The HMO Research Network is a consortium of 14 health plans that collaborate to perform public domain research.
HMO RESEARCH NETWORK
The
HMO Research Network is a consortium of 14 health plans that collaborate to
perform public domain research. Each of these health plans has linkable
auto-mated pharmacy, claims and membership data, and so are capable of
identifying important safety problems within a reasonable time following the
marketing of many new drugs. Some also have automated medi-cal records and
laboratory data. Ten of the Network plans, with a total population of almost 11
million, have been funded by the US government as a Center for Research and
Education in Therapeutics (CERTs), bolstering their efforts to create and
maintain the infrastructure needed to support research and educa-tion in
therapeutics, including the standardization of data, provision of central
programming support and mapping of drugs to a standard formulary (Chan et al., 2005). The HMOs participating in
this effort are Harvard Pilgrim
Health Care, which leads the CERTs, GHC of Washington State and Northern Idaho,
Health Partners Research Foundation in Minnesota, Meyers Primary Care
Institute/Fallon Healthcare System in central Massachusetts, Lovelace Health
System in New Mexico, UnitedHealthcare, with health plans in several states,
and four of the Kaiser Perma-nente HMOs: Kaiser Permanente Northern
Califor-nia, KPNW, Kaiser Permanente Georgia and Kaiser Permanente Colorado.
Outside of the CERTs and also part of the collaboration are four additional
plans: the Henry Ford Health System – Health Alliance Plan in Michigan, Kaiser
Permanente Hawaii, Kaiser Permanente Southern California and Scott and White
Memorial Hospital in Texas. These remain separate data resources, however, and
each HMO can elect to participate, or not, in any given study.
The
populations involved are ethnically and geographically diverse; the CERTs HMO
Research Network represents approximately 4% of the US population. Membership
in the respective health plans remains relatively stable, with annual turnover
rates between 10% and 15%. Retention rates tend to be higher among patients
with chronic diseases.
With
the advent of confidentiality requirements stip-ulated under HIPAA, each
participating health plan prepares its own data, stripping them of any patient
identifiers while preserving the link between the unique number assigned to
each patient and the plan iden-tifier within that plan’s locked file. All dates
are converted to age at a certain event (diagnosis, hospital-ization, etc.) to
further preserve the patient’s identity. Datasets are prepared and tailored for
each protocol. Once formulated and de-identified, they are forwarded to the
Channing Laboratory at Harvard for analy-sis. When necessary for confirmation
of diagnoses or obtaining information on confounders, medical records can be
retrieved at the participating sites.
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