FQHC Collaborative Research – What Fits your Organization?

1. FQHC Collaborative Research –What Fits your Organization? By: Dale B. Fiedler Corporate Director of Planning and Development & Director of Southern Illinois Practice Based Research Organization

2. Presentation Outline Presentation Outline The Journey into Research The Research Continuum & A Strategy for Entry

3. SIHF Legal Structures • SIHF: Southern Illinois Healthcare Foundation (SIHF) • Private, not-for-profit, 501(C) (3) Corporation • Section 330 Community Health Center (Federally Qualified Health Center) • TRH: Touchette Regional Hospital • Private, not-for-profit, 501(C) (3) Corporation • Controlled affiliate of SIHF • Touchette Elderly Apartments I & II • These are two independent Private, not-for-profit, 501(C) (3) Corporations • Archview Economic Development Corporation • Private, not-for-profit, 501(C) (3) Corporation • IHEP (Illinois Health Exchange Partners) • Private Limited Liability Corporation

4. Subcontracts • Regional Extension Center subcontract for 41 counties • Subcontract with ILMCHC to develop a coalition of entities enrolling persons into the Affordable Care Act • Contract with IL Children’s Healthcare Foundation to plan a regional system to care for the oral health needs of special needs children.

5. SIHF Region

6. Perceptions in 2004 • Research = Dollars • Organizational Prestige • We can do this • Improve patient outcomes

7. Process • Promote PromotePromote • Practice Based Research Networks • www.pbrn.ahrq.gov • Southern Illinois University School of Medicine • Three years financial support • Extensive Consultation • Surveyed SIHF providers • Completed grant applications

8. Southern Illinois Practice Research Organization (SIPRO) • SIPRO Outcomes • Obtained Federal Wide Assurance FWA • www.hhs.gov/ohrp/assurances/filasurt.html • Statement of Values developed and Committee review process for any research at SIHF • Capacity Building Collaboration • Literature review publication in the American Family Physician • Challenge for FQHC Clinician to become PI • Pharmacists and midlevel staff are engaged in research / practice improvement activities

9. Promoting a Culture of Inquiry • Practice-based research is predicated on the idea that knowledge for improved health care delivery lay undiscovered within the clinical setting itself; it awaits discovery by those who need it most – by practicing clinicians. • PBRNs provide a supportive infrastructure within which research can be conducted, and from which research results can be translated directly into practice.

10. Promoting a Culture of Inquiry cont • Can improve clinicians knowledge of specific problems they see in their practices • Adds a level of inquiry to clinician practice; a slightly different thought process • Promote recruitment and retention • Adds value to the CHC’s mission • Provides opportunity for diverse underserved patients to be included

11. Continuum of Expertise Active Passive Model 1 Model 2 Model 3 Model 4 Model 5 Model 6 Technical research expertise resides in FQHC Technical research expertise resides in university and is developed in FQHC Technical research expertise resides in university/PBRN Technical research expertise resides in university/PBRN Technical research expertise resides in university & in FQHC Technical research expertise resides in university/PBRN

12. Continuum of Engagement Active Passive Model 1 Model 2 Model 3 Model 4 Model 5 Model 6 Universities/PBRN’s use FQHC’s patients in university's research FQHC Not “engaged” Vast majority of FQHC involvement today FQHC support staff trained in recruitment of study subjects (engaged) FQHC understands research and costs; actively negotiates with researchers and favorably positions FQHC Nursing and support staff may have CITI training. Capacity development of FQHC clinicians Major commitment of clinician time FQHC clinicians are the PI. FQHC administers research grants FQHC clinician input sought. Collaboration during study development to assure appropriate fit with FQHC operations FQHC engaged

13. & FQHC Passive

14. Active

15. A Process for Model 4

16. Where do we go from here? • Assess Your Clinicians’ Interest (Actual) • Develop Strategy • Collaborate with PBRNs (If interests match) • HCCNs • Other groups of CHCs • Individual approach

17. Thank You • Dale B. Fiedler • dfiedler@sihf.org • (618) 332 - 0694