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Duke Center for Community Research. J. Lloyd Michener, MD Professor and Chair Dept of Community & Family Medicine October 16, 2006 North American Primary Care Research Group Tucson, Arizona. Vision of Transformation: What has to be done?.

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duke center for community research

Duke Center for Community Research

J. Lloyd Michener, MD

Professor and Chair

Dept of Community & Family Medicine

October 16, 2006

North American Primary Care Research Group

Tucson, Arizona

vision of transformation what has to be done
Vision of Transformation: What has to be done?

Healthcare transformation will involve several bold moves:

  • National mandate on extensive reformation of healthcare delivery & financing systems
  • Campaign on Prevention, Health & Wellness and Prospective Health
  • Innovation that leads to transformative/ disruptive technologiesand approaches

(V.J. Dzau 2006)

bold reform of care delivery systems
Bold Reform of Care Delivery Systems
  • Develop true integrated care delivery systems from community to medical centers (national or state systems)
  • Increase investment in Primary Care (vs Focused Factories)
  • Replacing Physician Centered model with novel models of care-providers (physician extenders, laypersons)
  • Use of Innovative IT technology for clinical information capture, connectivity, remote monitoring and decision support

(V.J. Dzau 2006)

duke model of bench to bedside to population two interrelated signature initiatives
Duke Model of Bench to Bedside to Population: Two Interrelated, Signature Initiatives

Translational and Clinical Research Institute (TCRI)

- Duke Translational Research Institute (DTRI):

- Duke Clinical Research Institute (DCRI)

- Duke Center for Community Research (DCCR)

Global Health Institute (GHI)

- Policy & Research

- Education

- Service Delivery

(V.J. Dzau 2006)

duke translational and clinical research institute structure
Duke Translational and Clinical Research Institute Structure

TCRI Administration

Education & Training

Biostatistics & Bioinformatics

Core Laboratories

Regulatory Affairs

Project Leaders and the Portal Office

DTRI

DCRI

DCCR

New Molecule

Pre-clinical Development

First in Human

Phase II/III

Application in the Community

(V.J. Dzau 2006)

state wide programs

DUKE UNIVERSITY MEDICAL CENTER & HEALTH SYSTEM

State-wide Programs

Community Nutrition

Network

KBR and NCHWTF

Occupational Health Services

CFM State-Wide

...Across the U.S. and beyond

the duke center for community research dccr

DUKE UNIVERSITY MEDICAL CENTER & HEALTH SYSTEM

The Duke Center for Community Research (DCCR)

Moving the Community from Subject to Collaborative Partner

Governance:Community Research Advisory Board

Components:Community Research Liaison Center

Community Health Research Training Center

Electronic Health Record

community research liaison center
Community Research Liaison Center
  • The connection between CTSI and local communities and organizations
    • A virtual library:
      • for researchers to learn about communities
      • for community groups to learn about themselves
    • Outreach and training to assist communities with data and to connect communities with researchers
community health research training center
Community Health Research Training Center
  • Train and prepare researchers to work successfully with communities
    • Train and prepare learners/trainees for research with communities
    • Conduct formal regulatory training and testing for community engagement
      • IRB
      • Consent process
dccr electronic health record
DCCR Electronic Health Record
  • Covers citizens of Durham County
  • Captures data for Durham County
  • Develop analytic techniques using data from the DSR
    • Dealing with co-variates
    • Meshing advanced laboratory data with long term outcomes
  • Produce rapid & measurable improvement of community health status
  • Can perform rapid turn-around intervention studies

(V.J. Dzau 2006)

and after that
And after that…
  • World peace
  • Subtext – be careful what you ask for!
general comments and advice
General Comments and Advice
  • Be bold - try to make a difference
  • Be inclusive – more than one network, discipline, department
  • Embrace diversity – there is no one right way
  • Give back – how will your communities and networks be better for the project?
cfm vision mission

DUKE UNIVERSITY MEDICAL CENTER & HEALTH SYSTEM

CFM Vision/Mission

The Department’s mission is:

  • to advance understanding of health and illness in the community, workplace and family;
  • to design innovative interventions to promote health and prevent disease; and
  • to teach others what we have learned
emphasis on health and prevention
Emphasis on Health and Prevention
  • Prevention
  • Health and Wellness
  • Prospective Health
  • Personalized Medicine
  • Integrative Medicine
  • Biomarkers
  • Genomics, ‘omics
  • Risk Assessment
  • Informational Technology
  • Driven by Innovation

(V.J. Dzau 2006)

principles of community engagement

DUKE UNIVERSITY MEDICAL CENTER & HEALTH SYSTEM

Principles of Community Engagement
  • Proposed projects should be based on a need identified by the community that is beneficial to the community. Scope and time-frame of project should be clear to the community.
  • Partners must be willing to commit time and resources to the project, be good stewards of project data, and include the community in outcome reporting activities.
  • Partners must trust each other and build mutual respect for each other while learning from each other’s perspectives.
  • A diverse range of community members and agencies need to participate to ensure that proposed activities meet the needs of a diverse citizenry. All participants are considered experts.
  • A safe environment exists for all participants of all backgrounds to share ideas without fear of ridicule or criticism. No blaming or judgments. Keep lines of communication open.

Created by: Principles of Engagement Workgroup 9/20/05