Transcript Slide 1

HMORN: Growth, Governance & Process Improvement
Ella E Thompson, BS; Sarah M Greene, MPH; Eric B Larson, MD, MPH (Group Health Research Institute - Seattle, WA) and John F Steiner, MD, MPH (Kaiser Permanente Institute for Health Research - Denver, CO)
The HMO Research Network (HMORN) is a virtual organization
with formalized structures and processes to both facilitate new
and support existing research collaborations. As the size and
success of the HMORN and the breadth of research associated
with it have grown in recent years, governance and operations
have become more complex.
This poster summarizes HMORN growth and complexity over
time, mapping significant infrastructure and governance
milestones over its lifetime; relates best practices for network
governance to HMORN Governing Board actions to improve
executive functioning; and briefly presents a gap analysis of
three HMORN operational processes.
GROWTH
HMORN Cancer Research Network (RN) (NCI)
Ed Wagner at
NIH-DO
The number of large and high-profile multi-center projects has
expanded substantially over time – as well as the array of
research topics under study, as illustrated at left.
Epidemiological Studies of Biologics (CDER)
Centers for Education and Research in Therapeutics, including CERTs Coordinating Center (AHRQ)
National Bioterrorism Surveillance Program (CDC)
Coordinated Clinical Studies Network (NIH)
Developing Evidence to Inform Decisions about Effectiveness (ARHQ)
Pharmacogenomics RN (NHGRI/NIGMS)
Cardiovascular Research Network (CVRN) (NHLBI)
SEARCH1 (NCI)
CVRNSurvll2 (NCI)
Rx Exposure in Pregnancy (FDA)
Collab3
Mini Sentinel (FDA)
ACTION II4 (AHRQ)
Mental Health RN(NIMH)
Additional content was drawn from activities of HMORN
governance committees, and from two reports prepared by
the HMORN Collaboratory Supplement Team:
 Coordinating Center Governance Model Analysis:
Facilitators and Barriers to Success. Conceptual analysis
drawing from semi-structured interviews with leaders of five
complex coordinating centers.
 HMORN Administrative Processes Affecting the Efficiency
and Effectiveness of Collaboration with External Researchers:
A Gap Analysis. Analysis of present and desired states of
HMORN processes, and summary of barriers, actions needed,
and proposed metrics.
ACKNOWLEGEMENTS
Cancer Research Network Administrative Supplement:
Developing an HMORN Collaboratory. National Cancer
Institute Award No. 3-U19-CA-079689 – 12S.
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Governing
Board
GOVERNANCE
1st HMORN
KEY HMORN INFRASTRUCTURE DEVELOPMENTS
Existing documentation relating to HMORN projects and
milestones was compiled from multiple sources to construct a
timeline illustrating HMORN growth and critical infrastructure
development.
The evolution of key HMORN infrastructure closely mirrors this
growth, including the development of the Virtual Data
Warehouse (VDW), an HMORN brand identity, the
Collaboration Toolkit, and streamlined HMORN IRB and
contracting processes.
The Coordinated Clinical Studies Network (CCSN) created nontopic-specific, Network-wide infrastructure for the first time
and was a turning point in the evolution of the HMORN.
SUPREME DM5 (AHRQ)
SPAN for CER6 (AHRQ)
METHODS
Shared Bylaws
mission
& values
Shared
vision &
aims
Asset
Stewardship
Committee
Attendance
exceeds 200
ANNUAL CONFERENCE
conference
Portland, OR
Virtual Data COMMON DATA MODEL
Warehouse
HMORN
website
Infrastructure
financing
model
Attendance
exceeds 500
VDW Operations
Committee (VOC)
VDW
‘version 3’
Member
Resources,
HMORN logo
WEBSITE & COMMUNICATIONS
IRB REVIEW PROCESS
MPCI
LCF
1
MEMBERSHIP GROWTH
S&W,
MCRF
Listservs,
newsletter
SOP for IRB
ceding process
data only studies
GHS
SEARCH: Screening Effectiveness and Research in Community-Based Healthcare (NCI-ARRA)
Development of a Cardiovascular Surveillance System in the Cardiovascular Research Network (NHLBI-ARRA)
3 Cancer Research Network Administrative Supplement: Development of an HMO Research Network Collaboratory (NCI / NIH-OD)
4 Accelerating Change and Transformation in Organizations and Networks II (ARHQ)
5 Surveillance, Prevention, and Management of Diabetes Mellitus (AHRQ-ARRA)
6 Scalable Partnering Network for Comparative Effectiveness Research (AHRQ)
2
Executive
Committee
Attendance
exceeds 300
CONTRACTING PROCESS
GHRI, HFHS,
HPHC, HPRF,
KPCO, KPGA, KPHI,
KPNC, KPNW, and
KPSC
PROCESS IMPROVEMENT
Integrated Delivery Systems RN (AHRQ)
LARGEST HMORN CONSORTIUM PROJECTS
BACKGROUND
Vaccine Safety Datalink (CDC)
FOAs
News
page, SIGs, page
webinars
SOP for IRB ceding
process expanded
all non-FDA regulated
HMORN
Templates
Templates
refreshed
MHS
EIRH,
KPMA,
PAMFRI
As HMORN assets and success have grown, so too has interest
in membership. The HMORN now consists of 19 members,
with seven new member sites joining since 2005.
GOVERNANCE
The HMORN’s rising national prominence, growing
membership, and expanding research assets have led to an
increased need for Network-wide coordination and
management. To address these needs, in 2011 the Asset
Stewardship Committee’s work was refocused on developing a
broader array of tools to make research studies more efficient
and congruent. In 2012 an Executive Committee was launched
to enhance the Board’s ability to be nimble and efficient, and
respond to time-sensitive issues. The Executive Committee is
also charged with guiding the strategic vision of the HMORN
and strategic planning activities are now underway.
An Executive Committee that is trusted by the larger group can
drive the goals and agenda, prioritize activities, and
proactively tee up important issues for discussion. Factors
enabling effective executive functioning include clearly
documented processes for final decision-making; trusted and
admired leaders with excellent leadership and diplomacy skills;
and a high degree of engagement by members of the full
governing body along with a demonstrated commitment to
the success of the enterprise.
The HMORN has made significant improvement to multicenter IRB review and contracting processes. However, the
rapid growth of the HMORN intensifies the need to improve
additional processes affecting collaboration.
RAISING AWARENESS OF THE HMORN
While an assortment of descriptive materials and tables exist,
these have been developed opportunistically and are updated
sporadically, often in response to a request for a presentation
on the HMORN or its capabilities. A coordinated
communication plan has not been developed for the HMORN.
VETTING NEW PARTNERSHIPS AND PROPOSALS
While it is unrealistic that an individual point-of-contact at a
single site could be fully familiar with the availability and
interests of researchers across all 19 HMORN sites, a central
contact person could be supported by a ‘behind the scenes’
network of well-informed site contacts. In addition, tools to
better capture and catalogue faculty interests, and
collaboration connections could be especially useful.
ORIENTING NEW MEMBERS AND PARTNER ORGANIZATIONS
When new organizations join the HMORN they must be
integrated into administrative and governance processes, and
connections between researchers must be fostered. In
addition, this integration must be bidirectional. That is,
existing members must learn about the new members, just as
the new members learn about the HMORN – scientifically,
technically, interpersonally and administratively. Similar
orientation processes are needed for non-member
organizations looking to form new HMORN partnerships.
CONCLUSIONS
The size and number of HMORN-based research networks has
increased. While newer projects have benefited from prior
knowledge and experience, increased trust, and tools designed
to streamline project operations, the need for more agile
governance and stronger HMORN-wide coordinating functions
is clear. These findings will inform the next evolutionary phase
of the HMORN.