PBRN CONFERENCE A SUCCESS

Frank deGruy

doi:10.1370/afm.1458

On June 21-22, 2012, NAPCRG tried something new. It worked. On these dates NAPCRG held its first annual practice-based research network (PBRN) conference. This meeting was supported by a conference grant from AHRQ, who has a longstanding interest in PBRN work, and who, until now had put on an annual PBRN conference. This meeting therefore represents a new, formal relationship with AHRQ, a new annual meeting for NAPCRG, and a chance to work with a whole new set of scientists, educators, and clinicians who care about practice-based research. Over 200 registrants attended the conference, from 6 countries. Japan! Romania! Brazil! Australia! And 30 investigators from Canada! Under NAPCRG's stewardship, this conference could well become—most likely will become—a world forum for PBRN work. Moreover, a broad range of disciplines were represented, including family medicine, general internal medicine, pediatrics, nursing, public health, dentistry, pharmacy, psychology, and social work.

All of this is good, but the real news has to do with how PBRNs are evolving. For 3 decades, practice-based research networks have been a core resource in the primary care research armamentarium, and a preferred platform for describing practices and clinical conditions, as well as for testing clinical interventions. At this PBRN meeting we heard about:

Networks of networks linked together with elegant, efficient, lean infrastructures to answer difficult clinical or services questions
Very large networks of practices linked together by their electronic health records. Some of these networks are large enough to tackle detailed comparative effectiveness trials
Hybrid PBRN/CBPR networks that incorporate community resources, community boards, and deep community partnerships. These networks can test interventions that make use of public health, community health, and primary care resources
PBRNs whose datasets are linked to very large administrative datasets, or claims datasets, that can produce complete services data
PBRNs that cut across disciplines (eg, primary care, public health, dentistry, behavioral health) to address health and heath care issues that occur across these multiple sectors
Multinational PBRNs that take nesting to a whole higher level—that afford comparisons of similar clinical conditions in different systems of care
PBRNs that are taking on questions of practice redesign and system change, and are proving useful even with the sophisticated designs required of quality improvement efforts, during which interventions are continuously evolving; and
PBRNs that are used as platforms for disseminating innovations and keeping practitioners close to practice improvement research

Two additional highlights of this meeting merit mention: the 2 plenaries. The first was delivered by Joe Selby, Executive Director of PCORI, who described how well suited PBRNs are to addressing patient-centered outcomes research. The second was a panel discussion presented by Larry Green, Jon Kerner, Jim Mold, and Jack Westfall, who discussed the intersection of public health and primary care, and how PBRNs have begun to address this interface as it applies to cancer prevention, asthma control, and health and health care extension in a statewide network.

During an all-attendees evaluation and suggestion session at the conclusion of the conference, participants strongly endorsed this conference as a standing event, and suggested that we should consider expanding the international participation, deepening the interprofessional conversation, fostering additional opportunities for funders and researchers to engage with one another, continuing to explore the innovative ways researchers are designing PBRNs and PBRN studies, offering special events or sessions for PBRN staff, and above all, expanding the venues at which research results could be showcased.

Practice-based research networks have come of age, and are now capable of answering difficult, complex, and important questions. This conference demonstrated that to good effect. At the end of the conference, NAPCRG's Board of Directors concluded as much and recommended that efforts begin immediately to seek support and plan improvements for next year's PBRN conference.