Clinical Research Oriented Workshop (CROW) Meeting: Jan 29, 2009

Present: Matt Bovee, Kairn Kelley, Amanda Kennedy, Rodger Kessler, Connie van Eeghen
Absent: Abby Crocker, Kim Dittus, Liz Chen, Charlie MacLean, Ben Littenberg, Maria Ramos, Alan Rubin

1. Start up: Some morning whininess about the distractions found in working from home, contacting health care systems, snowshoeing in Vermont, and why we live here

2. Roundtable, with update, short term goals, long term goals

a. Rodger: Update on survey planned for the 600-1000 patient centered medical homes that are certified by NCQA. There is also a collaborative of Fortune 500 companies whose purpose is to govern/advise/think about PCMHs. About 15 months ago this group decided to focus on mental health/substance abuse; Rodger is a part of this effort. The group is diverse, with supporters and critics. Add to this, there is no accepted construct, evaluative model, or metrics related to the PCMH and mental health/substance abuse. It has taken awhile to support doing a survey just to find out what is actually happening. Rodger is looking for feedback on the Research Question and how the survey questions reflect the Research Question.
i. Survey purpose: describe the functions of PCMH related to mental health/substance abuse
ii. Research Question
1. In those practices that have been certified by NCQA, how do they respond to the presentation of mental health/substance abuse (mh/sa) issues.
2. Technical questions: significance of level of certification, process for screening, protocols, communication, QI, satisfaction
iii. Administration of survey
1. No further review of survey expected by sponsoring agency, but may happen
2. Will be reviewed next by the research group in Colorado
3. Research design is expected to include randomized interviews, but this is not fully known now. NCQA wants an initial review and report by early June.
4. Created from a set of domains identified previously by an AFP report; not from a validated source. Will be tested on a small group of individuals before wide-spread distribution and will be overseen by a survey specialist.
5. Respondents will be single representatives from each practice (one per practice)
6. Expected to be two pages long max
7. Consider administering at a national conference for the target population
iv. Funding: first phase is 40K to launch survey. There are no other efforts like this that Rodger knows of.
v. Survey questions:
1. There may be easier, more reliable ways to answer factual questions like NCQA certification
2. Looking ahead five years; what might you need to have to compare to in the future? Ask the respondents to measure now and predict in the future.
3. Look carefully at the primary research question; consider holding back on secondaries.
4. Design the one open-ended question to give you rich, qualitative data that relates directly to the research question
5. Consider flow:
a. Easy/demographic
b. Open-ended before structured questions (or after)
c. Structured/scaled questions

3. Next Fellows Meeting(s): Jan 29, 2009 from 9:30 – 11:00 a.m., at Given Courtyard Level 4
a. Feb 5: Connie’s next IRB application; Rodger’s 2nd version of his survey
b. Feb 12: Matt’s update (no Rodger or Kairn)
c. Feb 19: Peter Callas on data entry of results; no Connie
d. Feb 26: ???
e. Mar 5: Workshop self-assessment (students and faculty scholars only)
f. Future agenda to consider:
i. Future book club assignment: Atul Gawande’s “The Checklist Manifesto” (go to www.audible.com for downloadable copy)
ii. Skype demo: Connie & Matt? Wait until Amanda K is back. Or do twice?
iii. 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)
iv. Future: Informed consent QI: Connie to follow up with Nancy Stalnaker, Alan Rubin will follow up with Alan Wortheimer or Rob McCauly

4. Fellows document – nothing new this time

Recorder: Connie van Eeghen