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Building a Research Consortium of Large Health Systems: The Cancer Research Network
Affiliations of authors: Group Health Cooperative Center for Health Studies, Seattle, WA (EHW, SMG, GH); Meyers Primary Care Institute, University of Massachusetts, Worcester, MA (TSF); Department of Ambulatory Care and Prevention, Harvard Pilgrim Health Care, Boston, MA (SF); Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA (AMG); Division of Research, Kaiser Permanente Northern California, Oakland, CA (LJH); Henry Ford Health System, Detroit, MI (CCJ); Kaiser Permanente Colorado, Denver, CO (JM); HealthPartners Research Foundation, Minneapolis, MN (SJR); Center for Health Research, Kaiser Permanente Northwest, Portland, OR (MCH, VJS); National Cancer Institute, Bethesda, MD (SHT); Kaiser Permanente Georgia (DT); Center for Health Research Hawaii, Kaiser Permanente Hawaii (TMV)
Correspondence to: Edward Wagner, MD, MPH, Group Health Cooperative Center for Health Studies, 1730 Minor Ave., Ste. 1600, Seattle, WA 98101 (e-mail: wagner.e{at}ghc.org).
Critical questions about cancer prevention, care, and outcomes increasingly require research involving large patient populations and their care delivery organizations. The Cancer Research Network (CRN) includes 11 integrated health systems funded by the National Cancer Institute (NCI) to conduct collaborative cancer research. This article describes the challenges of constructing a productive consortium of large health systems, and explores the CRN's responses. The CRN was initially funded through an NCI cooperative agreement in 1999 and has since received a second 4-year grant. Leadership and policy development are provided through a steering committee, subcommittees, and an external advisory committee. The CRN includes integral and affiliated research projects supported by a Scientific and Data Resources Core. Three characteristics of the CRN intensified the general challenges of consortium research: 1) its members are large health systems with legitimate concerns about confidentiality of data about enrollees, providers, and the organization; 2) CRN research projects often generate highly sensitive data about quality of care; and therefore 3) each participating organization wants a strong voice in CRN direction. CRN experience to date confirms that a consortium of health systems with internal research capacity can address a range of important cancer research questions that would be difficult to study in other venues. The advantages and challenges of consortium research are explored, with suggestions for the development, execution, and management of multisystem population laboratories.
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