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 Summer 2025
(Pre-decisional)
Correction: Please note that the previously-distributed edition had an incorrect email address for the ACCENT CORE Data Team email. This issue has been corrected.
Editor's Note: At the present time, we are limited in distribution to recipients with a “va.gov” email only. If you would like to add or update your email address, please let us know at VHAACCENTCORE@va.gov
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ACCENT is a nationwide network of VA researchers and operations partners, fostering collaboration and knowledge diffusion in the areas of Access and Community Care among VA investigators, VA Operational Partners, VISN and VA facility leadership, and VA Health Systems Research to support and inform national priorities for achieving high-quality and timely access to care. ACCENT extends the work initiated by the Community Care Research Evaluation and Knowledge (CREEK) Center and the Veterans Access Research Consortium (VARC).
View the recording of the ACCENT CORE Cyberseminar (held February 12, 2024) Introducing the Access and Community Care Engagement Network Team (ACCENT)
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Interested in receiving the quarterly ACCENT CORE newsletter? Email VHAACCENTCORE@va.gov
New research published or presented at a conference? Please let us know so we can share it with the community in our next newsletter. Email VHAACCENTCORE@va.gov
Email accent.data@va.gov if you have questions for the ACCENT data team.
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Check out the ACCENT CORE Website
Check out the ACCENT website, where you will find funded projects, recently published papers, minutes from monthly calls with the VA Office of Integrated Veteran Care (IVC), information about using community care data captured in the Consolidated Data Set and Program Integrity Tool, and information about current access- and community care-related programs and projects.
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FAQ Alert!
The Access and Community Care Engagement Network Team (ACCENT) data group has compiled a list of responses to “Frequently Asked (Data) Questions,” The goal of this document is to provide more granular guidance for analysts and researchers using community care and access-related data; it is a complement to existing resources.
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Calculating Drive Times and Distances in ArcGIS Pro (VINCI)
The Access and Community Care Engagement Network Team (ACCENT) data group has published a how-to document for calculating drive times and distances using ArcGIS Pro software in VINCI. The document provides instructions for VINCI users who wish to measure drive times and distances between two points along a road network, an example being calculating the road driving distance from Veteran homes to the closest non-VA hospitals.
Calculating Drive Times and Distances in ArcGIS Pro (VINCI)
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Newly Funded Research Grant!
IIR 23-114-3 Understanding and Addressing the Determinants of Wait Time Disparities, PI: Dr. Deborah Gurewich
Start date: July 1, 2025
Delayed care adversely affects health outcomes and mortality. For these reasons, wait time (the amount of time it takes for a patient to get an appointment to see a provider) has emerged as a key indicator of how well a delivery system is performing. In prior work, our team found that Black and Hispanic compared to White Veterans waited longer for appointments for outpatient cardiology and orthopedic services. Further, we found that these disparities were largely driven by within-facility not between-facility wait time disparities. That is, Black and Hispanic relative to White Veterans waited longer for care at the same facility vs. disproportionately getting care at facilities that have longer wait times for all Veterans. Given the link between wait time and health outcomes, this is greatly concerning. Yet, little is known about the factors that contribute to these wait time differences, which means we do not know what changes need to be made to achieve care access equity. We thus propose to understand the determinants of wait time disparities between Black and Hispanic relative to White Veterans and to use this information to develop and pilot an intervention to improve care access for Black and Hispanic Veterans.
Highlighting Current Research
This perspective piece presents a framework for evaluating virtual specialty care, using VA’s Clinical Resource Hub (CRH) program as a model. CRHs extend access to clinical services in underserved areas via a telehealth “hub-and-spoke” system, helping Veterans receive care within the VA system when their home VA lacks capacity and thereby avoid fragmented, community-based alternatives. Using several specialty CRH clinics as examples, the authors propose an evaluation strategy that blends universal metrics—like patient satisfaction, clinician experience, and cost savings—with specialty-specific measures tailored to clinical contexts. This approach provides a scalable method to assess virtual care quality across diverse specialties and settings. Going forward, this work represents a roadmap to build evidence that can inform the optimal, equitable integration of telehealth into specialty care delivery both within and outside of VA.
For inquiries, contact: Rebecca Tisdale, MD, MPA, or Donna Zulman, MD, MS, both of the Center for Innovation to Implementation at the VA Palo Alto Healthcare System.
Tisdale RL, Burnett K, Rogers M, Nelson K, Heyworth L, Zulman DM. An approach to evaluating the impact of virtual specialty care: the Veterans Health Administration’s clinical resource hub as case study. JAMIA Open. 2025 Jun;8(3):ooaf038. https://pmc.ncbi.nlm.nih.gov/articles/PMC12092080/
Editor's Note: Currently, all webinar content is available on the VA intranet only.
To Register
In order to register or attend a session, you must have a "va.gov" email. To register for sessions, please copy and paste the following URL from your VA-intranet secure device: vaww.hsrd.research.va.gov/cyberseminars/catalog-upcoming.cfm
Upcoming Webinars
July 14, 2025, at 1pm EST
Access to Care for Veterans with Mental Health Conditions: Experiences with VA Telemental Health and VA-Purchased Community Care
Hosts: Samantha Connolly, PhD and Megan Vanneman, PhD
Register HERE or if the link does not work for you, register through the VA HSR Webinar Catalogue
NOTE: Trends and outcomes of community vs. VA nephrology referral 2012-2020
with host Ann O’Hare, MD, has been postponed. A new date for this session will be announced later this year.
Past Recordings
For a comprehensive list of past sessions, visit the HSR Cyberseminar's Past Sessions page. You will need access to the VA intranet in order to view previously-held sessions. To view a session, select that session, and then copy and paste the VA intranet link into your VA-secure device browser.
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Barrett, A. K., Cashy, J. P., Roehm, J., Zhao, X., Mor, M. K., Suda, K. J., Good, C. B., Rogal, S. S., Tran, K. A., Hale, J. A., Nosek, R., Thorpe, C. T., Cunningham, F., Fine, M. J., & Gellad, W. F. (2025). Measuring prescriptions dispensed from urgent care through the VA community care benefit. Healthcare, 13(2), 100765. https://doi.org/10.1016/j.hjdsi.2025.100765
Bolton, R. E., Núñez, E. R., Boudreau, J., Kearney, L. M., Ryan, S. K., Herbst, A., Slatore, C., & Wiener, R. S. (2025). “We don’t get that information right back to us unless it’s a full-blown cancer”: Challenges coordinating lung cancer screening across healthcare systems. Health Services Research, 60(1), e14384. https://doi.org/10.1111/1475-6773.14384
LeBeau, K., Ahonle, Z. J., Mburu, S. N., Romero, S., & Myers, K. J. (2025). Utilization and cost of Veterans Health Administration referrals to community care-based physical therapy. Federal Practitioner: For the Health Care Professionals of the VA, DoD, and PHS, 42(2), 1–15. https://doi.org/10.12788/fp.0556
Mattocks, K. M., Walker, L., Kroll-Desrosiers, A., Crowley, S., Moore, D. T., & Bonegio, R. (2025). Assessing rural Veterans’ experiences with a Tele-nephrology program in the Veterans Health Administration (VHA). American Journal of Nephrology. https://doi.org/10.1159/000546917
Miller, R., Nemeth, A., Taggart, J. L., Hall, M. A. K., & Akwe, J. (2025). Serving Vietnam Veterans hospitalized outside the VA system: A scoping review of presumptive service-related illnesses and presentations. Journal of General Internal Medicine. https://doi.org/10.1007/s11606-025-09601-8
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Rose, A. L., Coogan, S., Indresano, J., Zeliadt, S. B., & Chen, J. A. (2025). Evaluating spoke facilitation costs of implementing TelePain in the Veterans Health Administration. Implementation Science Communications, 6(1), 51. https://doi.org/10.1186/s43058-025-00729-6
Tisdale, R. L., Burnett, K., Rogers, M., Nelson, K., Heyworth, L., & Zulman, D. M. (2025). An approach to evaluating the impact of virtual specialty care: the Veterans Health Administration’s clinical resource hub as case study. JAMIA Open, 8(3), ooaf038. https://doi.org/10.1093/jamiaopen/ooaf038
Vanneman, M. E., Roberts, E. T., Li, Y., Sileanu, F. E., Essien, U. R., Mor, M. K., Fine, M. J., Thorpe, C. T., Radomski, T. R., Suda, K. J., & Gellad, W. F. (2025). Experiences with VA-purchased community care for US Veterans with mental health conditions. JAMA Network Open, 8(5), e2511548. https://doi.org/10.1001/jamanetworkopen.2025.11548
Wheat, C. L., Kath, S. E., Nelson, K. M., Curtis, I., & Reddy, A. (2025). Early implementation of a regional telehealth contingency staffing program and primary care quality in the Veterans Health Administration: Evidence from the Clinical Resource Hub program. Journal of General Internal Medicine. https://doi.org/10.1007/s11606-025-09615-2
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