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COIN News

 

29 September 2021

2021 | 2020

2021 News

 

 HSR&D Merit Award given to Lucas Donovan, MD, MS
29 September 2021 - Dr. Lucas Donovan was awarded an HSR&D Merit Award for his study, Pragmatic Obstructive Sleep Apnea Weight Loss Trial Assessing Effectiveness and Reach (POWER). The funding period will be: October 2021 - September 2025.
Learn more about Dr. Donovan's grant.
 UW News Release: Tele-psychiatry a resounding success in 5-year trial
25 August 2021 - Dr. John Fortney was fetured in this news release for his study titled, "Comparison of Teleintegrated Care and Telereferral Care for Treating Complex Psychiatric Disorders in Primary Care: A Pragmatic Randomized Comparative Effectiveness Trial". As the news release suggests the study was a great success. In Dr. Fortney's words, "The results of our trial showed that if you give access to high-quality care for patients who are underserved, they improve their quality of life".
Read the news release which has links to the article and video discussing the study
 Dr. Jessica Chen interviewed on PainRelief.com: Telehealth for Pain Care Broadens Access to Treatment for Veterans
27 July 2021 - Dr. Jessica Chen appeared on PainRelief.com to talk about her recent publication (co-authored with a number of others including Dr. Steven Zeliadt), Telehealth and rural-urban differences in receipt of pain care in the Veterans Health Administration.
Read the full interview.
 Dr. Joseph Simonetti receives Career Development Award for work on firearm injury prevention
21 July 2021 - Dr. Joseph Simonetti received his 4 year grant (July 2021 - June 2025) for work related to firearm injury prevention. The proposed work will address this critical gap in VHA suicide prevention efforts by developing and testing a Veteran-centered, Emergency Department based Lethal Means Safety (LMS) intervention for multiple methods of suicide.
Learn more about this grant.
 Dr. Jessica Chen Awarded Grant:
Evaluating the National Implementation of Virtual Interdisciplinary Pain Care Teams - TelePain
23 June 2021 - Dr. Jessica Chen was awarded a grant for her work related to pain care and opioid safety. The National Pain Management and Opioid Safety Program (PMOP) is implementing virtual interdisciplinary pain management teams, TelePain, to improve access to evidence-based pain care among rural Veterans and those served by smaller VA facilities. The proposed evaluation, developed closely with PMOP, uses a rigorous prospective design to evaluate TelePain’s impact on clinical outcomes for Veterans and costs to VHA, while also evaluating TelePain’s impact on access to care and other implementation outcomes. These findings will provide actionable information to improving ongoing TelePain implementation efforts and inform VHA of the potential sustainability of TelePain as a model of care.
Find information about the grant
For a well done infographic
 Dr. David Saxon named Chief of Endocrinology, Rocky Mountain Regional VA Medical Center
2 June 2021 - From the official announcement:
"Dr. Saxon is an Assistant Professor who joined the VA and University endocrine faculty after completing Internal Medicine Residency at the University of Michigan, then an Endocrinology Fellowship and a 2-year VA Advanced Health Services Fellowship here in Colorado. Prior to pursuing endocrine fellowship, he was a primary care physician at the Ann Arbor VA. Dr. Saxon's clinical areas of focus are diabetes, obesity, and lipid disorders. His research interests include the study of the utilization of more recently approved medications for chronic metabolic diseases within the VHA, and he is passionate about the innovative delivery of endocrine care through telehealth, e-consults, remote patient monitoring, and the ECHO model. He looks forward to collaborating with colleagues within and outside of the endocrine section for years to come."
 Article: The Opioid Addiction and Recovery Veteran Engagement Board
In the March 2021 issue of HSRD Vet Perspectives Dr. Joe Frank and team have a focus feature on their work with the Opioid Addiction and Recovery Veteran Engagement Board (OAR-VEB). The OAR-VEB is a national board of thirteen Veterans from a wide variety of backgrounds and military experiences that was recruited to provide Veterans’ perspectives to CONDUIT implementation teams.
Read more
 March 2021 Highlights
In March 2021 we had 23 Seattle Denver COIN Investigators publish 15 peer reviewed articles and gave 2 National presentations.
 Assessing changes in delivery and utilization of telehealth between Department of Veterans Affairs Medical Centers and State Veterans' Nursing Homes due to the COVID-19 pandemic to inform future utilization, scalability, and adoption of telehealth modalities
Dr. Leah Haverhals has received funding from the VA Office of Connected care to study changes in delivery of VA telehealth to State Veterans’ Nursing Homes (SVHs) related to the COVID-19 pandemic.
Dr. Haverhals has worked with Dr. Cari Levy on improving access to telehealth specialty care to Veterans in contracted community nursing homes as well as State Veterans’ Nursing Homes since 2017. This work involved developing a telehealth program called VetConnect that provided telehealth care to nursing home Veterans in geriatrics, palliative care, psychology, and psychiatry, among other specialties. Dr. Haverhals and Dr. Levy also evaluated the expansion of VA telehealth to SVHs in FY 2018 and 2019 across the VA system. This funding is an extension of that work to better describe how the pandemic affected delivery of VA telehealth to SVHs. This is of particular importance as the pandemic limited in-person medical visits and because many SVHs are in rural areas across the country. Further, more must be learned about increases and decreases in the provision of telehealth to SVHs during the pandemic, especially as overall VA telehealth care has increased dramatically during this time.
This project will survey VA staff and SVH staff via an online needs assessment and conduct individual phone interviews with VA staff and SVH staff who are part of delivering telehealth to SVH Veterans. Following data collection, results will be reported back to VA and SVH staff with the goal of creating learning communities for VAs and SVHs to support each other and to ensure that positive changes and lessons learned in the delivery of telehealth services during the pandemic can inform future utilization, adoption, and sustainability as appropriate while ensuring high quality of care.
 Understanding and Overcoming the Digital Divide in Specialty Care Following the onset of COVID-19. Evan Carey, PhD
Drs. Evan Carey, Lauren Stevenson, George Sayre have received funding from the VA Office of Connected Care to explore the potential digital divide in access to chronic pain care following changes in the delivery of specialty care post COVID-19 onset.
The VA has been a leader in expanding care to Veterans with rural setting through telehealth in primary care and specialty care settings over the past several decades. In the context of the COVID-19 pandemic, in-person care for non-urgent conditions has been postponed or rescheduled across the nation at VA hospitals. For some facilities, telehealth offered an immediate avenue for patient care to continue despite the restrictions of in-person care availability during these times. The sudden decrease in availability of in-person care coupled with an increase in virtual care modalities introduces a potential exacerbation of disparities in access to health care and patient outcomes for Veterans who have a lower likelihood of utilizing telehealth.
The proposed work will identify segments of the Veteran population who are at a disproportionately high risk of experiencing decreases in access to chronic pain care due to shifts from in-person care to virtual care settings in the context of system changes after the onset of COVID-19. These insights will then guide targeted qualitative interviews of Veterans whose actual utilization is discordant from the risk model: Veterans at a high risk of losing access to care but did access virtual care for chronic pain in the 8 months following the onset of COVID-19, and Veterans with a low risk of losing access to care who did not actually receive care virtual care for chronic pain in the 8 months following the onset of COVID-19
 Dr David Au given Research Innovation and Translation Achievement Award
15 March 2021 - Dr. David Au, COIN Co-Director and UW professor (Pulmonary, Critical Care and Sleep Medicine) is the 2021 recipient of the American Thoracic Society Research Innovation and Translation Achievement Award. This award recognizes outstanding contributions to the advancement of respiratory research focused on specific innovations to improve health by advancing practice, policy and health care delivery.
 Webinar: Access and Virtual Care COREs: Complementary Initiatives to Speed the Research Cycle
3 March 2021 - Dr. Paul Hebert will present the results of an Office of Primary Care-funded study examining the impact of incorporating Nurse Practitioners into VA call centers on healthcare use, cost, and timeliness of care.
Watch recording of the presentation
 February 2021 Highlights
February 2021 was a very productive month for Seattle Denver COIN. Our investigators published 19 peer reviewed articles and gave 2 National presentations (Dr. Leah Haverhals and Dr. Paul Hebert).
 Honor Awarded to Dr. Susan P. Wong
1 February 2021 - Dr. Susan Wong has been given an award for her work on a quality improvement project that is working with the VA Seattle Home Based Primary Care (HBPC) Program to improve access and delivery of home-based primary care to Veterans with advanced kidney disease.
 Publication: The Referral Coordination Team: A Redesign of Specialty Care to Enhance Service Delivery and Value in Sleep Medicine
22 January 2021 - Drs Lucas Donovan and David Au were bookends on this publication exploring how the VA Puget Sound Health Care System organized an integrated referral coordination team and saw improved timeliness of appointments, greater patient satisfaction, and reduced specialist time devoted to initial referral management. Read the publication.
 Publication: VA Home Based Primary Care Teams: Partnering with and Acting as Caregivers for Veterans
21 January 2021 - Drs Leah Haverhals and Cari Levy were co-authors on this publication exploring Veterans Affairs' Home-Based Primary Care (HBPC) Interdisciplinary Team (IDT) which provide in-home, primary care for medically complex Veterans. Read the abstract.
 Funding: Improving Implementation of Outpatient Goals of Care Conversations for Veterans with Serious Illness, David Bekelman, MD, MPH
15 January 2021 - Dr. David Bekelman, MD, MPH, has received funding along with Dr. Annie Walling, MD, PhD, of VA Greater Los Angeles and Karleen Giannitrapani, PhD of VA Palo Alto to study how to improve implementation of the VA Life Sustaining Treatment Decisions Initiative (LSTDI).

The VA LSTDI is an initiative to elicit, document, and honor the values, goals, and preferences of Veterans with serious illness. The LSTDI is important to Veterans because it ensures they can express their preferences for life sustaining treatments (e.g., cardiopulmonary resuscitation, breathing machine, artificial nutrition) and have them honored. However, across VA nationally, only 39% of LSTDI conversations occur in the outpatient setting; the majority occur in the inpatient setting often close to death. At this late stage, Veterans are often not able to make their preferences known because they are so ill. Decisions fall to surrogates who may be uncertain about what the Veteran would have wanted.

This study will examine ways to increase LSTDI conversations among Veterans and their health care providers earlier in illness in the outpatient setting. The primary aim of this project is to use a clinician-level Sequential Multiple Assignment Randomized Trial (SMART) in three VA health systems to determine the effectiveness of clinician and patient implementation strategies to improve the occurrence of documented goals of care conversations in Veterans with serious medical illness.
 Webinar: Engaging Stakeholders in Identifying VA Access Research and Evaluation Priorities: A Foundation for the Access Research Roadmap
6 January 2021 - Dr. Karen Albright, PhD & Dr. Demetria McNeal, PhD, MBA gave this Health Services Research & Development (HSR&D) webinar regarding the Stakeholder Engagement Workgroup. The workgroup engages access researchers within and outside VA, Veterans, and VA operational partners to solicit their perspectives about the most important access-related research domains for VA to address in the next decade. The ultimate goal of this work is to inform VA HSR&D’s funding priorities for access research and, thus, help shape the direction of the field. Recent efforts from the workgroup include conducting
(1) a modified Delphi panel and
(2) a series of dialogues with Veteran Advisory Boards (VABs).

The Delphi process involved a multi-round engagement of 22 access researchers and VA operational partners, in which these experts identified important access related questions and then ranked them in terms of priority for VA support. Veterans’ perspectives on those questions and domains were then solicited from VABs in Iowa City, IA; Ann Arbor, MI; and Bedford, MA. This CyberSeminar will describe the engagement involved in this work and the highest priority access-related questions that emerged from the process.
Watch Engaging Stakeholders in Identifying VA Access Research and Evaluation Priorities: A Foundation for the Access Research Roadmap