Implementation Laboratory

执行实验室项目摘要 OCHIN基于实践的研究网络（PBRN）由20个国家的500多个社区卫生中心（CHC）组成。 各州将作为实施研究的实施实验室， 传播以缩小差距并实现癌症控制中心（BRIDGE-C2）的公平。OCHIN PBRN 拥有全国最大的CHC网络，共享中央托管的电子健康记录（EHR）， 研究人员，质量改进教练和信息学家团队能够支持一个大的投资组合， 传播和实施研究。OCHIN的成员社区卫生中心为服务不足的人提供护理 近260万患者，其中62%来自收入<联邦收入138%的家庭。 在贫困水平，49%的人有医疗保险，21%的人没有保险。OCHIN托管CHC的共享EHR， 并建立了一个集中的数据仓库，其中包括所有患者的纵向数据元素， 这些CHC。BRIDGE-C2中心的实施实验室将利用和增强强大的 OCHIN PBRN（目标1a），由一名实施科学家领导，并由一个多学科团队提供支持（目标1a 1 b）。实施实验室将让来自500多个CHC实践的利益相关者参与研究， 协调向社区卫生中心传播新知识（目标2）。实验室将建立数据库 管理股建立和维护一个数据仓库，支持桥-C2中心的工作， 协调数据共享和监管要求，确保数据质量和协调，并与 癌症控制联盟实施科学中心的其他实验室， 影响采用癌症筛查和预防的常见数据元素和指标定义 循证干预（目标3）。化验所亦会设立执业监察组， 确定关键癌症筛查和预防差异，以在未来的研究中实现目标， 不断监测旨在加强执行《公约》的战略的进展和可持续性， 在社区卫生中心采取循证干预措施（目标4）。实施实验室将建立在 创建OCHIN PBRN的工作。实验室实践的多样性（例如，农村/城市，大/小， 不同的地理区域），并纳入针对弱势群体的专门方案 加强了研究结果与许多不同CHC环境相关的可能性。此外，我们的能力， 为BRIDGE-C2中心的研究选择一个多样化的实践样本， 执行战略和支助战略将推广到许多其他初级保健网络。因此 实施实验室已做好准备与中心合作，迎接推进的重大挑战 实施科学，以改善缺医少药人群的癌症筛查和预防。

IMPLEMENTATION LABORATORY PROJECT SUMMARY The OCHIN practice-based research network (PBRN) of >500 community health centers (CHCs) across 20 states will serve as the Implementation Laboratory for the Building Research in Implementation and Dissemination to close Gaps and achieve Equity in Cancer Control (BRIDGE-C2) Center. The OCHIN PBRN has the nation's largest network of CHCs sharing a centrally-hosted electronic health record (EHR), and a team of researchers, quality improvement coaches, and informaticists capable of supporting a large portfolio of dissemination and implementation research studies. OCHIN's member CHCs provide care for an underserved population of nearly 2.6 million patients, of whom 62% are from households earning <138% of the federal poverty level, 49% are insured by Medicaid, and 21% are uninsured. OCHIN hosts the CHCs' shared EHR, and has built a centralized data warehouse that includes longitudinal data elements for all patients across these CHCs. The BRIDGE-C2 Center's Implementation Laboratory will leverage and enhance the robust OCHIN PBRN (Aim 1a) and be led by an implementation scientist, supported by a multi-disciplinary team (Aim 1b). The Implementation Laboratory will engage stakeholders from the >500 CHC practices in research and coordinate dissemination of new knowledge to CHCs (Aim 2). The Laboratory will establish a Data Management Unit to build and maintain a data warehouse that supports the work of the BRIDGE-C2 Center, coordinate data sharing and regulatory requirements, ensure data quality and harmonization, and liaise with other laboratories across the Implementation Science Centers for Cancer Control consortium to develop common data elements and metric definitions that impact adoption of cancer screening and prevention evidence-based interventions (Aim 3). The Laboratory will also establish a Practice Surveillance Unit to enable identification of critical cancer screening and prevention disparities to target in future research, and rapidly and continuously monitor the progress and sustainability of strategies designed to enhance the implementation of evidence-based interventions in CHCs (Aim 4). The Implementation Laboratory will build on the foundational work that created the OCHIN PBRN. The diversity of practices in the Laboratory (e.g., rural/urban, large/small, different geographic regions) and the inclusion of specialized programs for vulnerable subpopulations strengthens the likelihood that findings will be relevant to many different CHC settings. Further, our ability to select a diverse sample of practices for BRIDGE-C2 Center research studies will enable the development of implementation strategies and support strategies to be spread to many other primary care networks. Thus, the Implementation Laboratory is well-poised to work with the Center to take on the grand challenge of advancing implementation science to improve cancer screening and prevention in underserved populations.