Featured CORE: Virtual Care
Priorities | Impacts | Promising Practices
August 4, 2025
Veterans sometimes encounter barriers to the healthcare they need and deserve. For example, compared to urban-dwelling Veterans, the 4.4 million Veterans who live in rural communities [1] often face greater challenges related to poverty, isolation, and provider shortages.
For these and other Veterans, virtual care can be a game changer. Virtual care technology available through VA—such as telehealth treatments for PTSD or home-based cardiac monitoring—enables Veterans to easily meet with providers and specialists regardless of where they’re located. Virtual care also facilitates remote health monitoring for disease management and makes it easier for Veterans to communicate with their care team.
Virtual care technologies in VA—such as telehealth, computer-assisted communication platforms, mobile applications, and patient-generated health data—help mitigate the health, economic, environmental, and infrastructure factors that diminish Veterans’ care access, quality, experience, equity, and outcomes.
The Virtual Care Consortium of Research (VC CORE), part of VA’s Health Systems Research (HSR), facilitates research that evaluates and improves the use of virtual care to enhance the accessibility and quality of VA healthcare. Led by Principal Investigators Scott Sherman, MD, MPH; Tim Hogan, PhD; and Donna Zulman, MD, MS, the VC CORE promotes collaboration and communication among its 400 members from more than 70 VA medical centers nationwide. The VC CORE partners with VA’s Office of Connected Care (OCC), which oversees much of VHA’s portfolio of virtual care technologies, as well as other VA program offices.
VC CORE Priorities
- Strengthen the VC CORE’s network.
- Promote collaboration among VC CORE network members.
- Foster partnerships between VC CORE investigators and OCC, Office of Research and Development (ORD), other VA program offices and federal agencies.
- Support VA’s next generation of virtual care researchers through early career training and funding opportunities.
- Foster rapid, rigorous, and innovative virtual care research and quality improvement activities.
- Monitor evidence generation and curate VA virtual care research and evaluation priorities to address needs of operational partners and the VA healthcare system.
- Facilitate use of novel and existing data and measurement resources to advance virtual care priorities.
- Establish a Veteran Engagement Panel and Survey Cohort to promote Veteran-centered virtual care research and evaluations.
- Support VA’s efforts to implement virtual care across the enterprise.
- Identify promising virtual care innovations and effective programs that warrant further testing and/or implementation.
- Facilitate the translation of virtual care research findings from clinical trials to health system implementation through operational partnerships and the emerging structures of VA’s recently reorganized Office of Research and Development.
- Support the development of new data sources to evaluate implementation of virtual care technologies.
- Generate and synthesize evidence to advance VA practice and policy.
- Leverage VC CORE products, resources, and partnerships to synthesize evidence for congressional requests and other OCC needs.
- Coordinate funding opportunities for OCC-funded projects.
A 2024 special issue of the Journal of General Internal Medicine, edited by VC CORE leaders, highlighted virtual care priority areas that were identified during an HSR state-of-the-art virtual care conference (VC SOTA), as well as peer-reviewed papers from HSR investigators on virtual care access, engagement, and outcomes in VA. The priorities have informed the Office of Connected Care’s selection of quality improvement and evaluation projects, and findings of those projects are actively influencing policy and clinical practices related to virtual care in VA.
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VC CORE Impacts
- Facilitate OCC-funded projects that address virtual care knowledge gaps. From FY2020–FY2025, the VC CORE coordinated more than $13 million of OCC funding for 53 quality improvement projects and evaluations that address key priority areas. These projects span clinical and health service areas including primary and emergency care, cardiac rehab, sleep medicine, gastrointestinal disease, diabetes, obesity, amputee rehab, caregiver support, and health equity. Examples include:
- Tele pre-op anesthesia: Findings of this study showed that remote (e.g., via video, telephone) pre-anesthesia evaluation was comparable to conventional face-to-face pre-op evaluation. This led to the development of VA-wide goals for VA Video Connect (VVC) pre-anesthesia encounters.
- Veteran and provider perceptions of virtual vital sign assessment: This study evaluated feasibility and acceptability of VVC vital sign assessment via smartphone video. Findings will guide VA-wide deployment of a forthcoming state-of-the-art tool that is expected to receive FDA approval.
- Maintain a comprehensive database of ongoing and recent VA virtual care research and evaluations, including:
- More than 420 HSR-funded projects, to promote a data-driven approach that assists researchers, informs VA policy and operations, and delivers effective treatments to Veterans faster.
- More than 450 non-HSR quality improvement or program evaluation projects funded by VHA program offices (e.g., OCC, Office of Rural Health, Office of Mental Health, National Center for PTSD) and QUERI programs related to virtual care [e.g., Virtual Care QUERI, Expanding Expertise Through e-Health Network Development (EXTEND), Evaluating VA Patient-Centered Care (EPCC)].
- Share more than 50 virtual care implementation tools through the VC CORE SharePoint site, including toolkits, guidebooks, training documents, recruitment materials, and user manuals.
- Contribute to congressionally mandated reports, one of which provided an overview of scientific evidence on the effectiveness of telehealth for the Cleland-Dole Act.
- Host a Veteran Engagement Panel to help integrate Veterans’ perspectives and experiences in virtual care research, interventions, and quality improvement projects.
Recent VC CORE Projects that Address VA Priorities
- A study led by a VC CORE investigator examined how broadband availability affects video-based mental healthcare access. The findings generated foundational knowledge that has informed other studies examining the uptake of video visits by location and are being integrated in OCC’s plans to help Veterans access telehealth.
- VC CORE investigators co-authored a study that assessed homeless-experienced Veterans’ use of telehealth services in primary care and the characteristics of those users before and after the onset of the COVID-19 pandemic.
- A VC CORE investigator worked with Behavioral Health QUERI to improve outcomes for Veterans with mental health needs. The team has synthesized evidence of telehealth for mental health, including data related to implementation, user engagement, and evaluation.
- A study co-authored by VC CORE investigators investigated emergency telemental health barriers and facilitators. Clinicians, clinical and facility leaders, Veterans, and external partners who were interviewed by the study’s investigators indicated support for further spread of telemental health video, particularly given the shortage of mental health providers in rural settings.
- A study co-authored by VC CORE investigators examined whether virtual complementary and integrative health (CIH) therapies are as effective as in-person therapies for Veterans with chronic musculoskeletal pain. Researchers found that many Veterans perceived health improvements from CIH therapies, with similar improvements in pain and mental health for in-person and hybrid users.
- A study led by a VC CORE investigator found that rural Veterans at risk for suicide who received a VA-issued tablet (compared to those who did not) experienced increased mental health service use, as well as a 36% reduction in the likelihood of suicide-related emergency department (ED) visits and a 20% reduction in the likelihood of any ED visit. The paper was cited in an Office of Inspector General Report, disseminated by the Under Secretary for Health to highlight VA’s effective strategies for bridging the digital divide, and was recognized with an HSR Best Paper Award.
- A study led by VC CORE investigators on the use of virtual care for the treatment of type 2 diabetes identified determinants of providers’ use of continuous glucose monitoring (CGM), which will inform efforts to standardize use of CGM in VA.
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Promising Practices Assisted by the VC CORE
- A VC CORE team is working with OCC to identify virtual health resource (VHR) best practices to inform VHR navigation support and help integrate virtual care training at the clinical level. This will increase VHR interest, access, and use among clinicians. (Results not yet published.)
- A VC CORE team led a pilot evaluation of MyVAImages (MVAI) mobile application use in three amputation specialty clinics. The team worked with eight VHA sites to develop processes for using the application and disseminated guidance to the field on how to provide asynchronous amputation rehabilitation using MVAI. The VC CORE team is now working with OCC to address barriers identified by the sites before national rollout of this initiative. (Results not yet published.)
“Having a CORE associated with the Office of Connected Care has fostered research partnerships that advance our Office priorities and support the implementation and dissemination of effective telehealth and connected health services.”—Leonie Heyworth, MD, MPH, Deputy Director for Clinical Services, VHA Telehealth Services | Office of Connected Care, Digital Health Office
[1] https://www.ruralhealth.va.gov/aboutus/ruralvets.asp
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