Emerging Frontiers in Healthcare Research and Delivery.

• Health Maintenance Organization
• HMORN
• Healthcare research
• Virtual Data Warehouse
• Cancer Research Network

The Health Maintenance Organization Research Network (HMORN) is a collaboration of 16 nationally and internationally recognized research centers based within not-for-profit healthcare delivery systems. Research centers conduct non-proprietary clinical, epidemiologic and health services research using study populations captured within health maintenance organizations (HMOs). Collectively, the 16 member organizations cover about 13 million individuals via a diversity of coverage plans. Inspection and analysis of health and healthcare utilization data from the 16 sites is made possible by a fully functional Virtual Data Warehouse (VDW) maintained locally, but available for collaborative research projects by the 16 member organizations. The Network’s mission is to use its collective scientific strengths to integrate research and practice to improve healthcare and overall health among diverse populations. The network has been organizing annual conferences since 1995 with the purpose of advancing the quality, scope and transparency of public domain research conducted within member organizations and their external partners. The meeting provides a forum for HMORN investigators and their collaborators, who often represent non-HMORN member healthcare systems and universities, to present research findings, hold working meetings, and communicate with collaborators, funding agencies and other stakeholders.

The 16^th annual HMORN conference was hosted by Scott & White Healthcare in Austin, TX from March 21–24, 2010. The theme for the conference was “Emerging Frontiers in Healthcare Research and Delivery.” This theme not only provided the opportunity to build synergy among scientists and clinicians to influence the health of our nation, but at the same time, it demonstrated the network’s commitment to reach beyond its traditional collaborators to share experiences, discuss tools and technologies, and expand opportunities for productive public-private partnerships in cutting-edge healthcare research and delivery. Thus, means and methods of establishing collaborative research teams to address critical and emerging healthcare topics was a common theme of formal and informal discussions of the more than 320 researchers and healthcare professionals who attended this conference. Contributing to the conference’s drive to establish collaborative research teams were representatives from the Agency for Healthcare Research and Quality (AHRQ), the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH), as well as academic partners, who met with researchers to advance the quality and breadth of public domain research in HMOs.

The formal agenda included keynote addresses from nationally recognized leaders in the fields of healthcare delivery and healthcare research, and scientific research presentations by nationally recognized health service researchers. National leaders in healthcare and healthcare delivery research presided over two opening-day plenary sessions. The meeting started with a keynote address from J. James Rohack, MD, President of the American Medical Association (AMA). Dr. Rohack’s address to the conference attendees came at a historic time for our nation and healthcare reform; the night before his talk, US congress had voted to approve the Affordable Care Act. Dr. Rohack presented a brief overview of the critical elements of AMA’s agenda to address America’s healthcare issues and opportunities. He reviewed the role of the AMA in medical education and research, discussed future healthcare challenges regarding access, quality and cost, and outlined potential solutions to each. Dr. Rohack’s talk emphasized the need for collaboration between researchers and healthcare providers. His talk also included discussion on the Affordable Care Act provisions to eliminate denial of insurance coverage for pre-existing conditions, as well as addressing medical liability by pilot-testing the use of health courts.

The second plenary session of the day was led by Carolyn Clancy, MD, Director of AHRQ, who spoke on current trends and pressures shaping the healthcare delivery system. She also highlighted information technology, evidence-based care management and rapid translation of new advances. Referencing AHRQ’s long standing support of HMORN’s mission, Dr. Clancy spoke specifically to the importance of the HMORN’s research agenda as well as potential impact of comparative effectiveness research led by HMORN investigators.

Additional plenary sessions followed on each day of the conference. Maintaining a HMORN tradition, the current Chair of the HMORN Governing Board, Dr. Eric Larson, provided a State of the Network address which focused on new directions and infrastructure being developed by the HMORN to enhance collaborations between its members as well as new partners. The conference agenda also included plenary sessions to highlight the impressive research of HMORN early career investigators and the Cancer Research Network (CRN). Early career investigators make significant contributions to the HMORN. Four of these investigators, selected by a competitive process, delivered talks in the plenary session and were awarded with a plaque. In the Cancer Research plenary session, NCI Program Officers and CRN investigators provided an overview of where we are today with Cancer Comparative Effectiveness Research (CCER), the NIH’s Patient Reported Outcomes Measurement Information System (PROMIS) and communications research.

The conference’s formal agenda also included 16 concurrent sessions with oral presentations and three scientific poster sessions across a broad range of topics including cancer research, health and bioinformatics, Virtual Data Warehouse, cardiovascular research, genetics, physical activity and wellness, managing chronic illness, research and system changes/shared decision-making, diabetes and obesity, new issues in human subjects’ research, and research administration. Based on the evaluation and suggestions from the 2009 conference participants, dedicated time for poster sessions was provided, which was highly appreciated by the attendees. In all, about 150 scientific abstracts were featured in the meeting; a selection of them are presented within this special issue of Clinical Medicine & Research.

The 2010 conference agenda included a new participant-directed group format. For the first time in the HMORN conference history, Conversation Café sessions were included to facilitate an open discussion on 11 topics identified as potential areas of collaborative research. In this event, small groups were formed based on topics of interest to the group. Facilitators were provided by the organizing committee; however, the role of the facilitator was to manage the logistics of forming groups and allocating meeting space to groups. These were designed to stimulate spontaneous conversations and data sharing that could lead to future collaborative research projects and manuscripts. Multiple new research interest groups were formed from the Conversation Cafés, indicating participants’ interest in developing new collaborative research projects.

In addition to formal scientific sessions, which were designed to address the interest of all participants, a large number of ancillary meetings were held to facilitate advancement of ongoing collaborative research projects. These project specific meetings were used to develop strategies and infrastructure, and discuss findings from ongoing research projects funded by NIH, CDC and AHRQ. These ancillary meetings not only serve to advance ongoing projects but also provide stimulation for new projects to advance collaborative opportunities and the science of healthcare research. A total of 37 of these working meetings were scheduled during the conference. This included dedicated meeting time for HMORN investigators and staff working to make the HMORN Virtual Data Warehouse a national resource for health researchers. Important administrative sessions, designed to share procedures and promote efficient collaborative processes, were expanded this year given the increasing number of multi-center studies. Many of these working meetings were focused around the HMORN’s condition specific research networks such as the Cancer Research Network, Cardiovascular Research Network, and the Mental Health Network.

To learn more about the HMORN please visit www.hmoresearchnetwork.org. The research of the HMORN will be presented at the 17^th Annual HMO Research Network Conference hosted by Harvard Pilgrim Heath Care and Harvard Medical School in Boston, MA from March 23–25, 2011. The theme of 2011 conference is “Collaborations in Population-Based Health Research.”

• Received October 13, 2010.
• Accepted October 14, 2010.