Research Division

The VCU Department of Family Medicine has a long interest in primary care practice-based research, dating to the Virginia Study in the 1970s, which was among the first efforts to catalog the essential components of primary care. In the 1990s, the National Cancer Institute Prescribe for Health Programs funded the department to help study the use of office-based computer technology to improve the delivery of clinical preventive services.

Steven H. Woolf, professor and director of research in the Department of Family Medicine, currently leads the research activities of the department. A research committee meets regularly to manage the portfolio of research projects. The faculty members engaged in the following research efforts are active participants in the North American Primary Care Research Group and other national research organizations.

Since 1996, the department has been developing and operating a statewide practice-based research network, the Virginia Ambulatory Care Outcomes Research Network (ACORN). The mission is to collect longitudinal data on the health status of primary care patients and on the effectiveness and quality of the care they receive. The objectives are to provide observational data on important trends and patterns in primary care practice in Virginia and a research platform for the performance of clinical trials to test the effectiveness of interventions to improve quality and health outcomes. The information is intended to help clinicians improve care practices; to help policy-makers better understand and evaluate primary care in Virginia; to provide researchers with a unique longitudinal data set for observational and experimental studies; and to help educate the general public.

ACORN is one of 19 practice-based research networks around the country that have been funded for infrastructure development by the Agency for Healthcare Research and Quality. The ACORN effort also has received funding from the Health Resources and Services Administration. ACORN is a member of the Federation of Practice-Based Research Networks and participates nationally and internationally in research conferences, symposia and peer-reviewed publications concerned with health services and primary care research. The faculty members responsible for coordinating the ACORN research effort include Stephen H. Woolf, M.D., M.P.H., Stephen F. Rothemich, M.D., Robert E. Johnson, Ph.D. and Amy Burgett, R.N.

An example of the type of research conducted within ACORN is a randomized controlled trial of an intervention to improve the frequency with which primary care physicians offer smoking cessation counseling. Dr. Rothemich, principal investigator for this study, is funded under a Robert Wood Johnson Foundation Generalist Physician Faculty Scholar award to conduct this study at 12 practice sites within ACORN. The trial tests whether counseling rates improve when smoking status is assessed routinely along with other vital signs.

Dr. Woolf and Dr. Anton J. Kuzel are engaged in studying the definition and epidemiology of medical errors and patient safety in primary care. The Department of Family Medicine was among the first six centers to receive funding from the Agency for Healthcare Research and Quality as part of its increased interest in medical errors research. The project aims to create a typology of medical errors based on the way patients describe errors that they have experienced in primary care settings. Information obtained in direct interviews with patients and in interviews and surveys of primary care physicians are being examined using qualitative research methods. This project is being conducted in collaboration with the Department of Family Practice at Northeastern Ohio University’s College of Medicine and with social scientists and human factors experts in both the United States and United Kingdom.

The Department of Family Medicine leads the U.S. component of a six-country international study of medical errors in primary care organized by the American Academy of Family Physicians’ Robert Graham Center for Policy Studies in Family Practice and Primary Care. The six countries include the United States, Canada, the United Kingdom, the Netherlands, Australia and New Zealand. Drs. Woolf and Kuzel are responsible for the U.S. effort. In this project, family physicians and general practitioners use computer software to report errors they observe in clinical practice, which are transmitted anonymously via the Internet to a centralized database for research analysis. The Department of Family Medicine is responsible for organizing errors reported by family physicians in Virginia, Ohio, New York and New Hampshire.

Faculty members in the Department of Family Medicine have individual research interests that often involve collaborations with other colleagues, VCU departments and other academic centers. For example, Dr. Woolf engages in research on evidence-based medicine, systematic reviews, medical technology assessment and practice guideline development. Dr. Johnson conducts research on advanced techniques in biostatistical data analysis. To obtain further information about the research program, contact Steven Woolf.