Editor's Note: W. Perry Dickinson, MD, leads the Practice Innovation Program through the Department of Family Medicine. His team recently received some well-deserved support to further their mission of fostering innovation in health and health care. 

Editor: You are coming off a staggering and impressive couple of years that saw projects and partnerships with the likes of SIM, ENSW, and more – that made and continue to make impacts throughout Colorado and the nation in terms of improving health and health care through practice innovation tools and training.

How does this latest grant from AHRQ, to help primary care practices address patients’ unhealthy alcohol use, further the your team’s already established foot print and goals?

Perry: This project is a natural progression of the work we have done over the past five years in a couple of key ways. First, it is a natural follow-up to the Colorado State Innovation Model (SIM) initiative, which was particularly focused on improving behavioral health care in primary care practices. While substance use was included in the definition of behavioral health, SIM practices tended to focus more on mental health issues than on substance use, so this project is a great next step. In addition this project keeps us moving forward in further building and using the Colorado Health Extension cooperative of practice transformation organizations and state agencies for broad-based, statewide support of improvements and innovation in health care.

Editor: Please provide a brief description of how your team fits within the larger group of grantees. After all, you are not alone in network of sites that will be carrying out this work.

Perry: Through a series of projects, AHRQ is building a network of statewide health extension programs capable of providing support for practices in implementing new evidence-based interventions and frameworks to improve care. Efforts like EvidenceNOW and the unhealthy alcohol use project are greatly assisting us in networking and collaborating with other groups like us across the country in figuring out how to optimally structure our programs and our support of practices. Both the grantees and AHRQ are learning a lot across these projects, and it has been a great learning community. 

Editor: How is your Practice Innovation team uniquely suited to succeed in this particular project? What do you bring to the table that will benefit the overall project?

Perry: Our background in dealing with behavioral health issues in primary care and our work on large, statewide practice transformation projects have provided us with a wealth of experiences, expertise, and resources that we can share with the other grantees, AHRQ, and the external evaluator for the overall project.

Editor: What, exactly, will your team be doing as part of this project? What do you hope/plan to do or develop as a key player in this endeavor?

Perry: This project will allow us to support practices in improving their care across the broad spectrum of unhealthy alcohol use. This is a major problem in Colorado, where one in five Coloradans drink excessively, and causes early deaths, disability, and an estimated $5 billion per year in economic costs. Our practices can do a much better job in screening for unhealthy alcohol use, counseling and supporting those who are exceeding moderate drinking guideline, and providing treatment for those with alcohol use disorder. Colorado has had a number of excellent efforts to improve the identification and treatment of alcohol problems over the past decade, and this project will build on and extend those efforts.

Editor: The overall grant for the project is $16 million. Any estimate of how much of that total will help to fuel your team’s efforts?

Perry: Our program will receive just under $2.25 million over three years for this project.

Editor: This is just part of the Practice Innovation team portfolio – what more can you share about other potential grants/projects that are coming down the pipeline?

Perry: With support from the Dean of the College of Medicine and CU Medicine, the Practice Innovation Program was recently funded to provide practice transformation support to up to 80 practices a year to implement a slightly updated version of the framework and milestones developed in SIM. This funding will also allow continued statewide coordination and activities of the Regional Health Connector program, which enables important connection and collaboration across practices, public health, and community health organizations across the state. Under Kyle Knierim’s leadership, our team has also been engaged in a series of projects aimed at treatment and prevention of opioid use disorder in collaboration with the Colorado Office of Behavioral Health, the Colorado Department of Public Health and Environment, the High Plains Research Network, and many other Colorado groups. A new project being developed in collaboration with the Office of Behavioral Health will focus on improving identification and treatment of mental and substance use disorders in Colorado jails. Beyond that, our program has proposals pending or ideas in development for projects across a pretty broad range of implementation, research, health policy, and workforce development projects.