Health Services Research & Development

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COIN: Informatics, Decision-Enhancement and Analytic Sciences Center (IDEAS 2.0); Salt Lake City, UT


Director: Matthew Samore, M.D.


About the COIN

IDEAS 2.0's mission is to advance scientific discovery, implement novel interventions, promote cross-center collaboration, increase research capacity, and engage operational partners in order to improve the health of Veterans.

Focused Areas of Research

This Center's areas of research include:

Cognitive Support for Therapeutic Decision-Making

The Salt Lake City Collaborative Research to Enhance and Advance Transformation and Excellence (CREATE) will contribute to the transformation of VA healthcare by assisting clinicians and Veterans to make more informed decisions about medication use, delirium and antibiotic resistance. In turn, this will reduce variation, increase quality of care, and improve health outcomes in Veterans. The main goals are to:

  • Characterize clinical problems, information needs, and communication patterns associated with therapeutic decision-making for medication management;
  • Develop cognitive support systems for therapeutic decision-making and medication management, integrating informatics tools, and population analytics;
  • Implement cognitive support systems for therapeutic decision-making and medication management for use by nurses, pharmacists, physicians, operational partners, and Veterans; and
  • Measure the impact of these novel informatics systems on therapeutic decisions, medication management, and Veteran-centered outcomes.

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Healthcare-associated Infection and Antimicrobial Resistance

The goal of this area of research is to prevent healthcare-associated infection (HAI) and to decrease the emergence and spread of antimicrobial resistance. IDEAS 2.0 supports this mission by providing the infrastructure to facilitate cross-center and operational collaborations necessary to conduct novel, large-scale epidemiologic and interventional studies of HAI and antimicrobial resistance. The following four research objectives reflect IDEAS 2.0's commitment to research that protects and improves Veteran health, and include:

  • Identify and develop new approaches to prevent HAI and decrease antibiotic resistance in VA;
  • Quantify the impact of practice on infection outcomes and antibiotic resistance;
  • Use simulations and models to assist epidemiologists and policy-makers in the evaluation of alternative strategies to prevent HAI and decrease antibiotic resistance; and
  • Implement interventions through partnership-based research to prevent HAI and support antibiotic stewardship.

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Post-deployment Health

The goal of this area of research is to use population management approaches to improve community reintegration and enhance health outcomes of Veterans after deployment. In particular, investigators will focus on the clinical areas of medically unexplained syndromes (MUS), post-amputation care, homelessness, and reintegration challenges. Specific objectives include:

  • Develop and implement automated surveillance systemsto track persistent symptoms and other health problems in returned combat Veterans;
  • Design a clinical use case model for rehabilitation clinicians working in the Amputation System of Care that provides population monitoring and point of care service;
  • Build predictive modelsto enable early interdiction of returned combat Veterans at high risk for homelessness; and
  • Better define the health and social factorsthat contribute to reintegration challenges and successes in returned vulnerable populations of Veterans.

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Rural Health

The goal of this emerging area of research is to conduct high-impact research to improve access to health services and to coordinate care for Veterans living in rural settings (41% of the nation's Veterans). Overall objectives include:

  • Design and implement informatics tools to improve access to community-support resources for Veterans with caregiving needs;
  • Develop methods and implement systems to evaluate the quality of care delivered to Veterans by non-VA providers;
  • Design and implement informatics tools to improve care coordination for Veterans receiving specialty telehealth care; and
  • Conduct economic analyses to examine trade-offs associated with different strategies to improve access to care for Veterans living in rural settings.

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Partner Offices

Each COIN works closely with operational partners throughout the VA healthcare system. IDEAS 2.0's partners include:

  • Antimicrobial Stewardship Task Force: Gary Roselle, M.D., Co-Chair, and Melinda Neuhauser, Pharm.D., Co-Chair
  • Geriatrics and Extended Care (GEC): Kenneth Shay, D.D.S., Director of Geriatric Programs
  • Health Informatics Initiative (hi2): Michael Rubin, M.D., Clinical Lead, System/Population-Facing Health Management Platform
  • Interagency Electronic Health Records (iEHR): Jonathan Nebeker, M.D., Lead, Presentation Layer Product Line, Interagency Program Office
  • Multidrug Resistant Organisms Prevention Program: Martin Evans, M.D., Director
  • National Center on Homelessness among Veterans: Thomas O’Toole, M.D., Acting Director
  • National Infectious Diseases Service (NIDS): Gary Roselle, M.D., Director
  • Office of the Asst. Deputy Under Secretary for Health/Clinical Operations: Gavin West, M.D., Special Consultant and Clinical Liaison
  • Office of Nursing Services (ONS): Donna Gage, Ph.D., R.N., N.E.-B.C., Chief Nursing Officer
  • Pharmacy Benefits Management (PBM) Services: Francesca Cunningham, Pharm.D., Associate Chief Consultant, Medication Safety, and Melinda Neuhauser, Pharm.D., National PBM Clinical Program Manager, Infectious Diseases
  • VA Amputation System of Care: Joseph Webster, M.D., Medical Director
  • VA Informatics and Computing Infrastructure (VINCI): Jeffrey Scehnet, Ph.D., Director
  • War Related Illness and Injury Study Center (WRIISC): Drew Helmer, M.D., Director
  • Veterans Rural Health Resource Center, Western Region: Byron Bair, M.D., Director
  • VistA Evolution: Jonathan Nebeker, M.D., Deputy Chief Medical Informatics Officer for Strategy and Design

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