A driving force for health equity

Research at OCHIN -- not just for geeks

Dear Fellow OCHIN Clinician:

Do you have what it takes to be a researcher? To answer this question, let’s see how you do with a simple, two question quiz: 

Q#1: Do you know how to perform a Turnbull modified Product-limit estimator for fitting proportional hazards models?

A#1: Meh, who cares? I don’t know either, and NOT knowing certainly isn’t a knock-out blow to doing research. (Luckily, there are excellent statisticians at OCHIN to help with this.)

Q#2: Do you have any clinically significant research questions? 

A#2: If you spend your days with patients deliberating about best courses of action, then you have this essential research skill. You are challenged every day, every visit, with questions for which there are no ready answers. Even after searching Up-To-Date from several angles, even after taking the time to do a Pubmed lit search, you find - nothing. You call your subspecialist buddy from medical school, and she helps decide a course of action, but you get the sense that even her answer was a bit less than (cough, cough) evidence-based. Because to be honest, for much of what we do in primary care, there simply is no good evidence. A good researcher is someone who knows what needs to be known.

So, to recap: If you know what that Turnbull-thingie is, that’s pretty cool. You’ve been well educated in the finer points of statistics and have specialized skills in the field. BUT, if you regularly see patients and have ideas about important clinical research questions, you also have real research chops. The OCHIN Practice Based Research Network (PBRN) needs help from people like you.   

What, pray tell, is a PBRN? I’m delighted you asked. According to the Agency for Healthcare Research and Quality (AHRQ), “PBRNs are groups of primary care clinicians and practices working together to answer community-based health care questions and translate research findings into practice. PBRNs engage clinicians in quality improvement activities and an evidence-based culture in primary care practice to improve the health of all Americans.” As of October 2016, 178 PBRNs had registered with the AHRQ, representing practices from all 50 states and more than 25 countries ... but only one of these PBRNS is entirely focused on CHCs: the OCHIN PBRN. Our PBRN has further advantages over many others. Most PBRNs are made up of like clinical practices, but are supported by a plethora of EHR systems. They struggle to find ways to link their EHR data for outcomes. Our OCHIN PBRN’s data is already linked and research-ready to ask the questions that you care about.

When our Epic© electronic health record (EHR) rolled out in 2006 with its shared data repository, OCHIN leaders saw the potential of using this data to conduct research in our safety net population. OCHIN clinicians partnered with researchers from Oregon Health & Science University and the Kaiser Permanente NW Center for Health Research to develop research ideas. We registered the OCHIN PBRN with the AHRQ in 2007. The PBRN provided the impetus to start writing proposals. At first we sought funding to develop research infrastructure within OCHIN, and were successful with the American Recovery Act in 2010. 

Today, our PBRN’s data infrastructure allows us to study safety net clinics serving over 3.3 million patients in 15 states. Some of our practitioner members are leading or collaborating in groundbreaking studies that identify best practices and policies for improving safety-net care, seeking answers for those nagging primary care questions that may not be a priority in other research settings.

Now that you know about the OCHIN PRBN and we have confirmed you’d be a good PBRN partner, allow me to explain why you might want to do so:

  • It’s a great way to keep abreast of the most up-to-date knowledge in your field.  

  • You can be part of a paper-writing team and add impressive publications to your CV.

  • Because you’re intellectually curious and need a group of similarly-minded folks with whom to develop your ideas.

  • Taking part in cool projects helps prevent burn-out.

  • Sometimes there can be compensation for you or your clinic. I know money isn’t your only motivation, but it’s sometimes a nice sweetener in the coffee.

  • It’s the right thing to do. Our safety net population is understudied in the medical literature, and this is one way to correct that healthcare disparity. 

You would be a good research partner with the OCHIN PBRN. Participating would benefit you, your institution, and your patient community.  So how about it? The OCHIN PBRN meets every four months to discuss current and potential research projects. We’d love to have you join.  Shoot an email to Anna Templeton, templetona@ochin.org, if you’d like to be included in the meeting invitation for our January 15 meeting.

Sincerely yours,

John Muench, MD