1. Michael Parchman, MD, MPH Walter Calmbach, MD, MPH Marisa Rodriguez, BS UT Health Science Center at San Antonio South Texas Ambulatory Research Network STAR Net

2. What is a Practice-Based Research Network? An organization of community clinicians who work together with researchers to answer meaningful questions that will improve patient care

3. Why is Practice-Based Research Needed?

4. STARNet Leadership Walter Calmbach, MD, Michael Parchman, MD and Marisa Rodriguez Board of Directors Carlos Campos, MD Leo Cigarroa, MD Mitch Finnie, MD Abel Mu ñoz, MD Soloman Paley, MD Ramon Reyes, MD Lloyd Van Winkle, MD

5. The South Texas Ambulatory Research Network (STARNet) MISSION: –to create and disseminate new knowledge for community primary care physicians that will improve the health of our patients here in South Texas OBJECTIVES: –conduct studies and projects in the clinics and communities of STARNet members –link community primary care clinics to resources –create a community of learning among STARNet members and their communities in South Texas STAR Net

6. Where are PBRNs in the Research “Pipeline?” BenchBedsideCommunity Bookshelf “T1” “T2” The Academic Health Science Center:

7. “If we want more evidence- based practice, we need more practice-based evidence.” Green LW and R. Glasgow, 2006

8. Examples of STARNet Studies: Exercise in the Elderly Panic Disorder in Patients Presenting with Chest Pain Patient Preference for Discussion of Family Conflict/Violence Quality and Outcomes of Diabetes Care in Primary Care Settings Improving Risk Factors for Complications of Type 2 Diabetes in Primary Care (current) History and Physical Findings of Patients with MRSA Skin Infections in South Texas (current) Using interactive multimedia to promote colorectal cancer screening (current) Patient Safety survey (current) Electronic primary care research network (current) Aspirin in reducing events in the elderly (current)

10. Identify knowledge gap Systematic search for adequate answer Generate and clarify study question Design Study Collect data Analyze and interpret results Implement in practice Serious input from clinicians and office staff COLLABORATION IS KEY!

13. "I have had only positive comments from patients who are usually excited and pleased to be able to be a part of the studies. Patients don't just cooperate, they are enthusiastic participants. Many of our patients are impressed that their doctor's office is involved in medical research and that they can share in that.” Ramon Reyes, MD Helotes, TX

14. "The projects are interesting and designed to be an asset to the daily practice function. The studies have never been a problem; in fact, they do, on occasion, give rise to questions from patients that lead to important doctor-patient interactions. “ Able Munoz, MD Austin, TX

15. "STARNet is a part of my practice where everyone wins, the patient, the practice, and the specialty of Family Practice. I believe much of the future evidence establishing the value of primary care, in general, and family practice, specifically, will grow out of office-based medical research. So being involved in STARNet is my way of helping to insure a future that includes healthy patients, healthy practices, and a healthy future for family medicine.” Lloyd Van Winkle, MD Castroville, TX

16. What do I need to do to join the network? How can I join a research project?