jeralyn bernier, m.d., m.p.h. research director cincinnati pediatric research group
DESCRIPTION
Using an AHRQ-supported Practice- Based Research Network (PBRN) To Design, Implement, And Evaluate Communication Strategies. Jeralyn Bernier, M.D., M.P.H. Research Director Cincinnati Pediatric Research Group Cincinnati Children’s Hospital Medical Center Cincinnati, OH. Overview. - PowerPoint PPT PresentationTRANSCRIPT
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Using an AHRQ-supported Practice- Based Research Network (PBRN) To Design, Implement, And Evaluate Communication Strategies
Jeralyn Bernier, M.D., M.P.H.
Research DirectorCincinnati Pediatric Research GroupCincinnati Children’s Hospital
Medical CenterCincinnati, OH
Overview● Midwest regional Practice-Based Research
Network spanning 8 counties in three States● Established in 1996 with support from
General and Community Pediatrics, CCHMC● 45 providers in 22 practices● Ideas generated in “bottom-up” fashion at
monthly meetings of members tackling clinical problems
● Ongoing support from the Agency for Healthcare Research and Quality (AHRQ) and Cincinnati Children’s Hospital Medical Center
Symptom Surveillance Project
● Web-based password protected database
● Physicians enter data re: symptom complexes of high prevalence in outpatient office settings, as well as unusual cases
● Symptoms as manifest in children● Symptoms likely in transmissible
diseases or bioterrorism
Symptom Surveillance—Who?
● Practice-based research networks of primary care providers▬CPRG (Cincinnati Pediatric Research
Group)▬OPRC (Ohio Pediatric Research
Consortium)● Regionally distributed practices● Medical community leaders
Trends over time: CPRG at Large
0
50
100
150
200
250
300
350
400
450
500O
ct 6
-12,
200
3 (3
prov
ider
s/ 1
95vi
sits
)
Oct
13-
19, 2
003
(7pr
ovid
ers/
627
visi
ts)
Oct
20-
26, 2
003
(6pr
ovid
ers/
519
visi
ts)
Oct
27-
Nov
2, 2
003
(4 p
rovi
ders
/ 345
visi
ts)
Nov
3-9,
2003
(5pr
ovid
ers/
168
visi
ts)
Nov
10-1
6, 2
003
(8pr
ovid
ers/
620
visi
ts)
Nov
17-2
3, 2
003
7pro
vide
rs/6
80vi
sits
)
Nov
24-3
0, 2
003
(8pr
ovid
ers/
650
visi
ts)
Dec
1-7,
200
3 (7
prov
ider
s/ 8
00vi
sits
)
n/10
00
FeverRashBlisterMyalgiasEarPainSoreThroatRhinorrheaCoughHemoptysisRespiratoryDistressVomitingDiarrheaAbdominalPainParesthesiasSeizuresHeadacheDysuriaUrinary Frequency
Symptom Surveillance—Unique Features● Bidirectional communication between
providers and public health officials● Portal for educating providers to
facilitate timely translation of research into practice
● Symptoms vs. diagnoses● Community-based providers● Pediatric focus● Interactive graphical output
Symptom Surveillance—Provider Motivation● Involvement in ongoing research● Immediate data feedback● Access to public health officials● Office staff rewards● Modest financial remuneration
Symptom Surveillance—Health Department Participation● Regular review/analysis of data● Notices, bulletins to providers● Investigations as needed● Restrained use of alert function to
maintain effectiveness● Governing boards
Health Department Communications
Symptom Surveillance—Relevance to Everyday Practice● Answers the commonly posed
question, “What’s going around?”● More timely detection of naturally
occurring outbreaks● Rapid targeted information source
Symptom Complex Data
0
50
100
150
200
250
300
350
400
Oct
6-1
2, 2
003
(3pr
ovid
ers/
195
vis
its)
Oct
13-
19, 2
003
(7pr
ovid
ers/
627
vis
its)
Oct
20-
26, 2
003
(6pr
ovid
ers/
519
vis
its)
Oct
27-
Nov
2, 2
003
(4pr
ovid
ers/
345
vis
its)
Nov
3-9,
2003
(5pr
ovid
ers/
168
vis
its)
Nov
10-1
6, 2
003
(8pr
ovid
ers/
620
vis
its)
Nov
17-2
3, 2
003
(7p
rovi
ders
/680
vis
its)
Nov
24-3
0, 2
003
(8pr
ovid
ers/
650
vis
its)
Dec
1-7
, 200
3 (7
prov
ider
s/ 8
00 v
isits
)
n/10
00 p
atie
nt v
isits
0
20
40
60
80
100
120
140
160
180
200
raw
num
ber o
f con
firm
ed in
fluen
za c
ases
Fever with rhinnorhea,cough, headache, ormyalgias
Fever and Sore Throat
Sore throat, rhinorrhea,cough, headache
Fever and Rash
Ear Pain
Vomiting and Diarrhea
Confirmed Influenza
Symptom Surveillance—Future Expansion● Expansion
throughout Ohio via Health Departments and sister PBRNs
● Mapping feature with automated analysis
● Improved community provider penetration
Symptom Surveillance—Future Expansion
● Daily data entry ● Phone triage data collection● Automated analysis of
claims/billing data● Automated linkage to
corresponding lab data● Improved informational resources
Symptom Surveillance—Other Uses● Discussion of research and
preliminary findings● Network/Hospital/Health
Department news briefs● Shared practice management tools● Links to information resources● Meeting reminders● Event announcements