Health Services Research & Development

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COIN: Center for Healthcare Organization and Implementation Research (CHOIR) Bedford, MA and Boston, MA

Directors: Dan Berlowitz, M.D., M.P.H., and Martin Charns, D.B.A.

About the COIN

CHOIR's mission is to improve Veterans' health outcomes by developing, studying and applying evidence-based practices that will be widely implemented and sustained.

Focused Areas of Research


Recovery in Behaviorally Vulnerable Populations

In this area, CHOIR will strive to enhance the transformation of VA to a recovery-oriented healthcare system, and to improve recovery-oriented outcomes for behaviorally vulnerable Veterans, specifically those afflicted with a mental health condition or those who are homeless, or are at risk of being homeless. CHOIR's strategy involves:

  • Working to address a knowledge gap in operational definitions,
  • Building a scientific basis for implementing high-priority program roll-outs, and
  • Adapting and implementing existing interventional evidence for use with this behaviorally vulnerable population.


Medication Optimization

Providing optimal medication treatment to Veterans is a critical goal for CHOIR, and supports many VA priorities regarding safer, more effective, patient-centered, and cost-efficient prescriptive practices. Existing tools allow CHOIR's operational partner, Pharmacy Benefits Management (PBM), the ability to ensure medication optimization for patients. However, important gaps remain. In collaboration with PBM, CHOIR investigators will work to address these gaps by:

  • Examining patterns of practice variation in medication prescribing across VHA,
  • Estimating beneficial and harmful outcomes of medication therapy, and
  • Developing and evaluating implementation strategies to promote higher-quality use of medication therapies.

Products resulting from this collaboration will ensure that the science of medication optimization is indeed put into practice, and will facilitate improvements across VA.


Public Health Communication

CHOIR will address traditional and emerging media used to deliver and exchange information about public health priorities to Veterans both in and outside of VA care. Communication priorities include large-scale adverse events, deployment environmental health risks, and health behavior change. There remain important gaps regarding best practices in communicating information to improve VA care, maximizing trust in care, and encouraging Veterans' self-management. CHOIR's Public Health Communication Focus will provide an evidence base and tools for communicating about a range of public health issues, using optimal communication channels such as social media and mobile health platforms to create effective messaging that empowers Veterans to prioritize their health.



Partner Offices

Each COIN works closely with operational partners throughout the VA healthcare system. CHOIR's partners include:

  • Office of Mental Health Services (OMHS)
    • David Carroll, Ph.D., National Mental Health Director, Program Integration
    • Andrew Pomerantz, M.D., National Mental Health Director, Integrated Services
    • Jeffrey Burk, Ph.D., National Director, Psychosocial Rehabilitation and Recovery
  • National Center on Homelessness among Veterans (NCHV)
    • Vincent Kane, M.S.S., Director
    • Roger Casey, Ph.D., Director, NCHV Dissemination and Education Core
  • Pharmacy Benefits Management (PBM) Services
    • Fran Cunningham, Pharm.D., Director, VA Center for Medication Safety,
    • Anthony Morreale, Pharm.D., Assistant Chief Consultant for Clinical Pharmacy Services and Healthcare
    • C. Bernie Good, M.D., Member of Medical Advisory Panel to PBM
    • Peter Glassman, M.D., Member of Medical Advisory Panel to PBM
  • Office of Public Health (OPH)
    • Victoria J. Davey, Ph.D., M.P.H., R.N., Chief Public Health & Environmental Hazards Officer
    • Richard A. Martinello, M.D., Chief Consultant, Clinical Public Health
    • Drew A. Helmer, M.D., M.S., Director War-Related Illness and Injury Study Center, New Jersey
  • Office of Public and Intergovernmental Affairs: Lauren Bailey, Acting Director, VA Online Communications
  • Office of Informatics and Analytics: Kim M. Nazi, Ph.D., Veterans and Consumers Health Informatics Office
  • VA New England Healthcare System, VISN 1
    • Michael Mayo-Smith, M.D., M.P.H., Director
    • James Schlosser, M.D., Director, Veterans Resource Improvement Office
  • VA Boston Healthcare System
    • Vincent Ng, M.B.A., Director
  • Bedford VA Medical Center
    • Christine Croteau, M.B.A., Acting Director

Related Resources

VA HSR&D Investigator Insights — Bipolar Disorder

Bipolar Disorder
by Mark Bauer, MD (4:11)