Practice-Based Innovations: More Relevant and Transportable Than NIH-funded Studies

Article Figures & Data

Table 1. Contrast of Innovations Informed by National Institutes of Health (NIH)–Funded Studies and Practice Innovators

Characteristics of NIH-Funded Studies	Characteristics of Studies Based on Everyday Practice
Begin with identified gap in the literature	Begin with identified local need
Structured by idealized conceptual framework	Structured by awareness of known local assets
Design based on infusion of unsustainable resources	Design is responsive to local constraints
Grant often adds responsibilities to existing jobs	Design often redistributes responsibilities based on new services offered
Develop grant-dependent roles outside the practices	Develop relationships between practices and community resources
Designed to minimize impact on physicians	Designed to redefine physician role
Grant avoids perturbing the system or adding new outside system	Design intends to create a learning system
Intervention is responsive to pathology	Intervention is responsive to patient experiences of health and illness
Funded interventions engage idealized patients as represented in the literature	Interventions engage real patients as represented in the practice
Based on incremental change	Based on punctuated change or whole-practice transformation
Funded interventions almost exclusively motivated by disease-specific aims	Innovations almost exclusively motivated by the health of patients and community