FQHC Collaborative Research – What Fits your Organization? By: Dale B. Fiedler Corporate Director of Planning and Development & Director of Southern Illinois Practice Based Research Organization

Presentation Outline The Journey into Research The Research Continuum & A Strategy for Entry

SIHF Legal Structures SIHF: Southern Illinois Healthcare Foundation (SIHF) Private, not-for-profit, 501(C) (3) Corporation Section 330 Community Health Center (Federally Qualified Health Center) TRH: Touchette Regional Hospital Private, not-for-profit, 501(C) (3) Corporation Controlled affiliate of SIHF Touchette Elderly Apartments I & II These are two independent Private, not-for-profit, 501(C) (3) Corporations Archview Economic Development Corporation Private, not-for-profit, 501(C) (3) Corporation IHEP (Illinois Health Exchange Partners) Private Limited Liability Corporation

Subcontracts Regional Extension Center subcontract for 41 counties Subcontract with ILMCHC to develop a coalition of entities enrolling persons into the Affordable Care Act Contract with IL Children’s Healthcare Foundation to plan a regional system to care for the oral health needs of special needs children.

SIHF Region

Perceptions in 2004 Research = Dollars Organizational Prestige We can do this Improve patient outcomes

Process Promote Promote Promote Practice Based Research Networks Southern Illinois University School of Medicine Three years financial support Extensive Consultation Surveyed SIHF providers Completed grant applications

Southern Illinois Practice Research Organization (SIPRO) SIPRO Outcomes Obtained Federal Wide Assurance FWA Statement of Values developed and Committee review process for any research at SIHF Capacity Building Collaboration Literature review publication in the American Family Physician Challenge for FQHC Clinician to become PI Pharmacists and midlevel staff are engaged in research / practice improvement activities

Promoting a Culture of Inquiry Practice-based research is predicated on the idea that knowledge for improved health care delivery lay undiscovered within the clinical setting itself; it awaits discovery by those who need it most – by practicing clinicians. PBRNs provide a supportive infrastructure within which research can be conducted, and from which research results can be translated directly into practice.

Promoting a Culture of Inquiry cont Can improve clinicians knowledge of specific problems they see in their practices Adds a level of inquiry to clinician practice; a slightly different thought process Promote recruitment and retention Adds value to the CHC’s mission Provides opportunity for diverse underserved patients to be included

Continuum of Expertise Technical research expertise resides in FQHC Technical research expertise resides in university/ PBRN Passive Model 1Model 2Model 3Model 4Model 5Model 6 Active Technical research expertise resides in university/ PBRN Technical research expertise resides in university & in FQHC Technical research expertise resides in university and is developed in FQHC Technical research expertise resides in university/ PBRN

Continuum of Engagement FQHC clinician input sought. Collaboration during study development to assure appropriate fit with FQHC operations FQHC engaged Passive Model 1Model 2Model 3Model 4Model 5Model 6 Active Universities/ PBRN’s use FQHC’s patients in university's research FQHC Not “engaged” Vast majority of FQHC involvement today FQHC support staff trained in recruitment of study subjects (engaged) FQHC understands research and costs; actively negotiates with researchers and favorably positions FQHC Nursing and support staff may have CITI training. Capacity development of FQHC clinicians Major commitment of clinician time FQHC clinicians are the PI. FQHC administers research grants

& FQHC Passive

Active

A Process for Model 4

Where do we go from here? Assess Your Clinicians’ Interest (Actual) Develop Strategy –Collaborate with PBRNs (If interests match) –HCCNs –Other groups of CHCs –Individual approach

Thank You Dale B. Fiedler (618)