Research and Methods Core - Telehealth Research and Innovation for Veterans with Cancer (THRIVE)

New York University School Of Medicine, New York NY

Investigators

Linked publications, trials & patents

Abstract

The Veterans Affairs Health Administration (VA) is the largest integrated health care system in the US, caring for nearly 50,000 veterans with newly diagnosed cancer annually. Providing quality care for all veterans is a tenet of the VA healthcare mission. We hypothesize that there are factors (e.g., rurality, race/ethnicity and poverty) that are critical in determining access to healthcare, especially telehealth. Approximately 25% of veterans live in rural areas where there may not be adequate local VA cancer care facilities. Unfortunately, these same communities often lack specialized community-based cancer care services as well, making telehealth a necessary option to reduce barriers to quality, timely cancer care. However, little is known about how telehealth delivery for veterans with cancer impacts delivery of quality care, clinical outcomes and experiences of care. As a national integrated health care system focused on quality of cancer care, VA provides an outstanding national laboratory to examine how use of telehealth affects access and quality of care. We will be able to examine how interventions targeting specific factors such as rurality affect the use of telehealth and how use of telehealth affects quality. We will disseminate this information broadly to help other health care systems understand how best to integrate telehealth into the continuum of cancer care. Using principles of implementation science, Telehealth Research and Innovation for Veterans with Cancer (THRIVE) will build a new model of cancer care delivery addressing barriers to telehealth and fulfilling the promise of access to excellent cancer care for Veterans regardless of who they are or where they are located. The Research and Methods Core primarily focuses on understanding how to improve access to and quality of care for all Veterans. Our multidisciplinary team will achieve THRIVE’s vision by focusing on lung, colorectal, prostate and breast cancers and accomplishing five specific aims: (1) Assess stakeholders’ perspectives of contextual factors impacting cancer telehealth implementation and sustainment at multiple levels; (2) Measure the use of in- person and telehealth communication formats for cancer care throughout VA; (3) Evaluate what factors affect use of telehealth for cancer care and how telehealth use is associated with cancer care quality; (4) Oversee the selection, development, implementation and evaluation of 10 rapid-cycle pilot studies (2/year) at the intersection of implementation science and telehealth cancer care; and (5) Frame the affordability of scaling up effective interventions that are identified from the pilot studies.