COIN: Center for Clinical Management Research (CCMR); Ann Arbor, MI
Director: Sameer Saini, MD, MS
About the COIN
The Center for Clinical Management Research (CCMR) combines the expertise of clinicians and scientists from the VA Ann Arbor Healthcare System and the University of Michigan, and partners with VA clinical, policy, and operations leaders to implement and evaluate ways to make healthcare safer, more effective, and more affordable for our nation’s Veterans.
CCMR’s mission is to advance knowledge, promote innovations, and engage in collaborations that will improve Veteran’s health. The Center’s vision is to improve the quality, effectiveness, safety, and efficiency of Veterans’ healthcare through research and partnerships that are driven by important challenges in clinical management.
Research Focus Areas
The Center’s work focuses on the following:
- Promote personalized, appropriate, and efficient care by integrating the routine use of digital data into day-to-day care delivery through innovations in data collection, measurement, and analysis.
- Develop, implement, and evaluate systems-based approaches to improve safety and outcomes for our most vulnerable, high-risk, and complex patients.
- Develop and test innovative approaches for improving patient engagement in the prevention and management of chronic conditions.
Research to Impact for VeteRans (RIVRs)
The Research to Impact for VeteRans (RIVRs) program is a new HSR&D funding mechanism that gives researchers the opportunity to pursue a five-year impact goal. Each RIVR impact goal aligns with VA priority areas including VA legislative priorities (e.g., MISSION Act); cross-cutting ORD priorities (e.g. PTSD); other HSR&D defined clinical priorities (e.g. Health Equity); and HSR&D methodological priorities (e.g. Data Sciences, Implementation Sciences, Systems Engineering). Impact goals for RIVRS could include changes in VA policy or clinical guidelines, spread of operational processes across VISNs, scaling of an effective intervention to 2-3 additional sites, advancements in health services research methods, or any other impacts that have real-world effects on Veteran health and satisfaction.
Current RIVR project
Reducing Use of Low-Value Services and Enhancing Appropriate Care in the VA Healthcare System
Principal Investigator: Sameer Saini, MD
The 5-year goal of this project is to reduce use of low-value colonoscopy in VISN 10. Building on prior HSR&D-funded research, investigators will accomplish this goal by: (1) refining and deploying electronic measures of colonoscopy overuse; (2) developing and disseminating a toolkit comprising system-, provider-, and patient-level strategies for reducing overuse; and, (3) rapidly piloting and implementing these strategies across VISN 10. This work will be conducted in collaboration with existing partners in VISN 10, the GI National Program Office, and the Office of Veterans Access to Care. Investigators will also work closely with colleagues at the Safety and Quality QUERI in Seattle (who bring expertise in de-implementation), the PrOVE QUERI in Ann Arbor (quality improvement), the Measurement Science QUERI in San Francisco (colonoscopy quality and reporting), and the IDEAS COIN in Salt Lake City (informatics to enhance quality reporting), as well as collaborators at other sites in VISN 10 and nationally. Success will be monitored through a variety of measures, including change in rate of overuse and change in number of community care referrals.
Each COIN works closely with operational partners throughout the VA healthcare system. CCMR’s key VA partners in this work include: