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National Cancer Institute

A 23-year Experiment in Sustainable Team Science: The Health Care Systems Research Network

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Greene S. A 23-year Experiment in Sustainable Team Science: The Health Care Systems Research Network. Oral presentation at 2017 SciTS Conference. Clearwater Beach, FL. Jun 13, 2017. Multi-Site Health Research Collaborations Online at:

Real-world health care delivery systems provide unique advantages for conducting research on how to improve health of individuals and populations. These systems offer assets including: automated data from electronic health records and health care claims; a stable population base that can be observed in both across time and care settings; and the ability to study the impact of myriad changes in how care is organized, financed, and delivered. The Health Care Systems Research Network (HCSRN) was conceived in 1994 by leaders from six research centers embedded in delivery systems including Kaiser Permanente and many others. Since then, the HCSRN has grown to include 20 health systems with ability to conduct multi-site clinical trials, epidemiologic studies, and comparative studies of health care services. Many features of the HCSRN have contributed to Day 2: Tuesday, June 13 Abstracts SciTS 2017 Conference: Building the knowledge base for effective team science. 41 its success, and also provide instructive guidance for other research initiatives. This presentation will examine the factors that have contributed to the HCSRN’s longevity, as well as potential risks to the team-based multi-site collaborative model. Governance: The HCSRN has a representative governance structure, wherein each member has a designate on the Board of Governors. The Board provides leadership, pursues strategic imperatives, stewards the network assets, and collectively advises its members on scientific priorities. In 2016, the HCSRN hired an inaugural Executive Director recognizing the need for a full-time position empowered to lead the network, ensure visibility, and provide stability as Board members come and go. The Board sets the tone for the Network, creating the organizational ethos. As such, it strives for a balanced and ecumenical approach to sharing opportunities, such as the opportunity to lead large research projects. Research Funding: The HCSRN has been productive with respect to securing research dollars from federal and other sources, and in its ability to inform and influence care. In particular, the HCSRN spawned several condition-specific multi-site research networks in cancer, diabetes, mental health, aging, pharmacoepidemiology, and cardiovascular disease. In 2012 alone, HCSRN member research centers received $340 million in federal funding, as well as funding from other sources. An initial focus on a Cancer Research Network (CRN), funded by the National Cancer Institute, was the cornerstone initiative that allowed the HCSRN to develop a robust collaborative infrastructure that enabled studies ranging from cancer prevention to survivorship and end-of-life care. Central to this infrastructure was the discovery that cancer studies were frequently reusing the same research data elements (patient demographics, variables characterizing diagnosis and treatment, utilization, etc.). Hence, CRN leaders elected to build a federated data warehouse that could be re-used for multiple projects without re-work. Data: A common data model is the backbone of the HCSRN’s Virtual Data Warehouse (VDW). It is virtual in that local health system data remain in place at a local data warehouse, using standardized processes for improving data quality and validity, and governance of data sharing. Each HCSRN site incorporates information from EHRs and other clinical and administrative sources into a set of VDW data tables with standardized variable names, labels, definitions, and coding. Again, given that diverse studies have a relatively unified set of data needs, with perhaps 80% being common from study to study and 20% being de novo data collection, the VDW frees individual projects to develop new variables to address specific scientific questions. Thus, both the content and organization of the VDW continue to evolve, as does the HCSRN’s sophistication and knowledge base about using its data. Culture of collaboration: The importance of a network comprised of peers cannot be understated. HCSRN sites provide one another with complementary domain and disciplinary expertise (e.g., some sites have a deep “bench” of biostatisticians or health economists who can collaborate with sites that lack this expertise). Shared learning is a shared value, and an annual research conference enables collaborators to come together in a common venue to learn not only research results, but methods and approaches that are uniquely pertinent to delivery system research. Securing the Future: Given a growing focus on the “triple aim” in health care of better outcomes, better experience, and lower cost, the HCSRN is a vital cog in the wheel of comparative effectiveness research. Identifying ways to sustain the network in an uncertain funding climate is our next great challenge, but leveraging our culture, data, and infrastructure are central to evidence-based care.



Type of Publication:

Oral presentation


SciTS 2017 Conference, Presentation, Health Care Systems Research, Team Science, Science of Team Science

Addresses these goal(s):

  • Learn about the field of team science: history, theory and concepts
  • Establish or maintain effective team science endeavors
  • Conduct research on/evaluate team science

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Resource created by Jane Hwang on 10/3/2017 9:43:27 AM.

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