Preliminary Synthesis from the day & Wrap up/Next steps 

The Starfield Summit VI focused on leveraging Practice-Based Research Networks (PBRNs) to advance primary care, particularly in addressing health equity, improving infrastructure, fostering collaboration, and ensuring sustainability.

Major Themes

1. Health Equity and Workforce Challenges:

• PBRNs are seen as crucial in addressing health disparities and strengthening the primary care workforce.

• Discussions emphasized the need for PBRNs to engage with marginalized communities and contribute to more equitable healthcare outcomes.

2. Building and Strengthening Infrastructure:

• A significant focus was on developing robust infrastructure, such as creating Centers of Excellence in Primary Care Research.

• The need for sustainable models, including ongoing support for research and practices, was highlighted.

• Proposals included establishing data hubs, cores for implementation and dissemination, and ensuring protected research time for clinicians.

3. Collaboration and Partnerships:

• Emphasis on building partnerships between academic institutions, healthcare systems, and community organizations.

• PBRNs were encouraged to act as bridges, connecting different stakeholders to address complex healthcare challenges.

4. Education and Pipeline Development:

• Integration of research into the core curriculum of medical education, particularly for primary care, was recommended.

• New pipeline programs are needed to ensure that research becomes a fundamental aspect of primary care practice.

5. Sustainability of PBRNs:

• Discussions on securing long-term funding and aligning with health system priorities were central to ensuring the sustainability of PBRNs.

• Addressing challenges like staffing, burnout, and variability in practice quality was deemed essential for the success of PBRNs.

6. Leadership and Governance:

• Strong leadership and governance structures are required to guide PBRNs' growth and impact.

• Developing shared national goals and principles for PBRNs to align with broader healthcare objectives was suggested.

Key Recommendations

1. Enhance Infrastructure:

• Invest in and maintain robust infrastructures, such as data hubs and Centers of Excellence, to support PBRN activities.

2. Foster Collaboration:

• Strengthen partnerships between academia, healthcare systems, and community organizations.

3. Promote Education:

• Integrate research into medical education and develop programs that encourage participation in primary care research.

4. Ensure Sustainability:

• Develop sustainable models for PBRNs, including securing long-term funding and providing ongoing support for practices and research.

5. Strengthen Leadership:

• Establish leadership structures within PBRNs that promote shared vision and accountability.

Additional ‘parked’ issues

• Evening discussion with non-research primary care docs: Frontline doctors are suffering after the pandemic. The turnover of staff is very high a) everyone is new from nurses to receptionists, b) all are inexperienced and often “low functioning” c) there is likely to be more turnover during the coming few years as staff retire/change jobs. If we don’t provide practice facilitators for the practice, don’t expect that they will do much.

• Doctors are being paid by ACOs and Advantage plans a) poorly, as in less than when they were in fee-for-service practices and b) much later than when services were provided, i.e. 12-18 months. Yet they must do it b/c the macra payments etc. would otherwise drive them out of business within 5 years.