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As medication use increases with age and the presence of multiple chronic health conditions, it’s common for adults over the age of 65 to take multiple medications, which can sometimes lead to serious complications including hospital readmission.
Developed by Dr. Saraswathy Battar at Central Arkansas VA, VIONE is an innovation for identifying and discontinuing unnecessary medications that can harm or burden Veterans. Since 2016, over 21,000 VA health care providers across the Nation have carefully reviewed and successfully stopped over 2.6 million unnecessary medicines for over 1 million Veterans by engaging in shared decision-making efforts. By empowering VA providers to identify and discontinue unnecessary medications that can harm Veterans, VIONE improves the quality of life and safety of Veterans.
Veterans receiving care in any VA care setting, including hospitals, rural areas, outpatient facilities, and virtually, can benefit from VIONE and its web-based tools, such as a deprescribing platform, which enable clinicians to make medications work for Veterans rather than potentially creating harm. Soon, management of VIONE will transition to VHA’s Office of Geriatrics and Extended Care, further expanding its impact.
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The 2024 VHA State of Innovation report is available online! With the theme “From Promise to Progress: Evolving Veterans Healthcare,” the 2024 SOI Report has a clear mission: educate Veterans on the ways in which VHA OHIL is advancing and redefining VA health care, and empower them to access these resources. This year’s report is divided into four sections—access to care and services; mental health and social connection; collaboration to deliver innovation; and the future of Veteran health care.
Expanding Our Reach: Access to Care and Services
The State of Innovation Report feature series will share sneak peaks inside the 2024 SOI Report to explore each of the core sections. This week’s newsletter features projects included in the “Expanding Our Reach: Access to Care and Services” portion of the report.
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Primary caregivers, or homecare aides, help Veterans with the activities of daily life. The Technology Enabled Respite Homecare Model (TERHM) pilot gives eligible Veterans a choice in selecting who provides their home-based care. Programs like TERHM that offer respite care are designed to provide an opportunity for primary caregivers to relax and attend to their own needs while a trained homecare aide attends to the Veteran’s needs. TERHM, which has been launched at six VA medical centers, operates on a unique and empowering model that ensures Veterans are not just recipients of care, but are given a choice in who provides their approved homecare hours. Through a tech-enabled platform, Veterans and their families can find a homecare aide that fits their preferences; this alleviates the struggle many Veterans face when trying to find quality homecare and respite care services, especially in rural areas. Read more on page 15 of the report.
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VHA’s Office of Rehabilitation and Prosthetic Services, in conjunction with the Office of Primary Care, has developed a proactive and personalized approach to same-day physical therapy for Veterans through the VA Physical Therapy Patient Aligned Care Teams (PACT PT). Many Veterans experiencing common musculoskeletal or neurological issues spend weeks visiting numerous specialists before getting a physical therapy appointment; because of this, only 9-12% follow up on their doctors’ orders to see a physical therapist. By embedding physical therapists into primary care team processes, Veterans have access to same-day care. For Veterans living in rural locations, PACT PT eases the hardship of navigating multiple in-person appointments and allows patients to receive all the services they need at one appointment with virtual follow-ups. PACT PT, a 2020 VHA Shark Tank Promising Practice, has already been successfully adopted at 113 VHA health care systems. Read more on page 17 of the report.
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Gaps in podiatric care for Veterans with diabetes can lead to discomfort from untrimmed nails and calluses and, in extreme cases, increased risk of limb amputation. When Dr. Nichol Salvo, Chief of Podiatry at the Joseph Maxwell Cleland Atlanta VA Medical Center and Deputy Director of VHA’s National Podiatry Program, stopped seeing Veterans with diabetes living in rural areas for in-person basic foot care during the COVID-19 pandemic, she recognized that they were missing out on critical care. So, Dr. Salvo created the High-Risk Eye and Limb Preservation Program (HELPP), which integrates former military medics who now work as VA providers or intermediate care technicians (ICTs) into elective podiatric visits at rural VA community-based outpatient clinics. Virtual podiatrists and in-person ICTs work together to help Veterans with diabetes across the Atlanta area receive crucial basic foot care, minimizing the risk of amputation and allowing them to receive care closer to their homes. Read more on page 19 of the report.
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For the 1.8 million Veterans living with diabetes, access to tools and education that help them monitor and manage their diabetes can significantly improve their quality of life. Diabetes Self-Management Education and Support (DSMES) is a dynamic program in which people with diabetes gain the knowledge, self-management skills, and support needed to make changes to better manage their diabetes. DSMES is an interactive, ongoing process, engaging the person with diabetes, the caregiver or family, and a Certified Diabetes Care and Education Specialist. VA and the U.S. Department of Defense (DOD) organized a joint program to meet the unique needs for DSMES among Veterans and DOD service members. The program provides Veterans and DOD service members with self-management education services both virtually and in person. Currently, a significant focus of the DSMES program is to provide Veterans with monitoring, support, and access to continuous glucose monitors. Read more on page 21 of the report.
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The 10th annual VHA Shark Tank Competition kicked off the afternoon session of the 2024 VHA Innovation Experience (iEX) conference in Chicago last week.
A video from VA Under Secretary for Health Dr. Shereef Elnahal opened the event, highlighting the value of employee-developed solutions. The session’s hosts, Matthew Rowley and Dave Brimmer, and representatives of several past VHA Shark Tank winning practices then introduced each of the 15 finalists as they took the stage to share their practices.
VHA Shark Tank identifies frontline employee innovations that promote positive outcomes and improved experiences for Veterans and VA community. The competition shines a spotlight on employees who are passionate about solving some of the toughest challenges across VA.
To conclude the competition, the hosts announced this year’s 10 winners and their selected replication site based on bids from interested VA leadership. The winners will now work with Diffusion of Excellence to implement their practice in a new VA site. The 2024 VHA Shark Tank Competition winning practices include:
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FastTrack PGx Results: This practice began at Palo Alto Health Care System and will replicate at Durham VA Healthcare System. This practice also won proposal of the day, a crowd-voted designation.
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Investing in VA Nursing (IVAN): This practice began at St. Cloud VA Healthcare System and will replicate at VA Central Arkansas Healthcare System.
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Boothless Audiometry: This practice began at VA Alexandria Healthcare System and will replicate at South Texas Veterans’ Health Care System.
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Dignity Bags for Veterans: This practice began at North Florida/South Georgia Veterans Health System and will replicate at VA Sierra Nevada Health Care System.
Congratulations to the finalists and winners on their well-earned recognition!
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The MIT linQ program at the Institute for Medical Engineering and Science (IMES) has announced eight VA-affiliated members to the 2025 Catalyst Fellowship, a prestigious initiative that drives solutions to unmet health care needs through a hands-on, accelerated research process. Catalyst’s unique approach leverages interdisciplinary collaboration, compresses timelines, and cultivates leaders in biomedical innovation.
The following VA employees are joining the 2025 Catalyst Fellowship:
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David Beck, BSN, RN, CNN, is a Quality Management Specialist at James A. Haley VA Hospital, bringing innovative, collaborative solutions to health care challenges through Lean Six Sigma and VA innovation.
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Hao Cheng, MD, is the Section Chief of Sleep Medicine at Miami VA Healthcare System and is focusing on advancing sleep medicine through innovative technologies.
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Elizabeth Edmiston, PhD, RN, is the Chief Nurse Scientist at VA Northeast Ohio Healthcare System, specializing in quality improvement education and sleep science research.
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Jeremy Goldberg, LCSW, QS, is a Mental Health Clinical Social Worker at Orlando VA Healthcare System who focuses on innovative mental health programs for Veterans.
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Cristhiaan D. Ochoa, MD, PhD, the Director of the Lung Cancer Screening Program at Northern California VA Health Care System, is aiming to revolutionize Veteran lung cancer care through innovative diagnostics.
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Sam L. Phillips, PhD, a Health Scientist at James A. Haley Veterans' Hospital plans to focus on enhancing prosthetic technology and mobility solutions for underserved Veterans.
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Lindsay Pristou, MS is a Biomedical Engineer at VA Greater Los Angeles Medical Center and seeks to integrate cutting-edge medical technologies into clinical environments to enhance patient care.
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Alok Sharma, MD, an interventional and structural cardiologist at Minneapolis VA Medical Center, is leading cardiovascular research and innovation while also training future cardiologists.
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The Fellows’ collective mission is to translate research into real-world solutions, with a focus on improving health care accessibility and outcomes for Veterans and underserved communities.
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