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HSR&D: The “Bedside Investigators”. Presentation to: 2009 ORD Local Accountability for Research. Seth Eisen, MD, MSc Director, Health Services Research & Development. Jan 14, 2009. Presentation. Define Health Services Research (HSR), Describe VA HSR’s priorities,
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HSR&D: The “Bedside Investigators” Presentation to: 2009 ORD Local Accountability for Research Seth Eisen, MD, MSc Director, Health Services Research & Development Jan 14, 2009
Presentation • Define Health Services Research (HSR), • Describe VA HSR’s priorities, • Present VA HSR characteristics, • Describe recent HSR initiatives, • Present recent HSR results.
Office of Research & Development (ORD) Chief Research and Development Officer: Joel Kupersmith, MD Deputy CRADO: Tim O’Leary, MD, PhD Biomedical Laboratory Clinical Science Rehabilitation Health Services Director: Micky Selzer, MD, PhD Director: Seth Eisen, MD, MSc Director: Ron Przygodzki, MD Director: Tim O’Leary, MD, PhD QUERI * Director: David Atkins, MD * Quality Enhancement Research Initiative
Health Services Research “The Bedside Investigators” • Access, • Patient Preferences, • Outcomes, • Quality, • Delivery, • Implementation, • Organization, • Costs / Effectiveness.
HSR&D Priorities Disease Oriented: • Mental Health (PTSD, substance abuse, suicide) • Post Deployment Health (TBI, polytrauma, pain) • Care of Complex, Chronic Conditions • Women’s Health • Health Services Genomics Sociological & Cultural: • Equity & Health Disparities • Long-Term Care & Caregiving Methodological: • Research Methodology • Implementation & Management Research • Access/Rural Health • Healthcare Informatics
HSR&D Statistics • 2008 Budget: ~ $88 m (HSR&D + QUERI) • Investigators: ~ 600 • Career development awardees: ~ 50 • Active research projects: ~ 400 • Centers of Excellence & Research Enhancement Award Program (REAP) PI’s: 27
Clinical Research Strengths • Outstanding, university affiliated investigators, • Electronic medical record, • Centralized clinical databases, • Integrated national system, • Implementation focused organization.
Primary Funding Mechanisms • Investigator Initiated Research (IIR) • Request for Proposals (RFP) • Service Directed Project (SDP)
Recent Initiatives • Veterans Informatics, Information, & Computing Infrastructure (VINCI) • Consortium for Healthcare Informatics Research (CHIR) • Provider education to Improve Patient Outcomes • Health Services Genomics
VINCI Research Initiative Data Sources Investigator Health Administrative VINCI (Continuously Update) Investigator Other (e.g., Medicare, DoD, Investigator) Investigator VA Research & IT Provide VINCI Oversight
Advantages of VINCI Concept More data available, Enhanced data security & privacy, Real time mirror with clinical data will facilitate clinical & decision support research, Text data promotes research, Substantial computing power, Rapid adoption of technical computer advances, Rapid sharing & dissemination of informatics products.
Consortium for Healthcare Informatics Research (CHIR) • Create a virtual informatics research consortium, • Extract, cleanse, reformat, de-identify text, • Prepare text for data mining • Apply text processing to clinical issues, • Encourage non-consortium investigators to develop informatics research projects that include text data.
Provider Education to Improve Patient Outcomes • Emphasizes: • Impact of provider education on patient outcomes, • Collaboration with OAA, EES, health educators, • Development of education measurement tools, • Understanding the education process, • Creating & evaluating alternate education methodologies
Summary • Health services researchers are the ‘bedside investigators’ • VA HSR: • priorities address issues related to post-deployment health & VHA quality of care • is implementing several innovative research programs • results are important to both VHA & the nation.