Monday, April 4, 2011

Clinical Research Oriented Workshop (CROW) Meeting: March 31, 2011

Present: Rodger Kessler, Ben Littenberg, Charlie MacLean, Connie van Eeghen

1. Check In: All well; it might be spring one of these days

2. Rodger: Preparation for Blueprint Discussion Next One

a. Study question: testing whether money and IT support are sufficient to provide improved health and mental health outcomes in a medical home model

i. This question is intended to frame and “effectiveness” study, not an “efficacy” study

ii. The primary research question is how to achieve high Peek Paradigm Case scores

iii. This is different than the “Diamond” or Impact study of implementing a case management strategy for depression

iv. Discussion of approach: ask for permission to help willing practices already recruited for collaborative care implementation and observe results across all practices

1. Self-selected across all arms; may be

2. Stratify by initial Peek scores and/or MH scores

b. Review of three arms to research design:

i. Participants told to provide mental health to patients cared for in a primary care setting with funds and IT support (self-selected by practice)

ii. Same as (i) above, plus eight hour structured QI facilitation to design and implement a program using process design to plan workflow (randomized)

iii. Same as (ii) above, plus facilitated support to install RK’s Collaborative Care (randomized)

c. Measures :

i. Adherence to the Peek Paradigm Case checklist

ii. Patient outcomes (analyzed by a correlation)

iii. RE-AIM structure

d. Note that implementation of the study is part of the research study in arms (ii) and (iii) above; Ben calls this “fidelity”

e. New language: integrative care instead of collaborative care

3. Rodger: Review of NCQA Survey Results

a. Survey of all NCQA practices from levels 1- 3 primary care in U.S., of which 50% responded

b. Known data not provided yet: practice characteristics, including NCQA certification

c. Discussion of how to use the data, for research and NCQA purposes

4. Next Workshop Meeting(s): Thursday, 2:30 p.m. – 4:00 p.m., at Given Courtyard Level 4

a. April 7: (no Connie or Ben or Charlie; Rodger late)

b. April 14: Rodger: validation of Peek measure (no Connie or Ben)

c. April 21: (no Connie or Rodger)

d. April 28: (no Connie or Rodger)

e. Future agenda to consider:

i. Rodger: Mixed methods article; article on Behavior’s Influence on Medical Conditions (unpublished)

ii. Future: Review of different types of journal articles (lit review, case study, original article, letter to editor…), when each is appropriate, tips on planning/writing (Abby)

Recorder: Connie van Eeghen

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