WReN's Response to Emerging Public Health Threats

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DESCRIPTION (provided by applicant): Background: Practice-based research networks [PBRNs] serve as the essential research laboratories for enhancing the discipline of family medicine and the translation of research findings into everyday medical practice. The Wisconsin Research Network [WReN] is a well recognized and successful, yet presently quiescent, PBRN. This current stagnation comes at a time of leadership transition and identity confusion. Objectives of Category I Project: To reorganize WReN as a self-sustaining PBRN with the following key components: (1) scientific oversight by well-established research teams from two medical schools, (2) information technology to enhance electronic communication and data collection, (3) use of an established clinical data warehouse and a proposed clinician registry to target recruitment of additional practices with priority populations, and (4) expand an existing interface with a highly-successful public health surveillance network, thus creating an ongoing public health monitoring function for WReN. Methods for Category I Project. An annual WReN convocation will be created at which research teams from the University of Wisconsin and the Medical College of Wisconsin will work with WReN clinicians at all stages of research projects to enhance the quality, completion and translation of discipline relevant research. The Wisconsin Academy of Family Physicians will support a portal on their web site for WReN communication and data entry. Data from an annual electronic registration form at this site and the UW Department of Family Medicine's Clinical Data Warehouse will be used to identify potential new WReN practices. Objective of Category II Project: To assess the feasibility and benefits of PBRN interaction with public health surveillance network, to evaluate the PBRN role in detection of, and response to, emerging public health threats, such as acts of bioterrorism. Methods for Category II Project: All WReN clinicians will enroll in the Wisconsin Influenza Surveillance Program. Compliance with the surveillance protocol will be evaluated for each participant over a two-year study period allowing comparison of WReN and non-WReN surveillance clinicians. Retrospective evaluations, based upon billing record/chart review and public health record review, will be conducted to assess whether participation in public health surveillance is associated with improved direct patient care and communication with public health agencies. The rates of influenza immunization in elderly patients (aged 65 and above), rates of erroneous influenza diagnosis, self-reported level of contact with public health agencies, and volume of filing Wisconsin "Acute & Communicable Disease Case Report" forms will be compared to rates of compliance to surveillance protocol. Outcomes: The primary outcomes are enhanced function and efficiency of WReN, with "top-down" and "bottom-up" approaches to primary care research, increased publication of research findings, and submission of grant applications. The role and feasibility of PBRNs in detecting and responding to emerging public health threats will be defined.