Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, NC (TSC, JRH, KED, SC); the Division of General Medicine and Clinical Epidemiology, University of North Carolina, Chapel Hill (TSC, SC); the Department of Family Medicine, University of North Carolina, Chapel Hill (JRH, KED); and the North Carolina Area Health Education Centers, Chapel Hill (SC).
Katrina E
KE
Donahue
From the Cecil G Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, NC (TSC, JRH, KED, SC); the Division of General Medicine and Clinical Epidemiology, University of North Carolina, Chapel Hill (TSC, SC); the Department of Family Medicine, University of North Carolina, Chapel Hill (JRH, KED); and the North Carolina Area Health Education Centers, Chapel Hill (SC).
Samuel
S
Cykert
D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D057286:Electronic Health Records; D005194:Family Practice / Q000458:organization & administration; D006302:Health Services Research / Q000458:organization & administration*; D006801:Humans; D011320:Primary Health Care / Q000458:organization & administration*; D014481:United States
Electronic Medical Records; Practice-based Research