Alliance of Chicago Community Health Services EHRS-enabled PBRN of safety net health centers Fred Rachman, MD Erin Kaleba, MPH.

Alliance of Chicago Community Health

ServicesEHRS-enabled PBRN of safety net

health centers

Fred Rachman, MDErin Kaleba, MPH

Alliance Overview• HRSA-funded network of 4 independent,

federally qualified Health Centers located on the Near North Side of Chicago

• Target populations:– Latino, African American, Gay and Lesbian, and

Immigrant and Homeless

• Services encompass comprehensive Primary Care, Dental, Mental Health and Social Services, Health Education, and Research

Role of HIT“To utilize a fully-functioning EHR as a tool to improve the

quality and safety of health care delivered at the individual patient level and population level”

2004-2007 EQUIP Project (AHRQ-funded)• Enhanced availability of Information• Decision support (active and passive)• Performance measurement • Reporting (individual and population)• Support of clinical translational science, research

Alliance Research Infrastructure

Alliance Research Infrastructure

• Community-driven research platform• Infrastructure to link urban and rural

community sites through common technology platform

04/19/23

OverviewAlliance: PBRN Characteristics:• 23 safety net health centers across 9

states– 91 unique clinical sites– 294,000 patients; underserved minority

populations

• Shared technology platform (same EHRS, centralized data warehouse)

Current Research ProjectsProject Title Funder Time Period Study Partners

Improving HIV/AIDS quality through HIT

AHRQ 2007-2009 •Alliance (HB, HHO)•HRET

A Partnership for Clinician EHR Use and Quality of Care

AHRQ 2007-2010 •Alliance (HB, HHO, Erie)•MPHI - Inst for Nursing Ctrs•University of Michigan•3 nurse-managed centers

Validating national HIV performance measures with a commercial EHR in the safety net

AMA 2008-2009 •Alliance (HB, HHO)•American Medical Association

UPQUAL AHRQ 2008-2010 •Alliance (Erie, Near North)•Northwestern University

Health Information Exchange (HIE) Planning Grant

HRSA 2008-2009 •Alliance (Erie, Near North)•NMH/NU

REACH Network Grants NU CTSA grant 2008 - ongoing •Alliance (HIHC, Erie) •Northwestern University

Components of Research Infrastructure

Technical infrastructure to include:• Enhanced data extraction, analytic capability

to capture research data from central HER•

• Videoconferencing capability to: 1) link sites for research project communications; 2) potentially be used for patient recruitment; and 3) remotely deliver interventions

• Mobile device technology for data collection and unique interventions at patient level.

Components of Research Infrastructure

Administrative infrastructure would include:

• Research advisory board - foundation for involving academic researchers, community clinicians in planning/carrying out research

• Data use policy, procedure, and agreement• Templates for patient recruitment, consent • Centralized IRB • Informatics staff

Survey Results

• Survey sent to ~20 end user health centers to gauge interest in participating in an infrastructure that supports network-wide research

• Respondents: n=16

• 100% of respondents indicated interest in participating in a research network

Survey Results• HIGHLIGHTS:

What benefits would your health center hope to gain by participating in a research network? n=16

Enhance knowledge about how to improve quality of care delivered

94%

Access to infrastructure funding 88%

Access to larger populations with which to pool your health center data for research

69%

Access to research opportunities to enhance staff recruitment and retention

63%

Ability to work with other research institutions 44%

Increased involvement in setting research agendas 38%

Survey ResultsHIGHLIGHTS:

Currently involved in research? n=15Yes – 60%No – 40%

Major sources of research funding? n=8Government Agency (eg, AHRQ, CDC) – 63%Private National Foundation – 50%Private Local Foundation – 50%

Research relationship with academic center? n=14Yes – 57%No – 43%

Survey ResultsHIGHLIGHTS:

Does your health center have a federally negotiated indirect rate? n=14Yes – 14% No – 86%

Does your health center's notice of privacy practices (eg, HIPAA notice) include language about the use of data for research purposes? n=14Yes – 71% No – 29%

SUMMARY• Commitment to HIT-enabled, community-driven

research

• Areas of Interest:– Health Disparities

– Cost Effectiveness

– Testing New Devices

– Organizational Process Research

– Clinical Effectiveness

– Secondary Analysis of Existing Data

• Seeking NIH funding to strengthen infrastructure for research

• Eager to collaborate with other PBRNs

Thank You

Fred Rachman, MD

[email protected]

Erin Kaleba

[email protected]