Connecting UW Medicine research to primary care clinics around the region

The Practice Research Network allows rural clinics to benefit from technological solutions to big problems.

In north central Idaho, not far from where Lewis and Clark built five dug-out canoes and set out on the Clearwater River for the Pacific Ocean, lies Orofino, a town of about 3,000 souls. It’s where Kelly McGrath has spent more than 20 years practicing family medicine—and building relationships with the clinicians and researchers of the WWAMI region Practice Research Network.

This network—which covers Washington, Wyoming, Alaska, Montana and Idaho—is a collaboration of UW Medicine’s Institute of Translational Health Sciences and the Department of Family Medicine. Its role: to develop working relationships between primary-care practices spread throughout those five states and academic researchers, mainly based in Seattle, so they can jointly improve the health of communities across the Pacific Northwest.

In his case, McGrath, ’85, ’89, has been collaborating with UW Medicine researchers on the latest information for prescribing opioids and managing patients suffering from chronic pain. And it’s changed the way McGrath and his partners manage patients with challenging problems.

“When I think back before the UW collaboration, I think about the areas that were contributing to burnout of primary-care providers,” he says. “Today, I see physicians who don’t feel so alone anymore. The result is that it’s not just physicians who care for these patients now. It’s everyone in the practice. We’re also integrating mental health and behavioral medicine and treating more comprehensively the conditions that occur with addiction such as anxiety, depression and post-traumatic stress.”

Thanks to their work with UW faculty and undergraduate students in the College of Engineering, McGrath and the other primary-care practitioners in the 60-clinic network are looking at ways to implement technological fixes to the routine problems they encounter.

For example, a patient of McGrath is an elderly woman with type 1 diabetes, her vision so impaired that she couldn’t see how much insulin she was drawing in her syringe. Thus, she would administer too much, fall unconscious, and end up in the hospital. Because of the network, McGrath was able to turn to Jonathan Posner, associate professor of mechanical engineering, and his team of students to explore the development of a “smart syringe” to solve the problem.

Matthew Thompson, professor of family medicine and vice chair for research, sees the UW’s role as working to close the gap between new technology and primary-care practice. “For example,” he says, “now you can screen for many conditions with just a drop of blood or urine. But we need to translate these advances into daily clinic work.”

Thompson cites the example of a company that’s working with the UW on a new strep test that delivers immediate results as accurate as those from a hospital lab. Currently, a clinician can take a swab of the throat but today’s rapid strep tests just aren’t accurate enough. That requires clinicians to send additional samples to a lab and patients must wait two or three days for the results.

But Thompson says the near-future holds promise of highly-accurate, fingerstick tests that will transform how patients can get care for common conditions like diabetes and heart disease from urine or blood samples taken and analyzed right in the clinic.

Sometimes clinicians need solutions for problems that are a bit unusual. In parts of Alaska where there are few dentists, primary-care providers routinely apply fluoride to children’s teeth from age six months through middle school. It’s not an easy proposition; children squirm and sometimes object loudly to treatment. A physician in Alaska asked Posner’s students to see if they could apply engineering solutions to help make this easier. (A decision is pending.)

Thompson has nothing but praise for the physicians who collaborate with the UW on research projects and engineering solutions. “The WPRN network of clinics is a jewel in the crown of the UW,” he says. “There are many practice-based research networks, but none that occurs across five states that are so different and so vast.”