... for our health Lessons Learned During 24 Years of Practice-Based Research with WREN Paul D....

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. . . for our health Lessons Learned During 24 Years of Practice- Based Research with WREN Paul D. Smith, MD, Professor University of Wisconsin Department of Family Medicine [email protected] d by the University of Wisconsin Institute for Clinical and Translational Research (UW hrough an NIH Clinical and Translational Science Award (CTSA), grant number 1 UL1 RR02

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Page 1: ... for our health Lessons Learned During 24 Years of Practice-Based Research with WREN Paul D. Smith, MD, Professor University of Wisconsin Department.

. . . for our health

Lessons Learned During 24 Years of Practice-Based Research with WREN

Paul D. Smith, MD, ProfessorUniversity of Wisconsin

Department of Family [email protected]

Supported by the University of Wisconsin Institute for Clinical and Translational Research (UW ICTR), funded through an NIH Clinical and Translational Science Award (CTSA), grant number 1 UL1 RR025011

Page 2: ... for our health Lessons Learned During 24 Years of Practice-Based Research with WREN Paul D. Smith, MD, Professor University of Wisconsin Department.

Topics Today

• WREN description

• Research support model

• Recruitment methods

Page 3: ... for our health Lessons Learned During 24 Years of Practice-Based Research with WREN Paul D. Smith, MD, Professor University of Wisconsin Department.

Topics Today

• Business model

• Lessons learned

• Keys to success

Page 4: ... for our health Lessons Learned During 24 Years of Practice-Based Research with WREN Paul D. Smith, MD, Professor University of Wisconsin Department.

Why WREN?

Most biomedical research in the US during

past 50 years has been conducted at

about 200 tertiary care centers that

provide specialized care and conduct

research with highly selected patients.

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WREN Research is done here

1000 people

113 people (76.3%)

1 person (1.2%)

General Population

PrimaryCare

Academic Medical Centers

Adapted from Green L et al. N Engl J Med 2001;344:2021-2025

Most research is done here

Page 6: ... for our health Lessons Learned During 24 Years of Practice-Based Research with WREN Paul D. Smith, MD, Professor University of Wisconsin Department.

What is WREN?

• Founded in 1987

• Program of the University of Wisconsin

Department of Family Medicine

• Clinical Translational Science Award

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What is WREN?

• Primary care clinicians and researchers

• State wide

• Annual budget ~ $450,000

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What is WREN?

• Primary interest in improving care of patients

▪Conducting practice-based research

▪Quality improvement projects

▪Education

▪ Impact

Page 9: ... for our health Lessons Learned During 24 Years of Practice-Based Research with WREN Paul D. Smith, MD, Professor University of Wisconsin Department.

WREN Clinicians

• About 160 members

• About 130 clinicians

• 44 Communities

• 21 different health care organizations

• 13 different UW Health clinics

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WREN

• Individual clinicians VS entire practices

• “Full Support Practice”

▪Clinician champion

▪Practice liaison

▪Contract

▪$10,000/year for ~ 20% FTE

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WREN Full Support Practices

• Milwaukee

▪Aurora Medical Group

▪Milwaukee Health Services

• Mauston

• Tomah

• Richland Center

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Eau Claire

Madison

Tomah

Mauston

Dubuque

WREN full support clinic

WREN individual clinician site

WREN Practices

Milwaukee

Green Bay

Wausau

Richland Center

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WREN Steering Committee

• 11 members

• 1 MCW member

• 4 general members, not

affiliated with a University

• Sets WREN priorities

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WREN Advisory Committee

• Purpose: ▪Make recommendations to the Steering

Committee regarding overall direction, policy and procedure changes.

▪Advocate for Wisconsin citizens in general in regards to WREN activities.

▪Advocate for WREN to the general public and potential funders.

Page 15: ... for our health Lessons Learned During 24 Years of Practice-Based Research with WREN Paul D. Smith, MD, Professor University of Wisconsin Department.

WREN Staff

• Paul Smith, Director

• Mike Grasmick, Network Coordinator

• Veronica Harper, administrative assistant

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WREN Staff - RRCs

• Regional Research Coordinators

▪Peggy O’Halloran Eau

Claire

▪Mark Remiker Madison

▪Kate Judge Madison

▪Hannah Louks Milwaukee

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Questions?

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WREN Research Support Model

• Central WREN staff

• Principal Investigators

▪WREN Clinicians

▪Non-WREN collaborators

Page 19: ... for our health Lessons Learned During 24 Years of Practice-Based Research with WREN Paul D. Smith, MD, Professor University of Wisconsin Department.

Regional Research Coordinator

• Develop ongoing working relationships

• Assess clinic capacity to conduct research

• Technical assistance/training for practice staff

• Assure adherence to protocols

Page 20: ... for our health Lessons Learned During 24 Years of Practice-Based Research with WREN Paul D. Smith, MD, Professor University of Wisconsin Department.

RRCs

• Two way communication

• Share best practices/problem solve

• Assist with chart review and patient recruitment

Page 21: ... for our health Lessons Learned During 24 Years of Practice-Based Research with WREN Paul D. Smith, MD, Professor University of Wisconsin Department.

Types of WREN Projects

• Translational Research

• Dissemination/QI

• Projects that (will) directly impact patient care

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WREN Projects

• A variety of clinical topics

▪ Asthma treatment

▪ Cancer screening

▪ Heart disease prevention

▪ Evaluation of dyspepsia

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WREN Projects

▪ Office radiography use

▪ Health literacy

▪ Number of problems per encounter

▪ Office visit complexity

▪ Infectious disease reporting

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Current Projects

• Trust in Health Care

• Collaborating with pharmacist to improve

asthma care

• Testing an internet chronic kidney disease

management tool

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Current Projects

• Meditation as adjunct to usual care for

treatment of alcohol addiction

• Improving care of the elderly

• Facilitating improvement in CKD care

▪ 3 year AHRQ funded intervention studies

Page 26: ... for our health Lessons Learned During 24 Years of Practice-Based Research with WREN Paul D. Smith, MD, Professor University of Wisconsin Department.

Questions?

Page 27: ... for our health Lessons Learned During 24 Years of Practice-Based Research with WREN Paul D. Smith, MD, Professor University of Wisconsin Department.

Recruitment Methods

• Practices

• Clinicians

• Patients

▪At clinics- front desk, nurse, doctor

▪EHR + Mail (opt out) + phone

Page 28: ... for our health Lessons Learned During 24 Years of Practice-Based Research with WREN Paul D. Smith, MD, Professor University of Wisconsin Department.

Business Model

• Infrastructure funding + grants

• Investing in a relationship

• Don’t give it away (often)

▪ “Are you working for free? – don’t!”

Page 29: ... for our health Lessons Learned During 24 Years of Practice-Based Research with WREN Paul D. Smith, MD, Professor University of Wisconsin Department.

Business Model

• Know what it costs to do your work

▪ Calculate hours and double

• Justify the supervisor’s work in your

grant budget

• Identify and avoid “scope creep”

Page 30: ... for our health Lessons Learned During 24 Years of Practice-Based Research with WREN Paul D. Smith, MD, Professor University of Wisconsin Department.

Business Model

• Talk about money early

• Transparency with all partners

• Open process

• Share data (e.g., salary, % effort)

• Negotiate using collaborative process

• Be willing to walk away

▪ Money’s not right, project’s not right

Page 31: ... for our health Lessons Learned During 24 Years of Practice-Based Research with WREN Paul D. Smith, MD, Professor University of Wisconsin Department.

Business Model

• Market your network

▪ How are you uniquely positioned for research?

▪ What type (topics) of research does your network do?

▪ Reach out to PIs and people that can refer PIs to you

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Business Model

• Get your name out there

▪ Website

▪ Newsletter

▪ Presentations

▪ Publications

Page 33: ... for our health Lessons Learned During 24 Years of Practice-Based Research with WREN Paul D. Smith, MD, Professor University of Wisconsin Department.

Questions?

Page 34: ... for our health Lessons Learned During 24 Years of Practice-Based Research with WREN Paul D. Smith, MD, Professor University of Wisconsin Department.

Lessons Learned- the Hard Way

• Don’t give it away

• Be very clear about expectations and

responsibilities

• Talk about money early

• Ask, you might just get what you want

Page 35: ... for our health Lessons Learned During 24 Years of Practice-Based Research with WREN Paul D. Smith, MD, Professor University of Wisconsin Department.

Lessons Learned

• Be careful what you ask for, you might just get it.

• Slow growth is less stressful than rapid growth

• Plan for sustainability with multiple funding

sources

• Plan for leadership succession

Page 36: ... for our health Lessons Learned During 24 Years of Practice-Based Research with WREN Paul D. Smith, MD, Professor University of Wisconsin Department.

Keys to Success

• Research question that matters

• Minimal burden on clinicians

• Enough to do to maintain interest,

but not too much

Page 37: ... for our health Lessons Learned During 24 Years of Practice-Based Research with WREN Paul D. Smith, MD, Professor University of Wisconsin Department.

Keys to Success

• Effective communication

• Two way feedback with clinics

• Involvement of clinics and WREN staff

Page 38: ... for our health Lessons Learned During 24 Years of Practice-Based Research with WREN Paul D. Smith, MD, Professor University of Wisconsin Department.

Keys to Success

• Adequate funding for projects

• Infrastructure funding

• Have a business model

Page 39: ... for our health Lessons Learned During 24 Years of Practice-Based Research with WREN Paul D. Smith, MD, Professor University of Wisconsin Department.

For More Information

• www.wren.wisc.edu

• [email protected]

Page 40: ... for our health Lessons Learned During 24 Years of Practice-Based Research with WREN Paul D. Smith, MD, Professor University of Wisconsin Department.

Questions?

Page 41: ... for our health Lessons Learned During 24 Years of Practice-Based Research with WREN Paul D. Smith, MD, Professor University of Wisconsin Department.

. . . for our health


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