# Presentation: 221811

## PBRNS AND COMMUNITY COLLABORATIVESTHE NEW YORK EXPERIENCE

- CHET FOX MD (UNYNET)
- SHELLEY HIRSHBERG
-  (P2 COLLABORATIVE)
- STEVEN SZEBENYI MD, MMM
- (FOUNDATION FOR HEALTHY LIVING
- and CAP-AD PBRN)

## WHY COLLABORATE?

- Collaboration is making abundance out of scarcity. (Kurt Stange MD-PhD)
- Common mission of PBRN and community organizations is rapidly improving patient care
- Shared infrastructure and expertise
- Attractive to funders to have multiple stakeholders and a wide geographic involved in a project together

## Outline

- Past Successes: The Western NY CKD task force
- Present projects: The P2 collaborative; Foundation for Healthy Living and Cap-Ad PBRN
- Future Developments: The UNYCHRQ in partnership with the University of Rochester CTSA grant
- Regional PBRN (EMPIRENET) encompassing Albany, Syracuse, Rochester and Buffalo

## Western NY CKD Task Force

- Collaborators:
- UNYNET
- Niagara Health Quality Coalition
- Academic and Practicing Nephrologists
- Western New York Kidney Foundation
- Successes:
- Annual CKD symposium for PCP
- First 8 county region in the country to automatically report GFR
- All Major HMOs adopted a single evidence based guideline and care advisory letter for CKD
- Abstract at National Leadership Forum at NIH Inventory and Evaluation of Clinical Research Networks

## P2 COLLABORATIVE OF WNY

- Community  Consumers
- Employers
***Promote Healthy Lifestyles***

-           Providers
***      ***
***         ******Implement Medical  ***
***             ******Best Practices***

-             Healthcare Delivery 	      System
-         Health Plans
-         Hospitals
-         Ancillary Facilities
**            **

-  A
- Healthy
-   Community
***  ***
***  ******Health  Status         Feedback***

**     **

**        ****	****	****	****	**

## Slide 6

## P2 COLLABORATIVE OF WNYRWJF Aligning Forces for Quality (AF4Q)

-         Consumers        **Promote Healthy Lifestyles**
***Concept Mapping***
***“******Know Your Numbers”   ***
***      ******Campaign***
***Study Circles***

-       Providers
***  *****Implement Medical*****  ***
***       *****Best Practices**
**                  ****&**
**   ****Public Reporting of Quality**
**         *****Collaborative    ***
***             ******Learning Groups***

-                  Health Plans
-           **Provider & Consumer Incentives**
**        *****Quality Measures & Incentives***
*                  **** ******P******2 ******Club******           ***

-        Consumers –
-    Providers
-   A
-    Healthy
-   Community
***   *****Health  Status*****                   Feedback***
** **
***   ******Annual Conference***

**     **

- Consumers -
- Health Plans**	****	****	**

-     Providers -
-  Health Plans

## P2 COLLABORATIVE OF WNYRWJF Aligning Forces for Quality (AF4Q)

## Slide 9

## Our health care system was built in silos, leading to fragmentation, redundancy and inefficiency...

***...******collaboration****** breaks down the silo mentality.***

## The “Roadmap” is Not a Line

- Basic
- Science

- Community

- Population,
- Public Health,
- Health Services
- and Policy
- Research

- Data
- Bases

- Practice

- Clinical
- Trials

- Translation

- Translation

- Translation

- Translation

_**The “Roadmap” is Not a Line**_

- C
- O
- O
- R
- D
- I
- N
- A
- T
- I
- O
- N

- C
- O
- O
- R
- D
- I
- N
- A
- T
- I
- O
- N

- Dissemination
- and
- Reimbursement

## The Foundation for Healthy Living mission is to increase and disseminate knowledge about health care and improve the health of our communities (by building collaborations and partnerships).

http://www.foundationforhealthyliving.org

***The Foundation for Healthy Living mission is to increase and disseminate knowledge about health care and improve the health of our communities****** ******(by building collaborations and partnerships)******.***
***http://www.foundationforhealthyliving.org***

**Notes:**
HISTORY:
Incorp May 17,  2002
501(c)3 public charity, in Sept 2002  
AFFILIATED with HealthNow New York Inc.
Fully operational in 2005

MISSION: 
The Foundation for Healthy Living mission is to increase and disseminate knowledge about health care and improve the health of our communities.

## Capital-Adirondack PBRN

**CAP-AD** founded in 2004: 87 practices - 406 providers – >500k lives
- Affiliated organizations: SUNY Albany-SPH, Area Health Education Center, Upper Hudson Primary Care Consortium
- Affiliated with the National Research Network 2/2007
- Affiliated with **UNYNET** in 2006 (60/125/228k)
**Regional PBRN of New York**** ** Spring 2007 – more than ***one million*** primary care patients across NYS

**CAP-AD**

**UNYNET**

**ROCH**

**SYR**

**CAP-AD (future)**

**Notes:**
Let’s move into talking about Cap-Ad. 
Cap-Ad started with 14 original members that included  Hudson Headwaters Health Network and Hometown Health.  St. Clare’s Family Health Center joined last Fall and CapitalCare Health Centers came on board this summer. And we have interest from several other physician groups.
Now if all the practices that were represented in this room today joined the network, it would include over 70 practices and over 400 providers which if you think about it, gives Cap-Ad the potential to impact over a half million lives. 
Cap-Ad is also affiliated with academic and community based organizations including...

## Slide 14

**Notes:**
Evolved from the Center for Translation of Research into Practice (in brochure and on web)

A result of a three-year grant from HealthNow New York Inc. aimed at creating partnerships among academic centers across Upstate NY

The goal is to make Upstate NY competitive for medical research dollars with the rest of the country, by creating an efficient research consortium whose members represent a large and diverse investigator pool and patient population.

## UNYCHRQ and TRN GOALS

**Expand clinical, health services and policy research in New York by harnassing the power of “one”**
**Slash the delay in getting evidence-based care to patients by supporting translational research**
**Create an information infrastructure which promotes sharing of research and clinical data**
**Contribute to economic growth in Upstate NY**

_**UNYCHRQ and TRN GOALS**_

**Notes:**
Roster of participating organizations is still growing but includes”

All 4 Upstate med schools
Both Schools of Public Health
Both schools of Pharmacy
Two schools of Nursing
NYSDOH (affiliate)
Ordway Research Institute
Two PBRNs (affiliate)

## UNYCHRQ and TRN

_**UNYCHRQ and TRN**_

## UNYCHRQ and TRN Milestones

**UNYCHRQ created in 2006 with FHL as “neutral” sponsoring organization**
**Received subcontract from the CTSI at University of Rochester Medical Center for creation and integration of TRN **
**Established a streamlined multi-site IRB review process**
**Released first RFA (2007) to fund collaborative pilot studies**
**Began work on a Consortium-wide web-searchable investigator and resource database – target 09/07**

- _UNYCHRQ and TRN Milestones_

**Notes:**
Roster of participating organizations is still growing but includes”

All 4 Upstate med schools
Both Schools of Public Health
Both schools of Pharmacy
Two schools of Nursing
NYSDOH (affiliate)
Ordway Research Institute
Two PBRNs (affiliate)

## Future Plans

**Several institutions waiting to join UNYCHRQ**
**Develop link between Regional PBRN of New York and CTSI funding**
**Begin creation of a clinical database project**
**Pursue funding opportunities with state legislature and industry**

- _Future Plans_

***Regional PBRN***
***Of New York***

***URMC CTSI***

**Notes:**
Roster of participating organizations is still growing but includes”

All 4 Upstate med schools
Both Schools of Public Health
Both schools of Pharmacy
Two schools of Nursing
NYSDOH (affiliate)
Ordway Research Institute
Two PBRNs (affiliate)

## Lessons Learned

**Collaboration is hard work - dedicate a  lot of time to relationship and trust building**
**Seek a common value statement**
**Get the right people; then communicate, communicate, communicate**
**Try to find or create a “neutral” home**
**Go after low hanging fruit early**
**It helps to have some money**