Project Title

Scalable Partnering Network for Comparative Effectiveness Research Across Lifespan, Conditions, and Settings (SPAN)

Shortened Title


Publication Date


Author Information

Matthew F. Daley, M.D
Senior Investigator, Institute for Health Research
Kaiser Permanente Colorado


SPAN is developing a distributed research network that is interoperable across a range of health care systems and sites, incorporating large and diverse patient populations. The network infrastructure has the capability to conduct large CER studies using data collected by electronic health records at the point of care. The project addresses the important issue of governance to oversee all aspects of managing and conducting multi-site research with confidential health information. For more information, visit

Healthcare Settings

Primary care or ambulatory clinics, Inpatient facilities, Emergency departments, Specialty clinics, Academic medical centers, Community health centers, Long-term care facilities, Community households

Geographic scope type


Locations of Focus

Health systems are located in the following states and major metropolitan areas: Boston, MA; Atlanta, GA; Rural PA; Minneapolis, MN; Rural MN; Denver, CO; Seattle, WA; Portland, OR; San Francisco, CA; Honolulu, HI.

Population Network Size


Informatics Platform/Tools

SPAN Network, SQL Server, Microsoft Access, Oracle, SAS

Grant Type

Scalable Distributed Research Networks

Major Partners

Kaiser Permanente Colorado (Lead Site), Denver Health and Hospital Authority, Essentia Institute of Rural Health, Geisinger Clinic, Group Health Cooperative, Harvard Pilgrim Health Care, Inc., Health Partners Institute for Education and Research, Kaiser Permanente Colorado, Kaiser Permanente Georgia, Kaiser Permanente Hawaii, Kaiser Permanente Northern California, Kaiser Permanente Northwest, University of Pennsylvania, University of Colorado, Denver

CER/PCOR Study Priority Populations

Low-income groups, Minority groups, Women, Children, Individuals who need chronic care, Individuals who live in inner-city areas, Individuals who live in rural areas

Outcome(s) of Interest

  • ADHD Sub-Study #1: The validity of ICD-9 codes for identification of incident cases
  • ADHD Sub-Study #2: Pharmacotherapy for school-age children with ADHD: practice patterns and consistency with quality metrics
  • Obesity Sub-Study #1: Clinical validation of the DeMaria risk score to predict mortality after bariatric surgery
  • Obesity Sub-Study #2: Prognostic Risk Scores
  • Obesity Sub-Study #3: Cross-site variation in bariatric surgical care management programs
  • Obesity Sub-Study #4: Comparative risks of laparoscopic gastric band vs. laparoscopic gastric bypass surgery.
  • Obesity Sub-Study #5: Effect of bariatric surgery on chronic opioid use
  • Obesity Sub-Study #6: SPAN v. HMORN multisite study process
  • Obesity Sub-Study #7: Confounding adjustment in the SPAN’s “Comparative risks of laparoscopic gastric band vs. laparoscopic gastric bypass surgery” project