Recently I heard a talk by Tom Clark, CEO of the Metro Denver Economic Development Corporation, about their efforts over the last 25 years to improve the economic climate in metro Denver. Those of you who are long-time Denver residents (as I am) are aware of many of the changes in our area, but perhaps not how many of them have been fostered by the MDEDC: reducing air pollution (from a time in the 80's when Denver was the second most polluted city in the US); building two new sports stadiums; revitalizing Lower Downtown Denver (LoDo); building a light rail system; a new airport; and others. These efforts involved coordinating nine county governments and 70 municipalities, each with its own elected leadership. The challenge was to change the culture from one of competition, where communities would compete to host new businesses, to one of cooperation, where each group was willing to forego short-term economic advantages in order to achieve larger, long-term benefit. In other words, the MDEDC had to persuade groups to collaborate in an environment where it couldn't control them.

Sounds like network-based research, doesn't it?

Mr. Clark had some advice for networks and their leaders that applies pretty well to us in research networks:

1. Organize ourselves the way our customers see us rather than the way we see ourselves.
    
2. Mistrust is a key barrier to collaboration; find ways to keep each other informed.
    
3. Don't get out in front of the network members and persuade them to follow; stand behind them and encourage them in the right direction.
    
4. Words matter. Talk about the network as a whole, not the individual entities. Always take the regional (network. enterprise) perspective.
    
5. Develop networks within your network (e.g. networks of mayors, cultural/arts organizations, transit, airport, etc for MDEDC). Each of these networks must have leaders elected by its members (not imposed from "above").
    
6. Develop appreciation of one member for another (e.g. help suburbs appreciate the assets of the center city)
    
7. Listen and include stakeholders, and then act with intention.
    
8. Develop a code of ethics and live by it.
    
9. Create a culture of custom, not regulation.
    
10. Publicly recognize entities that act on behalf of others (e.g. a city that directs a business that it can't support to another city in the region)
     
11. Enlarge the tent - you get your say, not necessarily your way.
     
12. Be curious - look outside your own network for answers. Don't be insular.
     
13. Create an environment where people feel safe enough to take risks, and stand behind them when they do.
     
14. Be vigilant about giving credit, not about asking for it.

You may or may not agree with all of these points, but it's an inspiring and humbling list to me. These ideals are hard to live up to. One way of summarizing this might be - if you want to be an agent of change, act on the behalf of interests larger than your own. And when you lead, lead by example.

As we enter a new era of research when fewer and fewer research studies will be based on members, data, or investigators from a single site, we need to learn how to live in, and lead in, collaborative networks. I think the IHR is off to a good start. We get lots of recognition for being good collaborators. These ideas can help keep us on the path.

John

John F. Steiner, MD, MPH
Senior Director

In an exceptionally tough environment for research funding, 2013 was another strong year for the IHR.  Our researchers sustained a diverse portfolio of extramural and KP-supported research activities to achieve the IHR’s mission of conducting research that can be translated into clinical practice, health promotion, and policies to influence the health of individuals and populations.  Although total funding of $21.5 million represents a slight decrease from the all-time peak in 2012, much of this is due to the end of American Recovery and Reinvestment Act (ARRA) research projects late in the year. A significant component of this trend is a decrease in revenue for subawards, since the largest ARRA grants involved collaboration with multiple research sites across the U.S.  In addition to an ongoing focus on externally-funded research in 2014, the IHR will continue to work closely with KP Colorado to conduct research of relevance to operations, carry out pilot projects/programs, and help KP fulfill its mission to provide high-quality, affordable health care services to improve the health of our members and the communities we serve.

Dr. Matthew Daley was appointed Chair of the Vaccine Advisory Committee for Colorado (VACC). The purpose of this committee is to provide advice and guidance on vaccine-related matters to the Colorado Department of Public Health and Environment (CDPHE), particularly in support of the Immunization Section at CDPHE.

Dr. David Price is Chair-elect of the American Association of Medical Colleges Committee on Continuing Education and Improvement, Dr. Price also completed a brief visiting professorship at the University of Toronto School of Medicine (Department of Continuous Professional Development) in May.

Dr. Matthew Daley presented “Leveraging Community and Population Health Efforts: A Close Look at Colorado’s Collaborative Efforts to Identify and Target Prevention Efforts and Interventions” at the Alliance of Community Health Plans/Trust for America’s Health.  Webinar, Denver, Colorado, October 15, 2013.

Dr. Daley also presented “Data governance challenges and opportunities for health services research,” delivered at the AcademyHealth Research Meeting, June, 2013.

Dr. Arne Beck presented “Implementing High Performing Well Child Care within A Large HMO” at University of Colorado Denver CRISP D&I Workshop Training, Aurora, Colorado, October 2013.

Dr. Beck also presented “The Evolution of Integrated Care at Kaiser Permanente Colorado: Challenges and Opportunities” at the Collaborative Family Healthcare Association 15th Annual Conference, Denver, October 2013.

Dr. Beck presented “Patient-Reported Outcomes for Mental Health Services: Current Practice and Future Possibilities” at Patient Reported Outcomes (PRO) Infrastructure Workshop, Atlanta, GA, November, 2013.

Dr. David Price presented at the Implementation Science Symposium, Association of American Medical Colleges Annual Meeting/Society for Academic CME Fall Meeting, Philadelphia PA, November 3, 2013.

Dr. Price led the workshop: Effecting and Studying Change and Healthcare Improvement through Continuing Education, Professional Development, and Lifelong Learning. Society for Academic CME Research Workshop, Philadelphia PA, November 4, 2013.
He also gave the Keynote Presentation:  Effecting and Studying Change & Healthcare Improvement through Continuing Education, Professional Development, and Lifelong Learning.  Association of American Medical Colleges Annual Meeting/Society for Academic CME Fall Meeting, Philadelphia PA, November 2, 2013.

Dr. Price was the Moderator of the Kaiser Permanente National Education-Simulation Summit, Oakland, CA, April 25, 2013.

Dr. Price also presented “Interprofessional Education….Everybody’s Talking About It – How Do You Do It?” at the  Robert Wood Johnson Foundation Alumni Network National Webinar, April 26, 2013, as well as “Pearls and Sage Advice on Assessment and Evaluation: Ask the Experts” at the Alliance for Continuing Education in the Health Professions Annual Meeting, San Francisco, CA, January 31, 2013.

Lisa Harner and Elena Kuo (of Group Health's Center for Community Health and Evaluation) presented at the 2013 Kaiser Permanente Community Health Initiatives (CHI) Academy on "Using ‘Dose’ Methodology to Estimate Impact of LIVEWell Colorado Community Initiatives”.  November 13-14, San Francisco, CA.

Betsy Nugent, Senior Manager of Clinical Trials, presented a seminar, "The Truth is In The Data: A Systems Approach to Quality in Clinical Trials" at the MAGI West Annual Conference, October 2013 in Las Vegas and also "Metrics for Site Management" at the SOCRA Conference in New Orleans September 2013.

Debrah Ritzwoller PhD gave lectures on Economic Evaluations within D& I Research
at the NIH, OBSSR, & VA sponsored 2013 Training Institute for Dissemination and Implementation Research in Health, June 3-7, 2013, Washington University, St. Louis, MO.

Dr. Ritzwoller was an invited Participant at the NCI-sponsored Provocative Questions Workshop, “Identifying Perplexing Problems to Drive Progress Against Cancer,” May 29, 2013, Bethesda, MA. 

Dr. Ritzwoller presented “Cancer Research Conducted at Kaiser Permanente Using Tumor Registry Data,” Colorado Cancer Registrars Association Fall Education Meeting. September 27th, 2013, Denver, CO

Dr. Ritzwoller also presented “Economic Studies in D&I Research,” at the D&I Training Workshop sponsored by the Center for Research in Implementation Science and Prevention (CRISP),  October 13, 2013, University of Colorado, Denver, Denver, CO

Dr. Ritzwoller presented “Treatment Costs of Advanced Cancer: Variation in Costs for Stage IV vs. Recurrent Breast, Colorectal, Lung, and Prostate Cancers” at the poster presentations at the AcademyHealth 2013 Annual Research Meeting, June 23, 2013 Baltimore, MD.

The Institute for Health Research at Kaiser Permanente of Colorado is delighted to be hosting the 2014 HMORN conference, to be held in Phoenix, AZ on April 1-3. This marks the 20th anniversary of the conference, and we think the conference theme, Embedded Research to Improve Health, will help highlight the ways in which our research has improved the health and well being of the members of the delivery systems where our research centers are based. Our network is unique in its dual commitment to conducting research that benefits both our members and the broader community, and examples of this work will be a major focus of our 2014 Annual Meeting. We hope you will join us from start to finish of the 2014 HMORN conference in Phoenix, and look forward to seeing you there. Click here for the HMORN website and additional conference information.

David Magid published a study involving a Pharmacist-led home blood pressure monitoring intervention that demonstrated increased blood pressure control and improved Kaiser Permanente member satisfaction. (PM:23821085)

In a study led by Marsha Raebel, 77% of patients who were chronic opioid users before undergoing bariatric surgery continued chronic opioid use in the year following surgery, and the amount of chronic opioid use was greater postoperatively than preoperatively. (PM:24084922)

Heather Feigelson published a study investigating factors associated with the use of total mastectomy for the management of breast cancer. The results suggest that additional evaluation of patient understanding of surgical options and outcomes in breast cancer and the impact of the surgeon provider is warranted.
(PM:23490543)

Jason Glanz and his team found that undervaccinated children were more likely to contract pertussis. (PM:24019039)

Liz Bayliss led a study that found most patients with poor-prognosis cancers in KPCO continued statin treatment. It was unclear whether continuing statins prescribed for secondary prevention affects cardiovascular outcomes There may be an opportunity to reevaluate medication burden in persons taking statins for primary prevention. (PM:23305190)

Emily Schroeder, Liz Bayliss, and John Steiner in a publication pending in Women’s Health Issues found evidence that in cases of incident diabetes, men and women had important differences in risk factor control at the time of diabetes diagnosis. These differences varied by age and decreased over time.

Lisa Harner was awarded the “Blood, Sweat and Tears” award at the 2013 Kaiser Permanente Community Health Initiatives (CHI) Academy in San Francisco.  Lisa lightheartedly describes this as an “award for someone involved in CB's Community Health Initiative work that puts forth a strong effort to get the job done, overcoming obstacles, above and beyond type attitude. People are nominated for awards which are voted on by peers. Nothing earth shattering - but a wonderful, and much appreciated recognition nonetheless.”  Way to go, Lisa!

Check out the 2013 IHR publications by clicking here!