FORUM - Translating research into quality health care for Veterans

Summer 2017

In This Issue

Director's Letter

Director's Letter
by David Atkins, MD, MPH, Director, HSR&D

As VA expands into a world of "Choice" and community partnerships, providing access will increasingly draw on community providers. But truly supporting the needs of rural Veterans must go beyond providing health care access...

Commentary

Increasing Rural Veterans' Access to Care Through Research
By Thomas F. Klobucar, PhD, Acting Executive Director, Office of Rural Health, Washington, DC

To the extent that rural Veteran dependency on VA health care continues to grow relative to urban reliance, it is imperative that researchers strengthen their efforts to focus on Secretary Shulkin's priorities of access and modernization to give Veterans "true choice"...

Response to Commentary

Partnered Research to Improve Health of Rural Veterans
By Teresa Hudson, PharmD, PhD, HSR&D Center for Mental Healthcare and Outcomes Research, North Little Rock, Arkansas

The VA research community has undertaken highly partnered, rigorous work to develop and test innovative implementation strategies that help ensure delivery of evidence-based care for rural Veterans. Indeed, several HSR&D-funded centers, known as Centers of Innovation (COINs), focus on strategies for optimizing care among rural Veterans...

Research Highlights

The Virtual Specialty Care QUERI Program: Improving Access to High-Quality Specialty Care for Rural Veterans
By John Fortney, PhD, Greg Reger, PhD, and Alexis Beatty, MD, all with HSR&D's Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System; and Heather Reisinger, PhD, Caroline Turvey, PhD, and Michael Ohl, MD, all with HSR&D's Center for Comprehensive Access and Delivery Research and Evaluation, Iowa City VA Health Care System

Virtual care teams are groups of clinicians and patients working across time, space, and organizational boundaries using digital modes of communication (e.g., telehealth, ehealth, mhealth, and electronic exchange of health information). The goal of the Virtual Specialty Care (VSC) QUERI is to support operational partners (Office of Rural Health, Office of Connected Care, and Mental Health Services) in the national rollout of promising clinical practices that incorporate virtual care technologies in order to improve access to high-quality specialty care for rural Veterans...

Building an Adequate VA Care Network: Evaluating the Impact of Choice Providers
By Evan Carey, MS, HSR&D Center of Innovation for Veteran-Centered and Value Driven-Care, VA Eastern Colorado Health Care System, Denver, Colorado

In response to concerns about inadequate access to health care services for Veterans, Congress passed the Veterans Access, Choice and Accountability Act (Choice) of 2014, thereby expanding VA health care networks with the addition of community care providers. In this article, we review the results of a recently completed operations evaluation of approved Choice providers and discuss how VA can optimize future health care network expansion...

Identifying Barriers to Engagement in Mental Health Care: Perspectives of Rural Veterans and Providers
By Ellen P. Fischer, PhD, HSR&D Center for Mental Healthcare and Outcomes Research and South Central Mental Illness Research, Education and Clinical Center, North Little Rock, Arkansas; Jean C. McSweeney, PhD, and Patricia Wright, PhD, College of Nursing, University of Arkansas for Medical Sciences, Little Rock, Arkansas

Historically, rural residents have used fewer mental health services than urban residents despite equal or greater need. VA is aggressively addressing structural barriers to rural Veterans' access to mental health care by opening community-based outpatient clinics (CBOCs), reaching out through mobile clinics and telemedicine, and contracting with community providers, most recently through the Veterans Choice Act...

VHA-Indian Health Service Collaborations Reveal Opportunities to Improve Rural Health Care
By B. Josea Kramer, PhD, Beth Creekmur, MA, and Debra Saliba MD, MPH; Drs. Kramer and Saliba are with the VA Greater Los Angeles Healthcare System, Geriatric Research Education and Clinical Center, Los Angeles, California; Ms. Creekmur is with the Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California

VA Home Based Primary Care (HBPC) is an interdisciplinary, longitudinal program for Veterans who are vulnerable to poor outcomes because of complex, intertwined functional and medical needs. In 2009, VA Office of Rural Health funded expansion of HBPC to rural areas and to American Indian reservations, where health care is also provided by Indian Health Service (IHS) or Tribal Health Programs (THP) in accordance with a Memorandum of Understanding between VA and IHS. By using the "natural laboratory" of these expansion programs, the research team was able to identify the key barriers and facilitators to implementing NILTC for vulnerable rural populations...

Questions about the HSR website? Email the Web Team

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.

VA Health Systems Research

In This Issue