MEMBERSHIP GROWTH

1. HMORN: Growth, Governance & Process Improvement Ella E Thompson, BS; Sarah M Greene, MPH; Eric B Larson, MD, MPH (Group Health Research Institute - Seattle, WA) and John F Steiner, MD, MPH (Kaiser Permanente Institute for Health Research - Denver, CO) BACKGROUND GROWTH PROCESS IMPROVEMENT Vaccine Safety Datalink (CDC) HMORN Cancer Research Network (RN) (NCI) Ed Wagner at NIH-DO Integrated Delivery Systems RN (AHRQ) The number of large and high-profile multi-center projects has expanded substantially over time – as well as the array of research topics under study, as illustrated at left. The evolution of key HMORN infrastructure closely mirrors this growth, including the development of the Virtual Data Warehouse (VDW), an HMORN brand identity, the Collaboration Toolkit, and streamlined HMORN IRB and contracting processes. The Coordinated Clinical Studies Network (CCSN) created non-topic-specific, Network-wide infrastructure for the first time and was a turning point in the evolution of the HMORN. As HMORN assets and success have grown, so too has interest in membership. The HMORN now consists of 19 members, with seven new member sites joining since 2005. Epidemiological Studies of Biologics (CDER) The HMORN has made significant improvement to multi-center IRB review and contracting processes. However, the rapid growth of the HMORN intensifies the need to improve additional processes affecting collaboration. RAISING AWARENESS OF THE HMORN While an assortment of descriptive materials and tables exist, these have been developed opportunistically and are updated sporadically, often in response to a request for a presentation on the HMORN or its capabilities. A coordinated communication plan has not been developed for the HMORN. VETTING NEW PARTNERSHIPS AND PROPOSALS While it is unrealistic that an individual point-of-contact at a single site could be fully familiar with the availability and interests of researchers across all 19 HMORN sites, a central contact person could be supported by a ‘behind the scenes’ network of well-informed site contacts. In addition, tools to better capture and catalogue faculty interests, and collaboration connections could be especially useful. ORIENTING NEW MEMBERS AND PARTNER ORGANIZATIONS When new organizations join the HMORN they must be integrated into administrative and governance processes, and connections between researchers must be fostered. In addition, this integration must be bidirectional. That is, existing members must learn about the new members, just as the new members learn about the HMORN – scientifically, technically, interpersonally and administratively. Similar orientation processes are needed for non-member organizations looking to form new HMORN partnerships. The HMO Research Network (HMORN) is a virtual organization with formalized structures and processes to both facilitate new and support existing research collaborations. As the size and success of the HMORN and the breadth of research associated with it have grown in recent years, governance and operations have become more complex. This poster summarizes HMORN growth and complexity over time, mapping significant infrastructure and governance milestones over its lifetime; relates best practices for network governance to HMORN Governing Board actions to improve executive functioning; and briefly presents a gap analysis of three HMORN operational processes. Centers for Education and Research in Therapeutics, including CERTs Coordinating Center (AHRQ) National Bioterrorism Surveillance Program (CDC) Coordinated Clinical Studies Network (NIH) Developing Evidence to Inform Decisions about Effectiveness (ARHQ) Pharmacogenomics RN (NHGRI/NIGMS) Cardiovascular Research Network (CVRN) (NHLBI) LARGEST HMORN CONSORTIUM PROJECTS SEARCH1 (NCI) CVRNSurvll2(NCI) Rx Exposure in Pregnancy (FDA) Collab3 Mini Sentinel (FDA) ACTION II4 (AHRQ) MentalHealthRN(NIMH) 2012 SUPREME DM5 (AHRQ) SPAN for CER6 (AHRQ) 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 METHODS Existing documentation relating to HMORN projects and milestones was compiled from multiple sources to construct a timeline illustrating HMORN growth and critical infrastructure development. Additional content was drawn from activities of HMORN governance committees, and from two reports prepared by the HMORN Collaboratory Supplement Team: Coordinating Center Governance Model Analysis: Facilitators and Barriers to Success. Conceptual analysis drawing from semi-structured interviews with leaders of five complex coordinating centers.  HMORN Administrative Processes Affecting the Efficiency and Effectiveness of Collaboration with External Researchers: A Gap Analysis. Analysis of present and desired states of HMORN processes, and summary of barriers, actions needed, and proposed metrics. GOVERNANCE Asset Stewardship Committee Infrastructure financing model Executive Committee Governing Board Shared mission & values Bylaws Shared vision & aims GOVERNANCE Attendance exceeds 300 Attendance exceeds 200 Attendance exceeds 500 1stHMORN conferencePortland, OR The HMORN’s rising national prominence, growing membership, and expanding research assets have led to an increased need for Network-wide coordination and management. To address these needs, in 2011 the Asset Stewardship Committee’s work was refocused on developing a broader array of tools to make research studies more efficient and congruent. In 2012 an Executive Committee was launched to enhance the Board’s ability to be nimble and efficient, and respond to time-sensitive issues. The Executive Committee is also charged with guiding the strategic vision of the HMORN and strategic planning activities are now underway. An Executive Committee that is trusted by the larger group can drive the goals and agenda, prioritize activities, and proactively tee up important issues for discussion. Factors enabling effective executive functioning include clearly documented processes for final decision-making; trusted and admired leaders with excellent leadership and diplomacy skills; and a high degree of engagement by members of the full governing body along with a demonstrated commitment to the success of the enterprise. ANNUAL CONFERENCE Virtual Data Warehouse VDW ‘version 3’ VDW Operations Committee (VOC) COMMON DATA MODEL HMORN website Member Resources, HMORN logo Listservs, newsletter FOAs page News page, SIGs, webinars KEY HMORN INFRASTRUCTURE DEVELOPMENTS WEBSITE & COMMUNICATIONS SOP for IRB ceding process data only studies SOP for IRB ceding process expanded all non-FDA regulated IRB REVIEW PROCESS CONCLUSIONS HMORN Templates Templates refreshed The size and number of HMORN-based research networks has increased. While newer projects have benefited from prior knowledge and experience, increased trust, and tools designed to streamline project operations, the need for more agile governance and stronger HMORN-wide coordinating functions is clear. These findings will inform the next evolutionary phase of the HMORN. CONTRACTING PROCESS ACKNOWLEGEMENTS GHRI, HFHS, HPHC, HPRF, KPCO, KPGA, KPHI, KPNC, KPNW, and KPSC MPCI LCF S&W, MCRF GHS MHS EIRH, KPMA, PAMFRI MEMBERSHIP GROWTH 1 SEARCH: Screening Effectiveness and Research in Community-Based Healthcare (NCI-ARRA) 2 Development of a Cardiovascular Surveillance System in the Cardiovascular Research Network (NHLBI-ARRA) 3 Cancer Research Network Administrative Supplement: Development of an HMO Research Network Collaboratory (NCI / NIH-OD) 4 Accelerating Change and Transformation in Organizations and Networks II (ARHQ) 5 Surveillance, Prevention, and Management of Diabetes Mellitus (AHRQ-ARRA) 6 Scalable Partnering Network for Comparative Effectiveness Research (AHRQ) Cancer Research Network Administrative Supplement: Developing an HMORN Collaboratory. National Cancer Institute Award No. 3-U19-CA-079689 – 12S.