History of research at Group Health
Research has been a part of Group Health Cooperative's vision since it was founded in 1946. In fact, Group Health's first mission statement said that the organization would "contribute to medical research."
The Cooperative began its first research project in 1956 with K. Warner Schaie, PhD. Called "The Seattle Longitudinal Study," this investigation of age-related cognitive changes among Group Health members continues today under the direction of the University of Washington's Sherry L. Willis, PhD.
Other early research consisted of a handful of externally initiated projects, including a study of Pap tests at Group Health showing that fewer new cases of cervical cancer when individual women had repeated Pap tests—a finding that contributed to the development of cervical cancer screening guidelines.
First research department established
Requests for access to Group Health enrollees and data increased through the 1960s, prompting the organization to establish the Group Health Research Department in 1969. Led by Richard Handschin, MD, the Department coordinated external research and conducted studies in quality assurance, operations analysis, facilities planning, and marketing.
Under Handschin's leadership in the early 1970s, Group Health contributed to projects with major implications for national health policy. Among these were the RAND Health Insurance Experiment and two demonstration projects—the Model Cities Project and Plan 9 Rural Health Project—both designed to improve health care for low-income people.
In 1975, the Group Health Medical Staff founded the Department of Preventive Care Research, led by Robert S. "Tom" Thompson, MD. This department's early work led to Group Health's Lifetime Health Monitoring Program, Well-Child Visit schedule, and Breast Cancer Screening Program. In 1978, Thompson established the Group Health Committee on Prevention, which developed Group Health's first evidence-based clinical guidelines.
In 1978, the Group Health Board of Trustees adopted the organization's first formal research policy and guidelines, resulting in the current Research Committee and Human Subjects Review Committee. With representation from Group Health members, management, and medical staff, the Research Committee evaluates research proposals for problem significance, research design, and adequacy of research personnel and facilities. It also assesses each proposal's likely impact on Group Heath resources. The Human Subjects Review Committee serves as Group Health's federally mandated Institutional Review Board (IRB). This committee ensures that the rights and welfare of study participants are adequately safeguarded.
Center for Health Studies founded
With this solid foundation for research in place, the 1981 arrival of Group Health Chief Executive Officer Gail Warden marked a new era of commitment to scientific inquiry. In his administration's first strategic plan, Warden called for a more comprehensive, integrated system of monitoring and evaluating the care-delivery system and its relationship to the health status of its enrollees. The Group Health Board of Trustees established the Center for Health Studies (CHS) on January 26, 1983, and CHS opened its doors just nine months later.
In its first noteworthy success, CHS recruited Ed Wagner, MD, MPH, as director from the University of North Carolina at Chapel Hill. With Wagner at the helm, the Center's research soon helped Group Health become a national leader in such areas as breast cancer screening, immunization, smoking cessation, health promotion in seniors, and epidemiology and management of common chronic diseases. Focusing on evidence-based medicine and improved clinical outcomes, Group Health and the Center emerged as key players in transforming the U.S. health care system and helping shape global research priorities, clinical guidelines, and coverage standards.
Leading with a spirit of collaboration
By 1993, CHS was expanding, with grant revenue topping more than $5 million. As staff and funding grew, so did opportunities for cutting-edge collaboration. By teaming up with researchers locally, nationally, and internationally, CHS added breadth and depth to its findings, using multi-disciplinary approaches to study larger populations. Among our key partners—then and now—are the Fred Hutchinson Cancer Research Center, Veterans Affairs Puget Sound Health Care System, and several major universities, including the University of Washington (UW), Harvard University, and the University of Michigan.
This collaborative spirit reached new heights in 1996, when CHS leaders catalyzed the formation of the HMO Research Network (HMORN), a 15-member consortium of U.S. health plans with sophisticated research capabilities. Through the HMORN, CHS works with researchers nationwide to combine and study data from a diverse population more than 10 million strong. The HMORN's hallmark project is the National Cancer Institute-funded Cancer Research Network (CRN), led by Wagner and focused on gaining new insight into cancer prevention, early detection, treatment, long-term care, and surveillance. The CRN is now in its third funding cycle and is widely hailed as a model of multi-site collaboration at its best.
CHS also provided collaborative leadership through the MacColl Institute for Healthcare Innovation, founded in 1992. The Institute worked with Group Health to create and pioneer the Chronic Care Model, fueling another massive Wagner-led project called Improving Chronic Illness Care. Funded by the Robert Wood Johnson Foundation, this project has enhanced health care for chronically ill people by supporting systems change, promoting research in chronic illness management, and providing technical assistance to organizations nationwide.
By the decade's end, Wagner had stepped down from leading CHS to focus on directing the MacColl Institute. Sue Curry, PhD, became the Center's next director as grant revenue exceeded $10 million, with 19 investigators leading more than 150 active grants. Thanks in part to CHS leadership in several collaborative projects, grant revenue soon doubled.
Setting the pace in the new millennium
The Center's growth continued in the new century's first years, allowing CHS to keep stride as scientific discovery sped up while federal funding for research slowed. The research operations unit rose to the challenge of multiple system-wide administrative changes, thanks primarily to the dedication of CHS' project staff. Several other units within CHS were enhanced over time, dramatically bolstering our infrastructure. With more sophisticated information technology and biostatistics, CHS researchers were better equipped than ever to conduct rigorous scientific analyses. Advances in communications, innovations in medical record review, and the growth of a world-class survey research program helped the Center meet the fast-changing demands of health care research.
CHS also welcomed a new director in 2002: Eric Larson, MD, MPH, previously the medical director of the UW Medical Center. What drew him to Group Health and CHS? Research at Group Health provides the unique opportunity to look for meaningful answers in the "real world" and to help patients benefit from advances in understanding and technology—all to boost public health. In Larson's own words, "Through CHS, Group Health has a history of translating innovative discoveries into practice. CHS keeps finding ways to help real people everywhere benefit from the best innovations in medical science."
CHS becomes Group Health Research Institute
2008 marked the Center's 25th anniversary—a milestone that kicked-off a formal process of better defining its mission and identity. Interviews with community stakeholders, Group Health leaders, funders, collaborators, and others illustrated the significance of our role within Group Health. Yet it still wasn't widely known that Group Health conducted research—even among our own health plan members.
By changing its name to Group Health Research Institute in September 2009, the organization hoped to boost its visibility locally and nationally—and to further solidify Group Health's role as a leader in transforming health care.Much of the Institute's recent work focuses on putting tools for better health at Group Health members' fingertips and empowering them to participate actively in their care. The last several years have brought exciting findings in health informatics, mental health treatment, alternative healing, healthy aging, immunization, and quality of care. Many of these findings illustrate how the ongoing synergy between Group Health research and clinical care leads to groundbreaking innovations. GHRI researchers continue to leverage advances in information technology and patient-centered care, leading to positive outcomes that are changing how health care is delivered—at Group Health and beyond.