HHS grants target community-based care

Washington -- Medical teams that recently received grants from the government said the money will allow them to improve clinical outcomes among low-income and underinsured populations.

The awards, announced Sept. 1 by the Dept. of Health and Human Services through the Health Resources and Services Administration, will help establish a network of patient-centered outcomes research.

Fenway Health Center in Boston said its nearly $2 million award, which came from economic stimulus package funding, will go toward supporting two community health centers it helps oversee in Baltimore and rural South Carolina. Those centers will be able to coordinate with researchers at the University of Washington to develop electronic medical data systems that will extract and better assimilate recorded data. The data ultimately should make it easier for physicians to do their jobs.

In Fenway's case, the new capture systems will better help primary care services for patients with HIV.

"The community-based research [awards] are the latest example of the Obama administration's recognition that community health centers are the logical focus for patient care improvement efforts, using innovations in electronic medical informatics to prompt and educate providers to ensure that their clinical practices utilize state-of-the-art knowledge in order to optimize clinical services," said Kenneth H. Mayer, MD, professor of medicine at The Warren Alpert Medical School of Brown University in Rhode Island and medical research director at Fenway.

Dr. Mayer said the grant award will help further develop the electronic medical record system and better review the cases of people living with HIV, one of Fenway's core populations. The center will collaborate with community-based physicians and academic researchers to implement a comparative effectiveness model that it ultimately hopes will bolster treatment and care.

A research network

Five grants will go to organizations in four states to create the Community Health Applied Research Network to demonstrate that safety net providers and academic institutions can partner to create an effective infrastructure. CHARN consists of a coordinating center, based at the Kaiser Foundation Hospitals' Center for Health Research in Portland, Ore., and four networks selected as research "nodes" in California, Illinois, Massachusetts and Oregon. The nodes, according to HHS, are a geographically dispersed consortia of safety net providers in 17 states.

Three of the four research nodes will focus on patient-centered outcomes research related to the delivery of primary care, and the fourth (Fenway) will focus on HIV/AIDS research.

A $3.5 million grant will be awarded to Columbia University in New York to support patient-centered outcomes research within the Pediatric Emergency Care Applied Research Network. These funds will help boost data capacity and disseminate information on research findings involving pediatric emergency care.

In addition, $3.5 million will go to the American Academy of Pediatrics in Elk Grove Village, Ill., to support development of an electronic medical record subnetwork within PECARN. Researchers there coordinate with 750 practices, about a quarter of which use EMR systems, though not necessarily of the same variety.

"Right now, we're in a situation where the information doesn't all run on the same track," said Richard Wasserman, MD, MPH, the project's principal investigator and director of pediatric research in office settings at the University of Vermont College of Medicine. "Our grant money will be used to standardize some of the electronic elements and help bolster comparative effectiveness research."

The awards will help better leverage data quality and ultimately improve primary care services for low-income and underinsured populations, said Susan Chauvie, RN, chief clinical officer for the Oregon Community Health Information Network. The group oversees operations at 36 community health organizations in six states.

By improving its data quality and data acquisition capabilities, OCHIN ultimately will be able to better understand the unique health care needs and services required by low-income and underinsured populations in its safety net system, Chauvie said.

"Our goal is to engage in and generate community-based comparative effectiveness research in an improved fashion," she said.

Dr. Wasserman said this is an example where stimulus money is just being realized and will improve medical care down the road. "In the long run, this is an investment that will improve the nation's care."