• Distributed Ambulatory Research in Therapeutics Network (DARTNet)

    Study Description and Methods

    DARTNet is a rapidly growing collaboration of PBRNs that are working to build a national collection of electronic health record (EHR) data, claims data, and patient reported outcomes data. The networks seek to blend quality improvement, effectiveness and translational research with a data driven-learning system. The learning system includes advanced performance measures and assistance with the development and deployment of clinical decision support systems. All DARTNet members benefit from the DARTNet Learning Community, which provides benchmarked data to practices to identify high performers in clinical care. Leaders share their innovative approaches, effectively raising the bar for care in areas such as diabetes management, hypertension control, and chronic kidney disease.

    DARTNet has conducted a set of pilot studies to test the application, integrity, functionality, and security of the federated system. Topics include the comparative effectiveness and safety of oral medications for patients with type 2 diabetes, interventions for treating community acquired MRSA infections, and the comparative effectiveness and safety of therapies for major depression. DARTNet is currently assessing treatment of chronic kidney disease.

    Specific Aims and Objectives

    The original aim of DARTNet was to maximize electronic health record data for comparative effectiveness research and quality improvement.

    Currently the DARTNet members’ site is a growing portal for peer-to-peer interaction among members. The benchmarking reports are housed there, providing a venue for data-driven discussion and learning.

    Timeline

    Initial funding began in 2007.

    Status

    DARTNet, now DARTNet Institute, has grown to become a vibrant collaborative of research networks utilizing similar underlying technologies and is in the process of becoming an autonomous, not-for-profit institute focused on practice-based inquiry and the development of a learning health care system. The next step in stewardship will entail an arms-length relationship aimed at cultivating and incorporating an expanded variety of disciplines, including a wider range of specialties, researchers, funders and other private partners than is currently possible under the ambit of AAFP. The new DARTNet Institute seeks to become a more robust, leading edge, cross-specialty, cross-discipline network. The AAFP NRN, under the broad umbrella of the AAFP, will continue to provide coordination of the academic partners. The AAFP NRN scientific staff and other academic partners will collaboratively seek grant funding to fuel the operation.

    Key Findings and Publications

    Design and Implementation of N-of-1 Trials: A User’s Guide. Kravitz RL and Duan N (eds) and the DEcIDE Methods Center N-of-1 Guidance Panel (Duan N, Eslick I, Gabler NB, Kaplan HC, Kravitz RL, Larson EB, Pace WD, Schmid CH, Sim I, and Vohra S).  AHRQ Publication No. 13-EHC122-EF. Rockville, MD: Agency for Healthcare Research and Quality; anticipated release date: October 2013.

    An Electronic Practice-based Network for Observational Comparative Effectiveness Research. Pace WD, Cifuentes M, Valuck RJ, Staton EW, Brandt EC, West DR.  Ann Intern Med. 2009; 151 (5): 338-340. PMID: 19638402

    Contact Information

    For additional information about this study, please contact AAFP NRN staff at nrn@aafp.org, or visit the DARTNet Institute website.

    This study was first funded in 2007 by grants from the Agency for Healthcare Research and Quality (AHRQ).