Collaborating Across Sectors for Colorado's Health Equity and Wellness (CASCHEW)

BIGHORN’s mission is to transform a network of 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. This network comprises practices representative of busy community practices in both urban and rural areas across Colorado. BIGHORN has completed studies on patient safety, underinsurance, direct-to-consumer advertising, health information technology, and chronic pain with funding from the Centers for Disease Control and Prevention, Agency for Healthcare Research and Quality (AHRQ), and National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

CaReNet is a network of nearly 450 clinicians (family physicians, general internists, general pediatricians, and nurse practitioners) in both urban and rural practices (federally qualified health centers, community health center clinics, residency training sites, and university affiliated private practices). CaReNet practices are located along the front range, as well as in the San Luis Valley (SLV) in south central Colorado.

COCONet is a network that works with pediatric medical practices to improve the health and well-being of Colorado children and families. The mission of COCONet is to conduct collaborative practice-based research and quality improvement that informs real-world clinical practice to improve the health and well-being of Colorado children and families. COCONet supports and conducts studies and projects to improve children’s health. Projects have included topics such as improving immunization coverage, physician communication with patients and parents, referral systems, and mental health integration. COCONet is committed to connecting practicing physicians and researchers to examine the most pressing questions facing pediatric providers in Colorado. COCONet has a Network Advisory Board (NAB), as well as a Steering Committee, that both meet as-needed to discuss priority topics and to participate in projects and grant writing. The COCONet NAB meets each quarter and focuses meetings on current and developing projects. COCONet has received funding from Patient-Centered Outcomes Research Institute (PCORI), National Institute of Allergy and Infectious Diseases (NIAID), and elsewhere.

Established in 1997, HPRN is an integrated rural network of clinicians and health care facilities located in the 16 counties of eastern rural Colorado. The HPRN region covers 30,000 square miles and is home to approximately 150,000 people, 30% of whom are Hispanic. HPRN includes 16 hospitals ranging from six to 40 acute care beds all between 50 and 180 miles from the closest tertiary care center, 53 primary care practices, 15 nursing homes, 3 home health agencies, 4 public health departments, and 3 hospice organizations. Eight of the Colorado counties served by HPRN clinics have been officially designated Health Professional Shortage Areas, and 4 are Medically Underserved Area. HPRN’s mission is to provide excellent rural health care by translating the best scientific evidence into every day clinical practice. Since its first study which assessed the use of new medical technology in rural hospitals, HPRN’s studies have studied new interventions that support colon cancer screening; chronic disease diagnosis, treatment, and management (asthma, cancer survivorship care, opioid use disorder, hypertension); test diagnostic tools in primary care (chronic obstructive pulmonary disease); and describe patient, practice staff, and clinicians' knowledge and attitudes on a range of topics (underinsurance, behavioral health integration, patient centered medical home). HPRN research has been funded by the Centers for Disease Control and Prevention, Agency for Healthcare Research and Quality, Robert Wood Johnson Foundation, National Cancer Institute, National Institute of Nursing Research (NINR) Patient Centered Outcomes Research Institute, The Colorado Health Foundation, Caring for Colorado Foundation, Colorado Department of Public Health and Environment. The HPRN has an active Community Advisory Council (C.A.C.) that was established in 2003 and consists of 12 local residents of eastern Colorado, including farmers, ranchers, teachers, para-health professionals, small business workers, office workers, students, and retirees. By joining the best science with the best community knowledge, HPRN and the C.A.C. can produce something better than either could alone.

Starting in 2017, interest for starting a new PBRN on the Western Slope grew as a few practices became involved in PBRN projects and recognized that very few others were involved. In addition, there are issues specific to the geographic region that likely require asking different questions and potentially using different research strategies to answer them. The model for this PBRN is one that includes health care related organizations as well as practices and practitioners, as well as several different organizations ranging from academic institutions to Health Information Technology companies. Due to this scope of involvement, the network is called PEACHnet, which stands for Partners Engaged in Achieving Change in Healthcare Network. Currently, a small steering committee has been formed and staff has been starting to reach out to practices and organizations across the Western Slope. They are actively working to develop project ideas to attract practices and help to increase understanding of the incredible benefits PBRN projects can bring to communities. Funding for PEACHnet has come from Patient-Centered Outcomes Research Institute (PCORI) and the American Cancer Society. PEACHNet is actively working to create a Regional Advisory Board (RAB) as of 2019. The RAB will be composed of stakeholder groups including patients, health care workers, and community members from various organizations. This group will include 10 to 12 people and will meet monthly starting in July 2019. The name, “Regional Advisory Board, ” is being used to emphasize that PEACHnet includes practices and communities across a geographic region.