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In This Issue: Ensuring High Quality Care

From the Chief Research and Development Officer SCAN ECHO
Two of VA's highest priorities are to provide enrolled Veterans with timely and high-quality health care, and to ensure that all Veterans have access to the excellent care our facilities offer. VA researchers are working to identify and evaluate innovative strategies to improve access and quality, especially for Veterans who may face barriers to care because they live in rural areas, or because they belong to racial or ethnic minorities...Read more
New Initiatives VA Research holds conference on natural language processingVA Research holds conference on natural language processing
Natural language processing (NLP) is the ability of software programs to recognize and make sense of human speech as it is spoken, or everyday language as it is typed into a computer. It is a component of artificial intelligence, which is the simulation of human intelligence by machines. On Sept. 9 and 10, 2015, VA's Health Services Research and Development Service (HSR&D) convened a "state of the science" conference on NLP at VHA's National Conference Center in Washington, D.C ...

New initiatives to support VA as learning health care systemNew initiatives to support VA as learning health care system
In 2007, the Institute of Medicine (IOM) released a book-length report titled The Learning Healthcare System. The report defined and described a new conceptual approach for integrating clinical research and clinical medicine. HSR&D recently issued requests for applications (RFAs) to further VA's status as a learning health care system. Topics covered include measurement science, operations research, provider behavior, and randomized program implementation...

De-implementation study launchedDe-implementation study launched
In 2012, the ABIM Foundation launched Choosing Wisely to advance a national conversation on avoiding wasteful or unnecessary medical tests, treatments, and procedures. One goal is to stop using, or de-implement, health care practices that have only low value for patients, thereby improving the quality and value of health care. VA researchers and their clinical partners have identified an initial set of such practices, and a new study will test strategies for de-implementing them...

Clinical trial of maggot therapy underwayClinical trial of maggot therapy underway
VA researchers in Gainesville, Fla., are testing how maggots—or larvae—compare with standard wound care treatment. The team's study involves Veterans with chronic diabetic ulcers on their feet. The maggots being used are contained in fine mesh bags, have been sterilized in a laboratory, and are removed after a few days. The researchers will examine how well the wounds heal in each study group, and will also look at maggots' effects on harmful bacteria, which the larvae are known to ingest...

A Chat with Our Experts  Dr. Gala TrueUnderstanding how patients use eHealth technology
Dr. Donna M. Zulman is a physician-investigator at VA HSR&D's Center for Innovation to Implementation in Palo Alto Calif., and an assistant professor in the Division of General Medical Disciplines at Stanford University. Her research focuses on improving health care delivery for patients with multiple chronic conditions and complex health care needs. She is also interested in optimizing eHealth technology to personalize care and improve outcomes for patients with complex needs. She spoke with VARQU about her work in this area...
Noteworthy Publications Telemedicine works for older Veterans with depression Telemedicine works for older Veterans with depression
A study led by Dr. Leonard Egede of VA's Health Equity and Rural Outreach Innovation Center (HEROIC), in Charleston, S.C., found that talk therapy delivered by two-way video calls are at least as effective, if not more so, than in-person treatment delivery for older Veterans with depression. The study was published in the August 2015 issue of Lancet Psychiatry...

Veterans Choice program analyzed Veterans Choice Program analyzed
The Veterans Choice Program, administered by VA, allows Veterans already enrolled in VA health care to get care from non-VA doctors under certain circumstances, instead of waiting for a VA appointment or traveling to a VA facility. In an Aug. 20 editorial in the Journal of General Internal Medicine, Dr. Walid Gellad of the VA Pittsburgh Healthcare System and the University of Pittsburgh reviews the history of the program, which was formally enacted in 2014. Gellad also discusses problems associated with dual care use and care fragmentation, and offers some ideas for ensuring the safe and effective implementation of the program...

With equal care, blacks' health outcomes greatly improved With equal care, blacks' health outcomes greatly improved
Many studies have shown that in the American population, blacks have worse health outcomes than whites in most categories, except for kidney disease. Among the possible contributing factors that are usually cited are their lower socio-economic status and reduced access to care. A team of VA researchers, led by Dr. Csaba P. Kovesdy of the Memphis VA Medical Center, recently published a study in the journal Circulation suggesting that if all patients get the same care, not only do these health differences disappear, but blacks fare better than whites, at least with respect to a few important health care outcomes...

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