Health Services Research & Development

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

Directors: Barbara Bokhour, PhD (Acting)(Bedford) and Allen Gifford, MD (Boston)

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.


Health Communication

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.



Partner Offices

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

    • Office of Mental Health Operations (OMHO)
      • David Carroll, Ph.D., Executive Director
      • Kendra Weaver, Psy.D., Senior Consultant, Mental Health Clinical Operations
    • Office of Patient Care Services, Mental Health Services (MHS)
      • Harold Kudler, MD, Chief Consultant
      • Andrew Pomerantz, M.D., National Mental Health Director, Integrated Services
      • Jeffrey Burk, Ph.D., National Director, Psychosocial Rehabilitation and Recovery
  • 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)
    • Richard Kaslow, M.D., M.P.H., Chief Public Health & Environmental Hazards Officer
    • Drew A. Helmer, M.D., M.S., Director War-Related Illness and Injury Study Center, New Jersey
  • Office of Informatics and Analytics: Kim M. Nazi, Ph.D., Veterans and Consumers Health Informatics Office

Related Resources

Person-Centered Care by Christine Hartmann, PhD

Bipolar Disorder by Mark Bauer, MD