partnerships

Grand Rounds October 10, 2025: Integrating the BeatPain Study With PRaCTICe, a New Network Research Hub of the CARE for Health Initiative (Julie M. Fritz, PhD, PT, FAPTA; Sebastian Tong, MD, MPH)

Posted on by Sophia Ramirez

Speakers

Julie M. Fritz, PhD, PT, FAPTA
Distinguished Professor
Department of Physical Therapy & Athletic Training University of Utah

Sebastian Tong, MD, MPH
Associate Professor
University of Washington

Keywords

Engagement; Community-Engaged Research; Rural; Pain; Partnership

Key Points

  • In an assessment of 10 high-income nations, the United States ranked 10th in healthcare system performance despite maintaining a significant lead in terms of healthcare spending.
  • The capacity of clinical research to improve healthcare is limited by a lack of representation. Patients who are older; live in rural locations; are uninsured; have co-morbid conditions; belong to minority groups; and are more likely to receive non-standard treatment are all inadequately represented in trials.
  • The NIH CARE for Health Initiative seeks to address these interrelated challenges. It will develop infrastructure for a clinical research network focused on primary care (PC); establish a foundation for sustained engagement with underrepresented communities; implement innovative study designs; integrate research into routine PC without increasing the burden on providers; and facilitate the adoption of evidence-based research findings.
  • CARE for Health is based in 6 national research hubs. One is the Primary Care Rural and Frontier Clinical Trials Innovation Center (PRaCTICe), a research network partnering with 300 PC practices serving 7 underrepresented population across Oregon, Washington, Wyoming, Alaska, Montana, and Idaho.
  • PRaCTICe utilizes a continuum of community engagement, from outreach to shared leadership. Engagement strategies have included community needs assessment reviews, regional listening sessions, and a new study development process that involves co-designing studies with PRaCTICe partners.
  • In 2024, BeatPain – a pragmatic, decentralized, NIH Collaboratory Trial – was selected as 1 of 2 trials PRaCTICe would partner with during Year 1. By the presentation date, PRaCTICe had referred 165 patients to the BeatPain team, 95% of which were rural residents.
  • Rural populations simultaneously have higher incidence of chronic pain and are less likely to receive evidence-based, nonpharmacologic treatment for it. BeatPain seeks to serve this population by delivering physical therapy (PT) to federally qualified health center patients with lower back pain.
  • Over the course of their collaboration with PRaCTICe, BeatPain investigators have made strides in terms of localizing the study to partnering communities, building trust with referring providers and patients, and coordinating the end of the trial. Decentralized trial methods hold promise for engaging rural residents and clinics in clinical research.

Discussion Themes

Relationships between research staff and a variety of clinic staff were critical to effective engagement. In one example provided by Dr. Tong, staff helped identify which exercises were most effective when it came to getting providers interested in the referral process. Clinics were not passive recipients, but co-developers.

To deliver PT in a rural setting, the BeatPain team delivered a virtual intervention combining traditional PT, health coaching, motivational interviewing, and pain coping strategies. In some care processes, the hands-on component of PT is essential; less so for chronic pain. Strategic use of technology could expand access to nonpharmacologic care.

Research teams will need to be responsive to shifts in the capacity of rural hospitals and clinics due to funding cuts. This may look like designing interventions that don’t increase the burden on staff; supplying resources; and sharing strategies that clinics can use to be financially sustainable.

IT support proved central to the success of this partnered research. When clinic resources are constrained, the ability to help solve problems related to the electronic health record is essential.

Grand Rounds October 4, 2024: Health Trends Across Communities – A Novel Health System-Public Health Data Partnership (Tyler Winkelman, MD, MSc; David Johnson, MPH)

Posted on by Sophia Ramirez

Speakers

Tyler Winkelman, MD, MSc
Division Director, General Internal Medicine
Hennepin Healthcare
Co-Director, Health, Homelessness, and Criminal Justice Lab
HHRI

David Johnson, MPH
Health Informatics and Epidemiology
Program Manager
Hennepin County

Keywords

Electronic Health Record; Data Sharing; Public Health; Health Systems; Partnerships

Key Points

  • Collaboration across public health and health care is essential to developing actionable data for both sectors. Electronic Health Record (EHR) data can be used to fill the gaps in public health data and foster collaboration.
  • During the COVID-19 pandemic, it became clear that data infrastructure in the U.S. was underdeveloped. This made addressing COVID-19 challenging, is currently making addressing the overdose crisis challenging, and puts the country at risk for any future epidemics.
  • The Minnesota EHR Consortium (MNEHRC), formed in March 2020, facilitated collaboration between health systems in order to address gaps in COVID-19 data sharing and communication. They were able to develop the technical infrastructure to aggregate and share EHR data for real-time public health needs. Over time, the prioritization of data sharing for developing broader community health indicators became possible.
  • MNEHRC’s mission is to improve health by informing policy and practice through data-driven collaboration among members of Minnesota’s health care community. Dashboards are publicly available at www.mnehrconsortium.org.
  • Dr. Winkelman described how they built out a common data model at each of the MNEHRC health systems using Observational Medical Outcomes Partnership (OMOP), a common language for EHR data. OMOP was chosen because it’s open-source; it has a robust international online community; and some sites in the state had experience with OMOP, which helped with capacity building.
  • MNEHRC and Hennepin County’s Center for Community Health partnered to build Health Trends Across Communities (HTAC-MN), a unique data collaboration of health systems and public health agencies. They seek to develop comprehensive community health data infrastructure in Minnesota, ultimately strengthening community capacity to build healthy communities and promoting health equity.
  • Next steps for HTAC include developing and implementing processes to identify and prioritize new conditions; evaluating HTAC; and developing a plan for long-term sustainability.

Discussion Themes

Developing a central data model facilitated the collaboration.

Onboarding Federally Qualified Health Centers (FQHCs) to the consortium takes longer because of their internal capacity restraints. The team has had to be creative with figuring out how to onboard them; they are adding FQHCs in Hennepin County through EPIC affiliate agreements with Hennepin Healthcare and other sites through Minnesota’s quality measurement agency.

This is a new tool with a lot of potential, especially for the field of public health; researchers could use it to measure the impact of large-scale public health interventions. The HTAC team hopes that they’ll be able to further define the value that the data source can offer over the next few years.