Transcript Most research is done here - UW Family Medicine & Community

. . . for our health
Lessons Learned During 24
Years of Practice-Based
Research with WREN
Paul D. Smith, MD, Professor
University of Wisconsin
Department of Family Medicine
[email protected]
Supported by the University of Wisconsin Institute for Clinical and Translational Research (UW ICTR),
funded through an NIH Clinical and Translational Science Award (CTSA), grant number 1 UL1 RR025011
Topics Today
• WREN description
• Research support model
• Recruitment methods
Topics Today
• Business model
• Lessons learned
• Keys to success
Why WREN?
Most biomedical research in the US during
past 50 years has been conducted at
about 200 tertiary care centers that
provide specialized care and conduct
research with highly selected patients.
WREN Research is done here
General Population
1000 people
113 people (76.3%)
Primary
Care
Most research is done here
Academic Medical Centers
1 person (1.2%)
Adapted from Green L et al. N Engl J Med 2001;344:2021-2025
What is WREN?
• Founded in 1987
• Program of the University of Wisconsin
Department of Family Medicine
• Clinical Translational Science Award
What is WREN?
• Primary care clinicians and researchers
• State wide
• Annual budget ~ $450,000
What is WREN?
• Primary interest in improving care of patients
▪ Conducting practice-based research
▪ Quality improvement projects
▪ Education
▪ Impact
WREN Clinicians
• About 160 members
• About 130 clinicians
• 44 Communities
• 21 different health care organizations
• 13 different UW Health clinics
WREN
• Individual clinicians VS entire practices
• “Full Support Practice”
▪ Clinician champion
▪ Practice liaison
▪ Contract
▪ $10,000/year for ~ 20% FTE
WREN Full Support Practices
• Milwaukee
▪ Aurora Medical Group
▪ Milwaukee Health Services
• Mauston
• Tomah
• Richland Center
WREN Practices
Wausau
Eau Claire
Green Bay
Tomah
WREN full
support clinic
WREN individual
clinician site
Mauston
Richland Center
Dubuque
Madison
Milwaukee
WREN Steering Committee
• 11 members
• 1 MCW member
• 4 general members, not
affiliated with a University
• Sets WREN priorities
WREN Advisory Committee
• Purpose:
▪ Make recommendations to the Steering
Committee regarding overall direction, policy
and procedure changes.
▪ Advocate for Wisconsin citizens in general in
regards to WREN activities.
▪ Advocate for WREN to the general public and
potential funders.
WREN Staff
• Paul Smith, Director
• Mike Grasmick, Network Coordinator
• Veronica Harper, administrative assistant
WREN Staff - RRCs
• Regional Research Coordinators
▪ Peggy O’Halloran
Eau Claire
▪ Mark Remiker
Madison
▪ Kate Judge
Madison
▪ Hannah Louks
Milwaukee
Questions?
WREN Research Support Model
• Central WREN staff
• Principal Investigators
▪ WREN Clinicians
▪ Non-WREN collaborators
Regional Research Coordinator
• Develop ongoing working relationships
• Assess clinic capacity to conduct research
• Technical assistance/training for practice staff
• Assure adherence to protocols
RRCs
• Two way communication
• Share best practices/problem solve
• Assist with chart review and patient recruitment
Types of WREN Projects
• Translational Research
• Dissemination/QI
• Projects that (will) directly impact patient care
WREN Projects
• A variety of clinical topics
▪ Asthma treatment
▪ Cancer screening
▪ Heart disease prevention
▪ Evaluation of dyspepsia
WREN Projects
▪ Office radiography use
▪ Health literacy
▪ Number of problems per encounter
▪ Office visit complexity
▪ Infectious disease reporting
Current Projects
• Trust in Health Care
• Collaborating with pharmacist to improve
asthma care
• Testing an internet chronic kidney disease
management tool
Current Projects
• Meditation as adjunct to usual care for
treatment of alcohol addiction
• Improving care of the elderly
• Facilitating improvement in CKD care
▪ 3 year AHRQ funded intervention studies
Questions?
Recruitment Methods
• Practices
• Clinicians
• Patients
▪ At clinics- front desk, nurse, doctor
▪ EHR + Mail (opt out) + phone
Business Model
• Infrastructure funding + grants
• Investing in a relationship
• Don’t give it away (often)
▪ “Are you working for free? – don’t!”
Business Model
• Know what it costs to do your work
▪ Calculate hours and double
• Justify the supervisor’s work in your
grant budget
• Identify and avoid “scope creep”
Business Model
• Talk about money early
• Transparency with all partners
• Open process
• Share data (e.g., salary, % effort)
• Negotiate using collaborative process
• Be willing to walk away
▪ Money’s not right, project’s not right
Business Model
• Market your network
▪ How are you uniquely positioned for research?
▪ What type (topics) of research does your network do?
▪ Reach out to PIs and people that can refer PIs to you
Business Model
• Get your name out there
▪ Website
▪ Newsletter
▪ Presentations
▪ Publications
Questions?
Lessons Learned- the Hard Way
• Don’t give it away
• Be very clear about expectations and
responsibilities
• Talk about money early
• Ask, you might just get what you want
Lessons Learned
• Be careful what you ask for, you might just get it.
• Slow growth is less stressful than rapid growth
• Plan for sustainability with multiple funding
sources
• Plan for leadership succession
Keys to Success
• Research question that matters
• Minimal burden on clinicians
• Enough to do to maintain interest,
but not too much
Keys to Success
• Effective communication
• Two way feedback with clinics
• Involvement of clinics and WREN staff
Keys to Success
• Adequate funding for projects
• Infrastructure funding
• Have a business model
For More Information
• www.wren.wisc.edu
• [email protected]
Questions?
. . . for our health