Reengineering the Clinical Research Enterprise to Involve More Community Clinicians

Background: The National Institutes of Health has called for expansion of practice-based research to improve the clinical research enterprise. Methods: This paper presents a model for the reorganization of clinical research to foster long-term participation by community clinicians. Based on the literature and interviews with clinicians and other stakeholders, we posited a model, conducted further interviews to test the viability of the model, and further adapted it. Results: We propose a three-dimensional system of checks and balances to support community clinicians using research support organizations, community outreach, a web-based registry of clinicians and studies, web-based training services, quality audits, and a feedback mechanism for clinicians engaged in research. Conclusions: The proposed model is designed to offer a systemic mechanism to address current barriers that prevent clinicians from participation in research. Transparent mechanisms to guarantee the safety of patients