Health Services Research & Development

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COIN: Charleston Health Equity and Rural Outreach Innovation Center (HEROIC); Charleston, SC

Director: Neal Axon, MD
Associate Director: Kenneth Ruggiero, Ph.D.

About the COIN

This Center's mission is to improve access and equity in healthcare for all Veterans by eliminating geographic, racial/ethnic, and gender-based disparities.

Focused Areas of Research

HEROIC's focused areas of research include:


Health Equity

HEROIC seeks to improve equity in healthcare and reduce disparities in health outcomes through the development and testing of innovative, patient-centered, and culturally-tailored interventions. A wide range of medical and psychiatric outcomes in rural and minority Veterans will be targeted through patient (e.g., self-management) and provider (e.g., patient-provider communication) level interventions. HEROIC also will develop, test, and disseminate innovative methodologies for analyzing health equity data, and will work with key partners to establish a VA equity report card using VA administration data.


Access to Care

HEROIC will focus on increasing access to care by developing interventions that address the geographical, temporal, financial, cultural, and digital dimensions that influence access to care, as well as Veterans' perceptions of care and their perceived need for care. This will be done through the development of innovative strategies and resources to improve access to high-quality care and the evaluation of strategies for increased implementation of effective telehealth interventions in the VA. HEROIC also will work with key partners to identify and refine new metrics for measuring access to care in both primary and specialty care settings.


Rural Health

HEROIC aims to improve health outcomes among rural Veterans by examining the increasing role of technology on access. Emphasis will be placed on:

  • Understanding barriers to care within the context of an increasingly technology-driven healthcare system; and
  • Working with operational partners to develop performance measures that--
  • more accurately reflect actual and perceived indices of access,
  • acknowledge the role of technology on access to care, and
  • capture differential outcomes with regard to technology-based interventions that may exist among rural and minority Veterans.

HEROIC investigators will conduct longitudinal analyses across multiple medical and mental health conditions to assess the contribution of rural/urban disparities, and develop tailored interventions to improve health outcomes.



Partner Offices

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

  • Office of Rural Health (ORH)
  • Office of Health Equity (OHE)
  • Office of Informatics and Analytics (OIA)
  • Center for Minority Veterans (CMV)
  • Center for Health Promotion and Disease Prevention (NCP)
  • VA Southeast Network , VISN 7
  • Center for Health Equity Research and Promotion (CHERP)
  • Affiliated VAMCs in Augusta, GA, Columbia, SC and Tuscaloosa, AL
  • MUSC Center for Health Disparities Research (CHDR)
    • MUSC Division of Biostatistics and Epidemiology
    • MUSC CTSA Program
  • University of Hawaii at Hilo
  • University of Maryland at College Park

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