# Practice-based research network

A practice-based research network (PBRN) is a group of practices devoted principally to the care of patients and affiliated for the purpose of examining the health care processes that occur in practices. PBRNs are characterized by an organizational framework that transcends a single practice or study. They provide a "laboratory" for studying broad populations of patients and care providers in community-based settings.

## History of primary care research

Before there were research institutes or networks of practices, individual practitioners studied their patients' problems with scientific rigor. Among these were five general practitioners who have been recognized for their seminal work during the past 125 years. They are James Mackenzie, Will Pickles, John Fry, F.J.A. Huygen and Curtis G. Hames. Each of these pioneers demonstrated that important new knowledge could be discovered by practicing family physicians. More recently, practicing primary care pediatricians such as Burtis Breese and William Carey contributed a body of knowledge on child health. These doctors all wondered about their patients' problems and they developed a means of gathering and recording data on their patients.
Each of these research pioneers provide inspiration for the development of practice-based, primary care research networks because each demonstrated that important new knowledge could be discovered by the practicing primary care physician. They each wondered about their patients, developed means of gathering and recording data, and found collaborators and support from their staff and local communities. Unfortunately, they practiced in an era that was over-committed to specialism. Research focused on molecular mechanisms of disease. The rush to specialization by the medical community and the linking of research to specialists resulted in decades of neglect of primary care and virtually no recognition of the need to investigate care in the primary care setting. Instead, the common wisdom viewed primary care practices as relatively boring places that could be potential sites of application of the fruits of research done elsewhere in research laboratories, hospitals and institutes.
Among the early regional networks started in the 1970s were the Dartmouth CO-OP PBRN in New Hampshire, Family Medicine Information System in Colorado (FMIS) and the Cooperative Information Project. These regional networks learned from each other and succeeded in conducting studies focused on what was happening in primary care. They attracted funding from medical schools, national philanthropic foundations and federal programs such as Health for Underserved Rural Areas. As the 1970s closed, these early networks enjoyed sufficient success to stimulate debate about the next steps in the context of the microcomputer's development. Among them was a small group convened by Gene Farley in Denver in 1978 to consider establishing a national sentinel practice system. It was this idea that lead to the Ambulatory Sentinel Practice Network and provided in retrospect what appears to have been a nidus for the establishment of primary care PBRNs in the United States. In the 1980s, pediatric research networks - the Pediatric Practice Research Group (PPRG) in metropolitan Chicago and the national Pediatric Research in Office Settings (PROS) network of the American Academy of Pediatrics - emerged as well.
PBRNs are feasible and that represent a useful infrastructure for the scientific discovery of family practice and primary care. Experience to date points out the great advantages enjoyed by those with enduring, core financial support—such as the Dutch with their early national commitment to primary care and their willingness to invest in primary care research. It is also obvious that these networks require collaboration, cooperation and a spirit of sharing and trust.
These networks are now at once both a place and a concept. As a place, they are a laboratory for surveillance and research. As a concept, they express the still unmet need for practicing primary care clinicians to accept responsibility to improve frontline clinical care by understanding what is happening in their practices. Successes to date have been sufficient to incite the Institute of Medicine's 1994 committee studying the future of primary care to recommend support to stabilize and expand practice-based primary care research networks.

## Currently active

* AAFP NRN – AAFP National Research Network Kansas
* AANPNR – American Academy of Nurse Practitioners Network for Research Texas
* ACCESSPBRN – ACCESSPBRN Illinois
* ACCP PBRN – American College of Clinical Pharmacy Practice-Based Research Network Kansas
* ACERN – Ambulatory Care Evaluation and Research Network New York
* ACORN – Virginia Ambulatory Care Outcomes Research Network Virginia
* ACPNet – ACPNet Pennsylvania
* APBRN – Alabama Practice Based Research Network Alabama
* A-PBRN - Ayurveda Practice Based Research Network United Kingdom
* APN-ARC – Advanced Practice Nurse-Ambulatory Research Consortium Ohio
* APPD LEARN – Association of Pediatric Program Directors Longitudinal Educational Assessment Research Network Virginia
* ARCHNAP St. Louis Ambulatory Care Research Consortium for Nurses in Advanced Practice Missouri
* AT-PBRN – Athletic Training Practice-Based Research Network Arizona
* ATSU SOMA PBRN – A.T. Still University School of Osteopathic Medicine in Arizona PBRN Arizona
* AppNET – The Appalachian Research Network Tennessee
* ArkPBRN – Arkansas Practice Based Research Network Arkansas
* BIGHORN – Building Investigative Practices for Better Health Outcomes Colorado
* BWPC PBRN – Brigham and Women's Primary Care Practice-Based Research Network Massachusetts
* BraveNet – The Bravewell Integrative Medicine Research Network North Carolina
* C-AHEAD PBRN – Center for the Advancement of Healthcare Education and Delivery PBRN Colorado
* CAARN - Community-Academic Aging Research Network (UW-Madison)
* CAPRICORN – Capital Area Primary Care Research Network District of Columbia
* CARinG Network – Cincinnati Area Research Group Network Ohio
* CCPC – Connecticut Center for Primary Care Connecticut
* CDN – Clinical Directors Network, Inc. New York
* COCONet – Colorado Child Outcomes Network Colorado
* CORC – CAMHS Outcomes Research Consortium UK
* CONCORD-PBRN – Consortium for Collaborative Osteopathic Research Development Practice-Based Research Network Texas
* CORNET – Continuity Research Network Virginia
* CPNet – Community Physician's Network Georgia
* CSPC – Centre for Studies in Primary Care
* CSRN – CLEAR Scoliosis Research Network Texas
* CaReNet – Colorado Research Network Colorado
* Cedars-Sinai PBRN-Cedars-Sinai Medical Delivery Network PBRN California
* CenTexNet – Central Texas Primary Care Research Network Texas
* DC PrimCare PBRN – District of Columbia Primary Care Practice-Based Research Network District of Columbia
* DO-Touch.NET – Doctors of Osteopathic Medicine Treating with OMM: Usefulness in Current Healthcare Missouri
* DesertNet – DesertNet Arizona Primary Care Research Network Arizona
* E-CARE – Eastern Carolina Association for Research & Education North Carolina
* EBD-PBRN – Evidence-Based Decisions in Dentistry Practice-Based Research Network California
* EPICnet – Eastern Pennsylvania Inquiry Collaborative Network Pennsylvania
* GR-PBRN – Greater Rochester Practice Research Network New York
* GRIN – Great Lakes Research Into Practice Network Michigan
* HCH PBRN – Health Care for the Homeless Practice Based Research Network Tennessee
* HHR – Holistic Healthcare and Research Centre
* HPRN – High Plains Research Network Colorado
* HamesNet – HamesNet Georgia
* Healthy Communities – Physicians of Southwest Washington Foundation for Quality Improvement Washington
* ICPA PBRN – International Chiropractic Pediatric Association PBRN Pennsylvania
* IDND – Indianapolis Discovery Network for Dementia Indiana
* IFHRN – Institute for Family Health Research Network New York
* IRENE – Iowa Research Network Iowa
* ISRN-RN – Improvement Science Research Network Texas
* JCCCR – Jefferson Coordinating Center for Clinical Research Pennsylvania
* JDPBRN – Dental PBRN Japan
* JHCP-PCRN – Johns Hopkins Community Physicians Primary Care Research Network Maryland
* JaxHERO – Jacksonville Health Equity Research Organization Florida
* KAN – Kentucky Ambulatory Network Kentucky
* LA Net – LA Net Community Health Network California
* LAC DHS ACN-R&I – Los Angeles County Department of Health Services, Ambulatory Care Network – Research & Innovation California
* La MAISON – Louisiana Medical Home Ambulatory Improvements and Outcomes Network Louisiana
* Lutheran Network – Lutheran Family Health Center Network New York
* MAFPRN – Minnesota Academy of Family Physicians Research Network Minnesota
* MAPPR – Mecklenburg Area Partnership for Primary Care Research North Carolina
* MASNRN – Massachusetts School Nurse Research Network Massachusetts
* MCHS PBRN – Mayo Clinic Health System Practice Based Research Network Minnesota
* MGPC-PBRN – Massachusetts General Primary Care Practice Based Research Network Massachusetts
* MPCRN – Military Primary Care Research Network Maryland
* MPPBRN – Minnesota Pharmacy Practice-Based Research Network Minnesota
* MTN – MO Therapy Network Missouri
* MedEdNet – Medical Education Research Network Oregon
* Mercy – Sisters of Mercy Health System Network Missouri
* MetroNet – Metropolitan Detroit Practice-based Research Network Michigan
* National Dental PBRN - National Dental Practice-Based Research Network Alabama
* NC MARCH – North Carolina Multisite Adolescent Research Consortium for Health North Carolina
* NC-FM-RN – North Carolina Family Medicine Research Network North Carolina
* NCCHRN – North Carolina Child Health Research Network North Carolina
* NCnet - Combined PBRNS founded at UNC-Chapel Hill contains NC-FM-RN, NCCHRN, NC MARCH and RCPCrN
* NECF PBRN – New England Clinicians Forum Practice-Based Research Network Connecticut
* NNE CO-OP PCBRN- Northern New England CO-OP Practice & Community Based Research Network (formerly known as the Dartmouth CO-OP PBRN)
* NEON – Northeastern Ohio Network Ohio
* NFPCRN – North Florida Pediatric Community Research Network Florida
* NIPC-PBRN – National Interdisciplinary Primary Care PBRN Iowa
* NJPCRN – New Jersey Primary Care Research Network New Jersey
* NP-PITTNet – NursePractitioner-PITTNet Pennsylvania
* NYC RING – New York City Research & Improvement Networking Group New York
* NYU-HHC CRA – New York University (NYU)-Health and Hospitals Corporation (HHC) Clinical Research Association (CRA) New York
* National Dental PBRN – The National Dental Practice-Based Research Network Alabama
* NetHaven at Yale – NetHaven Practice Based Research Network Connecticut
* NorTex – North Texas Primary Care Practice Based Research Network Texas
* NorthShore PBRN – NorthShore Practice-Based Improvement Research Network Illinois
* Northwest PRECEDENT – Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry Washington
* OCHRN – Oklahoma Child Health Practice Based Research Network Oklahoma
* OKPRN – Oklahoma Physicians Resource/Research Network Oklahoma
* ORPRN – Oregon Rural Practice-based Research Network Oregon
* OPTI-WestNet – OPTI-West Practice-Based Research Network Colorado
* OQUIN – Outpatient Quality Improvement Network South Carolina
* OSU-PCPBRN – Ohio State University Primary Care Practice Based Research Network Ohio
* PAMFRI – Palo Alto Medical Foundation Research Institute California
* PBRN-VA – VA Mental Health Practice-Based Research Network Texas
* PCRC – Duke Primary Care Research Consortium North Carolina
* PDC PBRN – Pediatric Diagnostic Center PBRN California
* PPOC – The Pediatric Physicians' Organization at Children's Massachusetts
* PRN – Portland Research Network Oregon
* PROS – Pediatric Research in Office Settings Illinois
* PSARN – Penn State Ambulatory Research Network Pennsylvania
* PeRC – The Pediatric Research Consortium Pennsylvania
* Pediatric PittNet – Pediatric PittNet: University of Pittsburgh CTSI PBRN Pennsylvania
* RAP – Research Association of Practices of the PBRN Shared Resource Ohio
* RCPCrN – Robeson County Primary Care research Network North Carolina
* REACH Network – Research and Education for Academic Achievement Network Illinois
* RIOS NET – Research Involving Outpatient Settings Network New Mexico
* Rx-SafeNet – Medication Safety Research Network of Indiana Indiana
* SAFTINet – Scalable Architecture for Federated Translational Inquiries Network Colorado
* SALT-Net – The Studying, Acting, Learning, and Teaching Network New York
* SAPPHIRE – South Asian Practice Partnership for Health Improvement and Research New York
* SCOR Network – Slone Center Office-based Research Network Massachusetts
* SCPPRN – South Carolina Pediatric Practice Research Network South Carolina
* SERCN – Southeast Regional Clinicians Network Georgia
* SF Bay CRN – San Francisco Bay Collaborative Research Network California
* SICTRN – Southeastern Integrated Clinical and Translational Research Network Florida
* SIPRO – Southern Illinois Practice Research Organization Illinois
* SOAR-Net – Southwestern Ohio Ambulatory Research Network Ohio
* SPUR-Net – Southern Primary-care Urban Research Network Texas
* SRN – ShowMe Research Network Missouri
* STARNet – South Texas Ambulatory Research Network Texas
* STOHN – South Texas Oral Health Network Texas
* STP PBRN – South Texas Psychiatric Practice-Based Research Network Texas
* SWIRLNet – South West Innovative Research and Learning Network Colorado
* Safety Net West – Safety Net West Oregon
* South Asian PBRN – South Asian PBRN
* Southeast Wisconsin Alliance for Translating Research into Practice – Southeast Wisconsin Alliance for Translating Research into Practice Wisconsin
* TAMHSC-RCHI – Texas A&M Health Science Center Rural and Community Health Institute Texas
* UCLA PCRN – UCLA Primary Care Research Network California
* UMASS-FM-PBRN – UMass Family Medicine PBRN Massachusetts
* UNYNET – Upstate New York Practice Based Research Network New York
* UT Pharm Net – University of Tennessee Pharmacist Practice Based Research Network Tennessee
* UUPCRN – Utah Health Research Network Utah
* VCMCDDCP – Ventura County Medical Center Diabetes Data Control Project Practice Based California
* WPRN – WWAMI Region Practice and Research Network Washington
* WREN – Wisconsin Research and Education Network Wisconsin
* WU PAARC – Washington University Pediatric and Adolescent Ambulatory Research Consortium Missouri
* WesTRN – West Texas Research Network Texas