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

2. 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

4. 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

6. Alliance Research Infrastructure

7. Community-driven research platform Infrastructure to link urban and rural community sites through common technology platform

8. 10/11/2015 Overview Alliance: 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)

9. Current Research Projects Project TitleFunderTime PeriodStudy Partners Improving HIV/AIDS quality through HIT AHRQ2007-2009Alliance (HB, HHO) HRET A Partnership for Clinician EHR Use and Quality of Care AHRQ2007-2010Alliance (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 AMA2008-2009Alliance (HB, HHO) American Medical Association UPQUALAHRQ2008-2010Alliance (Erie, Near North) Northwestern University Health Information Exchange (HIE) Planning Grant HRSA2008-2009Alliance (Erie, Near North) NMH/NU REACH Network GrantsNU CTSA grant2008 - ongoingAlliance (HIHC, Erie) Northwestern University

10. 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.

11. 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

12. 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

13. 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%

14. Survey Results HIGHLIGHTS: Currently involved in research? n=15  Yes – 60%  No – 40% Major sources of research funding? n=8  Government Agency (eg, AHRQ, CDC) – 63%  Private National Foundation – 50%  Private Local Foundation – 50% Research relationship with academic center? n=14  Yes – 57%  No – 43%

15. Survey Results HIGHLIGHTS: Does your health center have a federally negotiated indirect rate? n=14  Yes – 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=14  Yes – 71%  No – 29%

16. 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

17. Thank You Fred Rachman, MD frachman@alliancechicago.org Erin Kaleba ekaleba@alliancechicago.org