Looking Back to Move Forward: Reflections of PBRN Directors

Area of Science:

• Primary Care Research
• Practice-Based Research Networks (PBRNs)
• Health Services Research

Background:

• The Ambulatory Sentinel Practice Network (ASPN) was established in 1978 as a primary care research initiative.
• ASPN evolved into the National Research Network (NRN), expanding its scope and impact over four decades.
• The network navigated challenges, including funding and institutional support, to achieve mainstream research acceptance.

Purpose of the Study:

• To document the historical development and key learnings of the ASPN/NRN over its first 40 years.
• To distill enduring patterns and archetypal dilemmas encountered by leaders of practice-based research networks.
• To provide actionable insights and future directions for contemporary PBRN leaders.

Main Methods:

• A retrospective analysis based on facilitated conversations among network leaders over two years.
• Iterative synthesis of key facts and observed patterns across distinct developmental eras.
• Distillation of time-durable patterns for interpretation and application by current PBRN leaders.

Main Results:

• ASPN/NRN transitioned from a nascent concept to a significant force in primary care research.
• The network successfully addressed large, socially important research questions, increasing PBRN research volume.
• Current challenges include adapting to technological shifts, organizational changes, and emphasizing patient engagement, safety, and disparities.

Conclusions:

• The 40-year experience offers valuable lessons for navigating the evolution of practice-based research networks.
• Enduring dilemmas and adaptive strategies provide a framework for current and future PBRN leaders.
• The value proposition of PBRNs can be extended through promising future directions focused on adaptation and innovation.