VA Implementation Research Seth Eisen, MD, MSc Director Health Services Research and Development (HSR&D) Department of Veterans Affairs Washington, DC.

Slides:

Advertisements

Similar presentations

Evaluating best practice implementation within a network of 6 rehabilitation centres across Canada Presented by: Laura Mumme Koning C, Kras-Dupuis A, Mumme.

Advertisements

C are O f M ental, P hysical A nd S ubstance-use S yndromes Claire Neely, MD Medical Director, ICSI August 23, 2013.

Improving Depression Treatment in Primary Care: Dissemination and Implementation Edmund Chaney, PhD Department of Veterans Affairs, Seattle AcademyHealth.

PAYING FOR PERFORMANCE In PUBLIC HEALTH: Opportunities and Obstacles Glen P. Mays, Ph.D., M.P.H. Department of Health Policy and Administration UAMS College.

Mental Health is Integral to Overall Health. Health Issues Related to People with Serious Mental Illness People with SMI who receive services in the public.

Kate Gerrish Professor of Nursing Sheffield Teaching Hospitals NHS FT Sheffield Hallam University Translating Knowledge into Action Implementation Theme.

VETERANS HEALTH ADMINISTRATION Quality Improvement using the VA Electronic Health Record Matthew Bidwell Goetz, MD Chief, Infectious Diseases VA Greater.

Clinical Alliances and Partnerships Raul A. Romaguera, DMD, MPH Division of HIV/AIDS Prevention Centers for Disease Control and Prevention March 11, 2004.

Implementation Research: Using Science to Guide Implementation of Evidence-Based Practices Brian S. Mittman, PhD Director, VA Center for Implementation.

Primary Care-Mental Health Integration in the Department of Veterans Affairs Andrew Pomerantz, MD National Mental Health Director for Integrated Services,

FROM THE CLINIC TO THE COMMUNITY: THE ROLE OF PUBLIC HEALTH INSTITUTES IN MODELING THE EXPANSION OF THE COMMUNITY HEALTH WORKFORCE.

Department of Veterans Affairs Program. VA Overview: Organization  157 hospitals Nationwide  One of the largest health care systems in the USA  Conducts.

Hepatitis and Liver Cancer A National Strategy for Prevention and Control of Hepatitis B and C.

STI Prevention & Control Programs Local and State M. Terry Hogan, MPH STD/HIV Prevention Training Center at JH June 9, 2014 National Center for HIV/AIDS,

WHO GLOBAL ALCOHOL STRATEGY

Keith J. Mueller, Ph.D. Director, RUPRI Center for Rural Health Policy Analysis Head, Department of Health Management and Policy College of Public Health.

DELAWARE HEALTH AND SOCIAL SERVICES Division of Public Health Public Health and PCMH Karyl Rattay, MD, MS Director Delaware Division of Public Health.

EVOLVING PUBLIC HEALTH AND HEALTH CARE LANDSCAPE AND OPPORTUNITIES FOR CANCER COMMUNICATION NCI Health Communication and Informatics Research Branch CPCRN.

Genomics Alexandra Hayes. Genomics is the study of all the genes in a person, as well as the interactions of those genes with each other and a person’s.

The National Implementation of Care Coordination in VA SPRY Conference Washington DC 3 rd October 2003 Adam Darkins MD, MPH, Chief Consultant for Care.

2 AMERIGROUP Community Care Entered Maryland market in 1999 Largest MCO in Maryland Serving over 143,000 members in Baltimore City and 20 counties in.

1 NATIONAL ADVISORY COUNCIL ON HEALTHCARE RESEARCH AND QUALITY Subcommittee on Quality Measures for Children's Healthcare in Medicaid and CHIP Overview.

Integration of 5 Public Health Programs Jan Norman, RD, CDE Chronic Disease Prevention Unit Washington State Department of Health.

Program Collaboration and Service Integration: An NCHHSTP Green paper Kevin Fenton, M.D., Ph.D., F.F.P.H. Director National Center for HIV/AIDS, Viral.

ACCELERATING CLINICAL AND TRANSLATIONAL RESEARCH Engaging Hospitals in Research: Implementation Science Jose Azar, MD Medical Director,

Augusta Health Forum Specialty Providers Home Health Parks Economic Development Colleges Employers Nursing Homes Mental Health Drug Treatment Civic.

CMS as a Public Health Agency: Effective Health Care Research Barry M. Straube, M.D. Centers for Medicare & Medicaid Services January 11, 2006.

Chapter 6 – Data Handling and EPR. Electronic Health Record Systems: Government Initiatives and Public/Private Partnerships EHR is systematic collection.

The Center for Health Systems Transformation

State of California Department of Alcohol and Drug Programs Summit: Using Performance and Outcome Measures to Improve Treatment Performance Management.

Blueprint Integrated Pilot Programs Building an Integrated System of Health Craig Jones, MD Blueprint Executive Director 10/30/20151.

Efforts to Reduce Disparities: Barriers, Innovation, Implementation and Evaluation Joseph R. Betancourt, M.D., M.P.H. Director, The Disparities Solutions.

Organizational Context & Penetration of QI Interventions: Case Studies from Implementing Depression Collaborative Care Elizabeth Yano PhD 1, 2 ; JoAnn.

Making the Business Case for Improving HIV Testing Rates in the US Dept of Veterans Affairs Henry D. Anaya PhD Quality Enhancement Research Initiative.

National Strategy for Quality Improvement in Health Care June 15, 2011 Kana Enomoto Director Office of Policy, Planning, and Innovation.

Behavioral Health Integration

National Center for Chronic Disease Prevention and Health Promotion

GUIDE TO EVIDENCE-BASED INTERVENTIONS. ASDs now affect one in every 110 children Centers for Disease Control and Prevention Lifelong effect on functioning,

Lisa F. Waddell, MD, MPH Chief, Community Health and Prevention Association of State and Territorial Health Officials October 21, 2015 National Forum for.

1 Improving the Quality of Health Care for Mental and Substance-Use Conditions “America will not have a high-quality health system if equal attention is.

Hiring a Nurse Researcher/Scientist Nursing Research Field Advisory Committee (NRFAC) January 2015.

Local Accountability for Research Protection in Health Services Research Seth Eisen, MD, MSc Director, HSR&D.

HIV/AIDS and Mental Health Integration: Is Something Not Right

Health Reform: Is Your Community Ready for 2014? Frances M. Harding, Director SAMHSA’s Center for Substance Abuse Prevention 2011 School for Prevention.

Jan 14, 2009 Presentation to: 2009 ORD Local Accountability for Research Seth Eisen, MD, MSc Director, Health Services Research & Development HSR&D: The.

California Department of Public Health Office of AIDS HIV CARE and PREVENTION 2009: You Need to Know.

Primary Care Improvement Infrastructure: The Role of Practice Facilitation Michael L. Parchman, MD MPH MacColl Center for Health Care Innovation AHRQ Annual.

Georgia Comprehensive Cancer Control Program 3/10/2015 Program Monitoring and Evaluation Activities Short-Term Outcomes Long-Term Outcomes Intermediate.

Using Multiple Data Sources to Understand Variable Interventions Bruce E. Landon, M.D., M.B.A. Harvard Medical School AcademyHealth Annual Research Meeting.

John G. Demakis, MD - Director Shirley Meehan, MBA, PhD - Deputy Director Presentation to Administrative Officers for Research February 25, 2004 Health.

State of California Department of Alcohol and Drug Programs The Substance Abuse Research Consortium Semi Annual Meeting Improving the Quality, and Effectiveness.

VASA VA Statisticians’ Association HSRD Breakfast Session 02/15/2008 7:00am.

Transforming Care in Patient Centered Medical Home and Accountable Care Organization Hae Mi Choe, PharmD Director, Pharmacy Innovations & Partnerships.

PRACTICE TRANSFORMATION NETWORK 2/24/ Transforming Clinical Practice Initiative (TCPI) Practice Transformation Network (PTN)  $18.6 million –

Health Departments and HIV Screening Institute of Medicine Workshop 1: Screening and Access to Care April 15, 2010 Natalie Cramer, Associate Director,

Overview: Evidence-based Health Promotion and Disease Management Programs.

Use of Mentored Residency Teams to Enhance Addiction Medicine Education Maureen Strohm, MD, Ken Saffier, MD, Julie Nyquist, PhD, Steve Eickelberg, MD MERF.

David M. Murray, Ph.D. Associate Director for Prevention Director, Office of Disease Prevention Multilevel Intervention Research Methodology September.

Clinical Quality Improvement: Achieving BP Control

Champlain LHIN Collaboration

Promoting Healthy Weight for Children (and Staff) in DCPS

EDC ©2016. All rights reserved.

Health Services Research Postdoctoral Fellowship

Sandra M. Foote Senior Advisor, Chronic Care Improvement June 23, 2005

West Virginia Bureau for Medical Services (BMS)

Improving the Quality of Health Care for Mental and Substance-Use Conditions “America will not have a high-quality health system if equal attention is.

SAMPLE ONLY Dominion Health Center: Excellence in Medicaid Managed Care (or another defining message) Dominion Health Center is a community health center.

SAMPLE ONLY Dominion Health Center: Your Community Partner for Excellent Care (or another defining message) Dominion Health Center is a community health.

SAMPLE ONLY Dominion Health Center: Your Community Partner for Excellent Care (or another defining message) Dominion Health Center is a community health.

Presentation transcript:

VA Implementation Research Seth Eisen, MD, MSc Director Health Services Research and Development (HSR&D) Department of Veterans Affairs Washington, DC

VA Implementation Research Environment Electronic medical record National databases Outstanding group of clinical researchers Research funding programs Strong academic affiliations Clinical and research leadership and operations Large integrated health care delivery system involvement and support

Quality Enhancement Research Initiative QUERI

QUERI Mission To enhance the quality, outcomes, and efficiency of VA health care by systematically facilitating the implementation of evidence-based research findings into routine clinical practice

QUERIs Six-Step Process Identify high-risk/high-volume diseases or health problems among veterans, Identify best practices, Define existing practice patterns and outcomes across VA, and current variation from best practices, Identify and implement interventions to promote best practices, Document that best practices improve outcomes, Document that outcomes are associated with improved health-related quality of life.

QUERIs Research/Implementation Pipeline Implementation Research Implement Intervention & Document outcome Clinical Research / Guideline Development Mainstream Health Services Research Assess Existing Practice Identify Research Area Identify Best Practice Implementation Policy, Improved Health Phase 1 Pilot Projects Phase 1 Pilot Projects Phase 2 Small-Scale Demonstrations Phase 2 Small-Scale Demonstrations Phase 3 Regional Demonstrations Phase 3 Regional Demonstrations Phase 4 National Rollout

Nine QUERI Coordinating Centers Ischemic Heart Disease Chronic Heart Failure Diabetes Stroke HIV/Hepatitis C Polytrauma and Blast-Related Injuries Spinal Cord Injury Mental Health Substance Use Disorders

QUERI Coordinating Centers SUD-QUERI Houston, TX CHF-QUERI Palo Alto, CA HIV/HEPATITIS C-QUERI Greater Los Angeles PT/BRI-QUERI Minneapolis, MN IHD-QUERI Seattle, WA DM-QUERI Ann Arbor, MI MH-QUERI Little Rock, AR SCI-QUERI Hines, IL QUERI Centers STROKE-QUERI Indianapolis, IN

Funding Sources QUERI Coordinating Centers - $450,000 Core from Medical Care (~$200k for projects) Service-Directed Projects (SDP; $900k max) & Rapid Response Projects (RRP; $50k max) funded from Medical Care VA Investigator-Initiated Research NIH, AHRQ, RW Johnson

QUERI Projects and Impacts CHF-QUERI decreased hospital readmission rates by up to 10% through patient-centered care coordination. DM-QUERI improved BP control in veterans with diabetes in VISN 11.

QUERI Projects and Impacts contd HIV/Hepatitis-QUERI improved rates of HIV screening, and optimal treatment with antiretroviral drugs. MH-QUERI improved treatment and outcomes for veterans with depression by implementing collaborative care models.

QUERI Projects and Impacts contd SCI-QUERI doubled the rates of pneumonia and influenza vaccine for spinal cord injured veterans. Stroke QUERI improved quality of post- stroke depression care and produced and evaluated patient information materials on stroke prevention.

Challenges Simultaneous implementation of >1 evidence based best practice Implementation of treatments in clinically important areas with little evidence based knowledge De-implementation of widely used, non- evidence-based interventions Transition of implementation to routine patient care Identification of new QUERI areas

Possible New QUERI Areas Healthy Behavior, e.g., weight control, exercise, patient adherence Cancer Long-term community care Simultaneous implementation of several evidence based best practice

QUERI Summary VA provides an outstanding environment for implementation research QUERI identifies & evaluates the implementation of evidence based best practices, & assists with system-wide adoption Substantial challenges remain, including how to simultaneously implement several evidence based best practices

Essential Resource for Investigators: Online implementation guide: queri/implementation/

Contact Information: QUERI Program Manager: Implementation Portfolio Manager:

QUERI: Lessons Learned Partner leaders and researchers at the start Apply evidence to a broader range of issues Increase the emphasis on products needed by the system to improve performance Add capacity to conduct Implementation Research

Promoting Implementation Research: Within and Outside of VA Sponsorship of Open-Access Implementation Science Journal –QUERI theme issue to be published in 2007 Work with AHRQ, NIH and CDC to develop review criteria and methodological standards Active Involvement and Sponsorship of IOM Forum on Science of QI and Implementation Integrate activities across ORD and with key internal groups (NLB, OQP, PCS, OAA)