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A Dream to Serve Veterans
Indra Sandal is the Chief of Innovation at the James A. Haley Veterans’ Hospital and Clinics in Tampa, FL and National Lead of the VHA Uber Health Connect (VUHC) Initiative. Growing up, Indra was inspired by her father’s service in the Indian military and knew she wanted to dedicate her career to serving Veterans.
After receiving her PhD in Genomics and Infectious Disease in India, Indra moved to the U.S. to serve as Assistant Professor of Medicine at the University of Utah. Eager to realize her dream of working for VA, Indra applied to positions across the country and landed at the Lt. Col. Luke Weathers, Jr. VA Medical Center in Memphis, TN as a research biologist. At the same time, Indra began her MBA at the Kellogg School of Management studying how innovation and entrepreneurship can transform the health care ecosystem.
Rooted in Innovation
At VA, Indra surrounded herself with enthusiast mentors who helped her shape her innovation career. While in Memphis, Sandal took on the role of Innovation Specialist, working to empower fellow frontline innovators as they designed and tested their own solutions. Indra was selected as a 2020 VHA Innovation Ecosystem Entrepreneur in Residence fellow, where she began developing the VUHC Initiative.
The VUHC Initiative is a collaboration between VHA IE, the Veteran Transportation Program, and Uber Health, which offers rideshare as a supplemental transportation option for Veterans to get to and from their medical appointments. Indra launched Phase I of the VUHC Initiative in January 2022 at 10 VAMCs. The initiative has since expanded to 58 additional VAMCs, provided over 170K rides to nearly 28,000 Veterans, and saved VA over $129 million from faster emergency and inpatient discharges and avoiding no-show/missed appointments.
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Last year at the VHA Innovation Experience, Indra was honored with the Dr. Robert L. Jesse Award for Excellence in Innovation in the non-clinical category for her outstanding work with the VUHC Initiative. The award is presented to VA employees who have demonstrated brilliance enabling the discovery and spread of health care innovation that exceeds expectations, restores hope, and builds trust within VA.
Building a Culture of Innovation in Tampa and Beyond
In January 2023, Indra joined the Tampa VAMC as Chief of Innovation where she currently works to build an ecosystem for people to deliver transformative innovations to solve complex challenges within the VA health care system. Last year, Tampa also marked their entry into the VHA Innovators Network.
Indra is focused on engaging partners in academia, industry, and other government and non-government agencies on innovations that will improve the quality of Veteran care.
Looking Ahead
“The VUHC Initiative is just one step in my innovation journey,” Indra stated, “Innovation never ends, and innovators never stop innovating.” Indra is already looking for the next challenge. She is currently exploring the possibility of launching a collaboration with UberRX to test a new prescription delivery model to deliver life-saving medication to Veterans within a shorter delivery timeframe.
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 ‘The Exchange’ is a monthly VHA Innovation Ecosystem series led each month by a different team of individuals who are disrupting existing models of care to build the future, using the principles and tools of innovation. In January, we hosted a panel of innovators who discussed the challenges and triumphs in expanding access to VA health care services for Veterans residing in rural areas. The discussion began with panelists sharing overviews of the problems they identified and projects they lead that address those problems.
on a project that helps improve access to Veterans at increased risk of amputations and blindness. Her program, High-risk Limb Preservation Program, or HELPP, was created to provide footcare services and eye screenings in the rural setting.
Eli Kaufman, CPO, touched on the challenges Veterans can face when trying to reach VA medical centers in urban areas for orthotic and prosthetic (O&P) care when they have to travel from distant, rural areas to receive that care. In the case of O&P care, telehealth and virtual visits are difficult due to nature of care and the need for physical products. The Mobile Prosthetic and Orthotic Care Program, which you can read more about below, was created to address this need.
The panel moved on to discuss how their respective programs have evolved over time. began his innovation journey taking care of patients and identifying areas of improvement in the care he was providing. Dr. Abbott serves Veterans using a telehealth asynchronous modality to support optometrists in rural communities. He added that innovation is not just the idea but the implementation. His project has able to evolve into an effective implementation stage through building coalitions of likeminded problem solvers to reimagine the eye care he was seeking to provide.
Dr. Colleen McQuown leads SCOUTS, or the Supporting Community Outpatient Urgent care & Telehealth Services program, a Diffusion of Excellence Promising Practice and Office of Rural Health Enterprise Wide Initiative. SCOUTS is a post emergency department (ED) complementary service utilizing Intermediate Care Technicians (ICTs-former military medics and corpsman) to support care transitions for older Veterans by ensuring unmet care needs and digital divide concerns are addressed in an acute time frame. Expanding telehealth modalities, SCOUTS introduces older adults to technology so they can incorporate as many necessary providers as possible into their care, i.e., pharmacists, general practitioners, etc. Her project has evolved through the Diffusion Marketplace and utilizing other VA resources.
The panelist’s advice for fellow innovators? “We need to quantify and build numbers pipeline to model impact and sustain your project” Dr. Abbott said. McQuown touched on spreading awareness of her service to Veterans and potential patients: “Selling my project has been easier when sharing Veterans’ stories, statistics, etc.” Kristen Wing, Communications Director for Office of Rural Health, touched on the need to integrate innovation into everyday standard care to the point where it’s no longer innovation, it’s becoming normal.
Want to register for future Exchange calls? Register here.
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Veterans living with diabetes face the risk of developing diabetic foot ulcers (DFU), a serious complication that can result in amputation or even death. In 2017, VA began collaborating with Podimetrics to design and test a new care model at select VA facilities for Veterans at high-risk of developing an ulcer. This new care model utilizes a SmartMat TM, a remote temperature monitoring (RTM) device that enables early intervention for Veterans at risk of diabetic foot ulcers. The RTM of DFU program was selected as a 2020 VHA Shark Tank Competition winner, which accelerated their journey to provide care to more Veterans. Now, more than 179 VA facilities are using the technology, which has resulted in an estimated $74 million cost avoidance to date.
Recently, the national RTM of DFU implementation team, made up of representatives from VHA’s Office of Connected Care, Diffusion of Excellence, National Podiatry Office, and clinical implementation leads from the Cincinnati VA Medical Center have been conducting a series of visits to VHA facilities to better understand how sites have implemented the RTM Program. While in the field, the team is conducting interviews with Veterans, Podiatrists, Prosthetists and Orthotists, Nurses, facility leadership, and a host of administrative staff who support the program behind the scenes. The goals of these visits are to gain insight into Veteran experiences with the solution, identify additional resource needs, and gather data to support long-term strategic planning around RTM solutions. This month, the team visited Edward Hines Jr. VA Hospital near Chicago, to learn from the users of the program. Hines VA was one of the first VA sites to implement the program shortly after it launched in 2019. Read more about the Hines site visit in a recent article. Insights from the RTM site visits will be presented at the RTM Symposium to be held in Cincinnati later this year.
If you are a Veteran interested in learning more about the program, contact your local Podiatry or Primary Care Provider.
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The Mobile Prosthetic and Orthotic Care (MoPOC) program care model incorporates teams of mobile Orthotic & Prosthetic (O&P) clinicians who are equipped with specialty vehicles and tools to provide care at small VA clinics in rural communities and as needed, at the homes of Veterans. Developed by Eli Kaufman and Daniel Abrahamson of VISN 20 and established as an Office of Rural Health (ORH) Enterprise-Wide Initiative in 2021, MoPOC has successfully extended the reach of VA medical centers already offering O&P services. Kaufman received support from VHA Innovation Ecosystem first as an iNET Spark-Seed-Spread investee and then as a VHA IE Entrepreneur in Residence Fellow from 2020-2022.
MoPOC has been adopted by twenty sites across VA, including five this year and five more slated to start in 2025. In 2023 MoPOC clinicians had 4,008 patient visits with 2,026 Veterans, expanding access to O&P care to 154,539 Veterans. Veterans consistently praise the care provided by MoPOC clinicians, with 99% of surveyed Veterans rating the quality of their care good or excellent, and 20% noting that they would not have received O&P care without MoPOC. In 2022, Kaufman and Abrahamson were recognized for their work with the VHA Under Secretary for Health's Dr. Robert L. Jesse Award for Excellence in Innovation.
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