Accelerating TRIP in a Practice-Based Research Network

实践伙伴电子病历(EMR)的供应商医生微系统公司(PMSI)正在与其附属研究网络实践伙伴研究网络(PPRNet)合作提交这一申请。PPRNet是一个由在25个州执业的初级卫生保健提供者和来自3所大学的学术研究人员组成的联盟。申请中提出的示范项目的目的是扩大PPRNet在初级保健实践中提高质量的成功方法，该方法在一个正在进行的项目中得到验证，该项目是AHRQ将研究转化为实践(TRIP)II倡议的一部分(授予第1号U18 HS 11132-01)。拟议的项目将涉及优先条件和改进的实践准则。 在最近的医学研究所(IOM)报告和2010年健康人活动中倡导的方法。该项目的目标将是在8个临床领域批准遵守73项实践指南。这些领域是：心脏病和中风、糖尿病、癌症筛查、免疫接种、呼吸系统疾病/传染病、精神健康和药物滥用、营养和肥胖，以及老年人的药物处方。 该项目将在100个以社区为基础的初级保健实践中采用多种方法干预，照顾多达100万名患者，旨在帮助他们采用多组成部分的质量改进模式。干预基于公认的TRIP理论，包括三个主要组成部分：实践报告、现场访问和网络会议。改进模式结合了团队合作、组织变革、患者激活、个性化和基于人群的医学以及EMR等循证战略。每个PPRNet实践都有相同的EMR，并为质量改进工作共享数据。PPRNet的大型纵向临床信息数据库、基础设施和以实践为基础的质量改进经验为成功实施该项目提供了独特的机会。由于电子病历的使用正在增加，该项目的发现将适用于照顾大多数美国人的初级保健实践。

Physician Micro Systems, Inc. (PMSI), the vendor of the Practice Partner electronic medical record (EMR), is submitting this application in collaboration with its affiliated research network, the Practice Partner Research Network (PPRNet). PPRNet is a consortium of primary health care providers practicing in 25 States and academic researchers from 3 Universities. The purpose of the demonstration project proposed in the application is to expand PPRNet's successful approach to quality improvement in primary care practice, validated in an ongoing project as part of AHRQ's Translating Research into Practice (TRIP) II initiative (Grant No. 1 U18 HS 11132-01). The proposed project will address practice guidelines for priority conditions and improvement approaches advocated in the recent Institute of Medicine (IOM) report and Healthy People 2010 activities. Approved adherence with 73 practice guidelines in eight clinical areas will be the aim of the project. These areas are: heart disease and stroke, diabetes mellitus, cancer screening, immunizations, respiratory disease/infectious disease, mental health and substance abuse, nutrition and obesity, and drug prescribing in the elderly. The project will employ a multi-method intervention in 100 community-based primary care practices caring for up to one million patients, designed to help them adopt a multi-component quality improvement model. The intervention, based on well-accepted theories of TRIP, has three major components: practice reports, site visits, and network meetings. The improvement model incorporates evidence-based strategies of teamwork, organizational change, patient activation, individualized and population-based medicine, and EMR. Each PPRNet practice has the same EMR and share data for quality improvement work. PPRNet's large longitudinal database of clinical information, infrastructure, and experience with practice-based quality improvement provide the unique opportunity to successfully conduct this project. Since EMR use is increasing, this project's findings would be applicable to primary care practices that care for the majority of Americans.