Ann Arbor COIN Renewal Application

Veterans Health Administration, Decatur PA

Investigators

Abstract

The Ann Arbor Center for Clinical Management Research (CCMR) has the expertise, experience, infrastructure, collaborations, and partnerships necessary to conduct cutting-edge health services and implementation research that will help Veterans receive the highest quality, safest, and most patient-centered care possible. CCMR’s mission is to advance knowledge, promote innovations, and engage in collaborations that will improve the health and health care of Veterans and the nation. Our vision is to improve the quality, effectiveness, safety, and efficiency of Veterans’ health care through research and partnerships that are driven by important challenges in clinical management. Since 2008, CCMR’s Director has been Dr. Eve Kerr, a primary care physician and 2017 recipient of the VA Undersecretary Award for Outstanding Achievement in Health Services Research. Our Associate Director, Dr. Julie Lowery, is an implementation scientist who has been with Ann Arbor since 1979. Our Center is organized around seven cores that support our research agendas. CCMR enjoys support from VISN 10 and the VA Ann Arbor Healthcare System for research infrastructure, physician research salaries, funding to promote research and partnership development, and a 25,000 square-foot lease. Moreover, CCMR has brought together 39 superb, multidisciplinary core investigators who conduct ground-breaking research and play highly visible roles in VHA. CCMR has retained a remarkable 16 of 19 researchers we have trained under HSR&D CDA programs since 1996, as well as three NIH K-trained investigators. We are currently training an additional seven VA HSR&D CDA recipients and one NIH K- awardee. Thirteen of our 39 core investigators are early career, thus promising future continued productivity. Our investigators improve clinical management in VHA through three focused areas (FAs) of research: FA1. To 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. In the coming five years, our research will address VHA priorities on modernization, patient-centered care, care coordination, and access through studies that improve predictive modeling for disease progression, measure treatment de-intensification, track patient-reported outcomes, and reduce overuse of services in VA and the community. Our key partners include the national VA Offices of: Reporting, Analytics, Performance Improvement, and Deployment; Veterans Access to Care; and Community Care. FA2. To develop, implement, and evaluate systems-based approaches to improve safety and outcomes for our most vulnerable, high-risk, and complex patients. In the next five years, our studies will use innovative approaches for reducing misuse of opioids, alcohol, and cannabis, and for decreasing suicide risk, all key VHA priorities. We will also create tools to assess and implement systems-based interventions to decrease adverse events for hospitalized and critically ill patients, both during and after their inpatient stays. Our key partners include the Office of Mental Health and Suicide Prevention, VISN 10, and the National Center for Patient Safety. FA3. To develop innovative approaches for improving patient engagement in the prevention and management of chronic conditions. In the next five years, we will forward VHA priorities for Veteran and family engagement and innovative use of technology through studies that extend peer support approaches to new clinical areas, employ mHealth to examine Veterans’ experience with community care, improve screening decisions, and apply behavioral economics theory to decrease overuse of low-value services. Our key partners include the National Center for Health Promotion and Disease Prevention and the Michigan National Guard.