BIGHORN:
Building InvestiGative practices for better Health Outcomes Research Network
The Building InvestiGative practices for better Health Outcomes Research Network
(BIGHORN) is an emerging practice-based research network of private primary
care practices in Colorado. The mission of BIGHORN is to transform
a network of undifferentiated private practices into a community of reflective,
investigative practices and their patients, thereby enhancing the quality, safety,
efficiency, and accessibility of primary health care through practice-based
research. Peter Smith, MD, the Director of BIGHORN, seeks to realize the next
evolutionary step in PBRNs: a network of entire practices, rather than individual
providers, representing the true diversity of geography, practice structures,
patients, and communities of private primary care.
Short and long term goals of BIGHORN include:
- Describing the understudied, diverse world of these private, primary
care practices.
- Developing, testing, and disseminating practice-level interventions
that improve the quality, safety, efficiency, and accessibility of primary
health care.
- Enhancing interest in and thereby building capacity for
primary care, practice-based research by including private, community-based
practices that serve as learning sites for pre-doctoral medical students in
the network (note: we are intentionally (but not exclusively) targeting private
practices that serve as community-based preceptor sites for medical students).
- Systematically describing and improving community-based
pre-doctoral medical education.
- Eventually expanding to private practices from other states in the Rocky
Mountain West that currently lack the academic/organizational infrastructure
to create their own PBRNs de novo.
- Where appropriate, linking with other regional and national
networks to further national research and health care objectives.
BIGHORN will be strategically formed to enable the study of practice-level
issues by the nature of our member recruiting strategy: we will accept membership
from entire practices, not just individual clinicians. Current practices pledging
membership include private practices from urban and suburban greater Denver,
high-elevation mountain practices, and rural practices from central, western,
and southern Colorado.
All member practices are free-standing private practices, and thus representative
of busy community physicians. We have collected data about a number of member
practices. The majority (78%) of BIGHORN patients are white, 5% are black, 3%
are Asian, 1% or less are Native American or Pacific Islander, and 14% are “other.”
Sixteen percent of patients are Hispanic/Latino. Overall, patients pay for their
health care in the following ways: 12% Medicare, 8% Medicaid, 17% uninsured,
54% some other form of insurance (30% are considered under-insured).
For more information, e-mail BIGHORN Director, Peter Smith, MD: pete.smith@rfmr.com.
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