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EGEMS (Wash DC). 2019 Apr 12;7(1):16. doi: 10.5334/egems.283.

The Healthcare Systems Research Network (HCSRN) as an Environment for Dissemination and Implementation Research: A Case Study of Developing a Multi-Site Research Study in Precision Medicine.

Author information

Geisinger, US.
Kaiser Permanente Colorado, Institute for Health Research, US.
The Meyers Primary Care Institute and Department of Medicine, University of Massachusetts Medical School, US.
University of Colorado, US.
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, US.
HealthPartners Institute, US.
Weill Cornell Medicine, US.
Palo Alto Medical Foundation Research Institute, US.
Kaiser Permanente Northwest, US.



In existence for nearly 25 years, the Healthcare Systems Research Network (HCSRN) is an established and sustainable network of health care systems that serves as a "real world" laboratory to enable the integration of research findings into practice. The objective of this paper is to demonstrate how the HCSRN serves as an ideal environment for studying dissemination and implementation of evidence-based practices into health care systems through the example of developing a multi-site study on the implementation of evidence-based precision medicine practices.

Case description:

The "Implementing Universal Lynch Syndrome Screening (IMPULSS)" study (NIH R01CA211723) involves seven HCSRN health care systems and two external health care systems. The IMPULSS study will describe and explain organizational variability around Lynch syndrome (LS) screening to identify which factors in different organizational contexts are important for successful implementation of LS screening programs and will create a toolkit to facilitate organizational decision making around implementation and improvement of precision medicine programs in health care systems.

Major Themes:

The strengths of the HCSRN that facilitate D&I research include: 1) a culture of collaboration, 2) standardization of data and processes across systems, and 3) researchers embedded in diverse health care systems. We describe how these strengths contributed to developing the IMPULSS study.


Given the importance of conducting research in real world settings to improve patient outcomes, the unique strengths of the HCSRN are of vital importance. The IMPULSS study is one case example of how the strengths of the HCSRN make it an excellent environment for research on implementing evidence-based precision medicine practices in health care systems.


Dissemination and implementation; HCSRN; Lynch syndrome; implementation science; precision medicine

Conflict of interest statement

Funding for the IMPULSS study is provided by the National Cancer Institute (NCI) twenty-first Century Cures Act – Beau Biden Cancer Moonshot R01CA211723. The content of this article is the sole responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. AKR is the funded PI of the study, IL is the project director, and all other authors are site leads for the study. AKR serves an elected term on the Board of Directors for the Lynch Syndrome Screening Network (LSSN), which is a voluntary position. CYL is supported in part by an Ebert Career Development Award, Harvard Pilgrim Health Care Institute & Harvard Medical School, and reports contract with the Center for Genomic Medicine, Massachusetts General Hospital outside the submitted work. RNS is supported by K07CA216326 from the National Cancer Institute and an Improving Healthcare Systems award from the Patient Centered Outcomes Research Institute. He is a paid consultant for the non-profit Institute for Clinical and Economic Review (ICER). All other authors report no competing interests.

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