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.
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.
In this focus area, CHOIR strives to identify optimal mechanisms to use patient-centered communication. Our studies focus on communication through the use of ehealth technologies, communication about public health issues, and communication between patients and providers. We seek to develop and spread novel communication tools, and study their effectiveness for communicating with Veterans and providers. Our studies have improved methods for communicating large-scale adverse healthcare events (LSAE). Finally we seek to improve patient-centered communication between providers and patients around understanding and managing chronic illness and shared decision making for lung cancer screening.