In This Issue: Advancements in VA Primary Care
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VA takes a team approach to primary care through Patient Aligned Care Teams or PACTs, which normally include a primary care provider, clinical pharmacist, registered nurse care manager, and a licensed practical nurse or medical assistant and clerk. VA also offers Primary Care-Mental Health Integration (PCMHI) that promotes the full incorporation of mental health staff into the PACT, allowing for the treatment of depression, anxiety, PTSD, and substance use disorder without the need for a separate mental health consult. In addition, Post-Deployment Integrated Care (PDIC) provides specialized PACTs with expertise and training in syndromes common to returning combat Veterans (i.e., chronic pain, sleep disorders, and anxiety). VA also is implementing a homeless-tailored medical home model (H-PACT) to enhance access to care, address social determinants of health, and facilitate housing placement for Veterans who are homeless – or at risk of being homeless. Further, VA offers a Geriatric Patient Aligned Care Team (GeriPACT), which is designed to offer comprehensive primary care combined with specialty expertise for complex geriatric and high-risk Veterans.
HSR&D contributes to improving primary care for Veterans in several ways. For example, HSR&D’s Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP) works to improve the delivery and performance of VA primary care by developing and studying PACT innovations. HSR&D also supports the Care Coordination QUERI National Program that aims to improve care coordination and experience of care across settings for Veterans in PACT – and to develop novel approaches to coordinating care between the Veterans, his or her primary care team, and other healthcare providers such as specialty care, as well as home and community resources. Also funded by HSR&D, QUERI’s Improving Access to Opioid Use Disorder Treatment in Primary Care Settings National Partnered Evaluation will implement and evaluate the evidence-based practice of medication treatment of opioid use disorder in primary care settings.
HSR&D also supports a broad spectrum of ongoing research studies on primary care, including: Primary Care Quality and Homeless Service Tailoring, Engaging Veterans and Family Supporters in PACT to Improve Diabetes Management, Quality of Care and Patient Experience in GeriPACT, Implementing Shared Decision-Making for Cancer Screening in Primary Care, and Anxiety Diagnostic Accuracy in VA Primary Care Mental Health Integration Settings, to name a few. Projects such as these – and the ongoing HSR&D studies featured below – will help VA continue to improve primary care for all Veterans.