SPUR Net

The Family Medicine Department at Baylor College of Medicine organizes the practice-based research Network (PBRN) for the Houston area, the Southern Primary-care Urban Research Network (SPUR Net). SPUR Net is a member of the Primary Care Multi Ethnic Network (PRIME Net), a national consortium of Practice-Based Research Network (PBRNs). Anthony E Brown, MD, MPH, is the network director for the Southern Primary-care Urban Research Network (SPUR Net) in Houston, Texas and Assistant Professor in the Department of Family and Community Medicine at Baylor College of Medicine (BCM). Dr. Valory N Pavlik, PhD, MPH, is the Vice Chair for Research and Associate Professor in the Department of Family and Community Medicine at Baylor College of Medicine (BCM) in Houston, TX. The Department of Family and Community Medicine is the third largest department within BCM.

SPUR Net includes over 32 clinics and 313 primary care clinicians, consisting of 50 percent family physicians, 26 percent general internists, 20 percent pediatricians, and 4 percent other providers. The SPUR Net clinics serve a combined population of over 900,000 individuals; the population represented in these clinics is ethnically and socioeconomically diverse, and allows for highly-generalizable effectiveness research. The primary ethnic groups vary depending on the particular clinic site, but include white (4 percent-43 percent), Hispanic (10 percent-90 percent), black/African American (4 percent-67 percent), and Asian (1 percent-12 percent). The majority of our clinic sites are linked by a common electronic health record system, EpicCare.

Clinicians that are part of SPUR Net care for patients in community health centers, academic private practice settings, residency programs, a homeless health care outreach, and a large HMO. Local potential collaborative clinical sites include the Baylor Family Medicine (BFM) clinics, the Harris County Hospital District (HCHD) community health centers, Houston Service Workers Clinic (HSWC), Healthcare for the Homeless—Houston (HHH), the Memorial Hermann Healthcare System (MHHS) - Memorial Family Practice Residency Program, San Jacinto Methodist Family Medicine Residency, and the Kelsey-Seybold Clinics (KSC).

Baylor College of Medicine in Houston, Texas, is the nation’s fourth largest city, the only private medical school in the Greater Southwest, it is recognized as a premier academic health science center, and is known for excellence in education, research and patient care. Baylor College of Medicine ranks among the top ten medical schools nationwide in NIH funding. Furthermore, the college has total research support of $400 million, with $344 million from federal sources, and more than 90 research and patient-care centers and units. Currently, BCM trains more than 3,000 medical, graduate, nurse anesthesia, and physician assistant students, as well as residents and post-doctoral fellows. The College’s clinical practice group has implemented an EPIC electronic health record system in all of its facilities.

The Department of Family and Community Medicine is the third largest clinical department in the College, second only to Medicine and Pediatrics. Baylor’s Department of Family and Community Medicine has over 100 full-time faculty members and 18 residents in Family Medicine. The physician faculty staffs six Community Health Centers that are owned and operated by the Harris County’s publicly funded health system, Harris Health, providing primary health care to over 300,000 Houstonians.

Additionally, the department operates a private group practice. The department sponsors Spurn-Net, a practice-based research network which consists of over 30 clinics serving an ethnically- and socioeconomically-diverse population. The department’s training programs include a HRSA-funded post-doctoral primary care research fellowship program and a HRSA-funded faculty development fellowship. In 2010, Baylor established the Institute for Clinical and Translational Research (ICTR) to provide a full range of epidemiology, biostatistics and data management and community engagement support for clinical research within the college. 

SPUR Net is involved in several current projects. We are involved in an Agency for Healthcare Research and Quality (AHRQ) study, “Impact of Meaningful Use Patient Engagement Objectives in a Multicultural PBRN” in which the goal is to evaluate current utilization of patient engagement features of an widely implemented EHR (EpicCare) in primary care settings in order to provide data that will be useful in selecting Stage 3 Meaningful Use criteria. We are also participants of the AHRQ-funded P30 PRIME Net center in practice-based research and learning. Through this creation and infrastructure support of the PRIME Net Center in Practice-based Research and Learning, each affiliated PBRN will develop activities with their member practices for the purposes of expanding a pipeline of investigators and launching new studies which address concerns of underserved and vulnerable patients.

Through the support of the Center, we will test innovative diffusion strategies to accelerate the implementation of new research knowledge into primary care practice.  We are also funded through a Center for Disease Control (CDC) subcontract through the University of Pittsburgh for a Vaccination Standing Order Program (SOP) Toolkit in Diverse Practices Implemented & Tested with Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM). The objective of this study is to demonstrate the scalability, fidelity, and maintenance of Standing Orders Programs (SOPs) for increasing adult immunization rates in physician office settings particularly those serving disadvantaged populations.

SPUR Net was involved in several completed projects.  PRIME Net/SPUR Net was funded through the Agency for Healthcare Research and Quality (AHRQ) on task order 17, “Using Health Information Technology to Improve Healthcare Quality in Primary Care Practices and in Transitions between Care Settings.” The goal of this study was to determine the optimal format for a computer-generated post-visit summary in primary care settings, serving economically and ethnically diverse patient populations.

SPUR Net was also part of the PRIME Net team of subcontractors on another recent project through the National Center on Minority Health and Health Disparities (NCMHD) challenge grant, “Recruitment and Retention Best Practices in Primary Care Settings”. The objective was to identify best practices for recruiting and retaining diverse primary care patients into clinical research studies. This collaborative multi-site study engaged 5 of the 8 members of the Primary Care Multiethnic Network (PRIME Net) consortium that conducts research with traditionally underrepresented and underserved population groups. This collaborative multi-site study identified best practices and developed a guide for recruiting and retaining diverse primary care patients of African American, Hispanic American, Chinese American, Arab American and the Navajo nation descent into clinical research studies with varying gradations of design complexity.


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