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Office of Budget

Fiscal Year 2004 Performance and Accountability Report
Published November 15, 2004

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Objective 4.2

FY 2004 Obligation ($ in Millions) % of Total VA Resources
Strategic Goal 4: Contribute to the public health, emergency management, socioeconomic well-being, and history of the Nation. $1,039 1.5%
Objective Performance Results
4.2 Advance VA medical research and development programs that address veterans' needs, with an emphasis on service-connected injuries and illnesses, and contribute to the Nation's knowledge of disease and disability. Increased to 229 the number of Career Development Awardees (goal was 237) $452 0.6%

Performance

The mission of the VA Research and Development Program (R&D), which supports Objective 4.2, is to discover knowledge and create innovations that advance the health and care of veterans and the Nation. Today, as in the past, VA is sharing research discoveries with health care providers throughout the Nation. VA R&D pursues collaborative opportunities to be cost efficient and effective in addressing veteran health care needs, and carefully coordinates its research activities with other Federal agencies and non-governmental organizations to ensure the benefits of its research activities to veterans. In FY 2004, VA designed and implemented a total of 229 career development programs for all four services: Bio-medical Laboratory Science, Health Services Research, Rehabilitation Research, and Clinical Service. The career development program specifically supports clinicians for a period of concentrated research training with limited nonresearch responsibilities. VA's research program made many discoveries that moved the Department closer to achieving the ultimate aim of Objective 4.2. For example, VA researchers:

  • Identified a link between service in the Gulf War and amyotrophic lateral sclerosis.
  • Determined that using the anti-convulsive drug, divalproex, in combination with either of two commonly used anti-psychotic drugs, results in decreased suffering and shorter hospital stays for schizophrenia patients.
  • Developed a DNA vaccine technology and successfully demonstrated the efficacy of such vaccines against the intracellular bacterial pathogen, Listeria monocytogenes.
  • Identified a synthetic compound that reverses bone loss in mice without affecting the reproductive system, which may lead to new treatments to prevent osteoporosis for millions of people and lead to safer alternatives than current hormone treatment protocols.

Program Assessment Rating Tool (PART) Evaluation

During the development of the FY 2005 budget, the Administration conducted a PART review of the R&D program, which is essential to the accomplishment of Objective 4.2. The assessment demonstrated that the VA R&D program has a clearly defined purpose and is well managed. In addition, the Administration reiterated the importance of the VA R&D program as the only medical research program focused on veterans' health issues. However, this program received a rating of "Results Not Demonstrated," due mainly to a lack of documented ambitious goals and performance measures that accurately assess the strengths and weaknesses of the program. To address this concern, VA has developed several new performance measures that will be included in future budgets and reports.

Major Management Challenges

Neither VA's Office of Inspector General nor the Government Accountability Office identified any major management challenges related to Objective 4.2.

Program Evaluations

There have not been any independent program evaluations conducted recently that specifically address Objective 4.2.

New Policies and Procedures

Several new policies and procedures have been implemented in the recent past that highlight our focus on medical research in support of Objective 4.2. For example, VA:

  • Implemented a new technology transfer program that allows the Department to take the lead in disseminating new discoveries and inventions made by VA researchers.
  • Developed an inter-institutional agreement giving universities unimpeded access and authority to patent and market intellectual property on VA's behalf as well as theirs.
  • Strengthened oversight of human research protocols.
  • Completed training for compliance officers in human subjects protection and for administrative officers in finance and administration to ensure that all responsible R&D staff are aware of, and adhere to, VA and other Federal regulations.
  • Established a forum with DoD to share best practices in health research and development methods.

Objective 4.2 - Key Performance Goal: Achieve 237 Career Development Awardees.

Number of Career Development Awardees
2000 195
2001 193
2002 209
2003 210
2004 Actual 229
2004 Plan 237
2005 Plan 240
Strategic Target 240

Description, Importance, and Results

VHA supports the public health of the Nation as a whole through medical research. The objective of the career development program is to build and maintain the number of VA clinicians who can conduct research in areas of high relevance to the health care of veterans. Focusing on career development awardees improves the overall caliber and number of researchers and ensures the continuation of this high-caliber program. The performance measure target is an annual count of all the career development awardees in each of the four services of the VA research and development program: Bio-medical Laboratory Science, Health Services Research, Rehabilitation Research, and Clinical Science. We have achieved 229 career development awardees. VA has continued to increase the number of awardees since 2001.

Management and Policy Issues

VHA's primary strategy to implement this strategic objective will be to focus research efforts on veterans' special health care needs. VA will maintain the proportion of research funding directed to projects addressing veteran-related issues. VA will conduct medical research that leads to demonstrable improvements in the lives of veterans, their families, and the general public. The established designated research areas on which VA-sponsored research will be conducted include Aging, Chronic Disease, Mental Illness, Substance Abuse, Sensory Loss, Trauma-Related Illness, Health Systems, Special Populations, and Military Occupations and Environmental Exposure. We will incorporate veterans' military history and potential consequences of service into the Clinical Patient Record System (CPRS). VA will develop, distribute, and promote orientation videos for incoming medical house staff and other health care trainees. Much of the research conducted in VA facilities is subject to the regulations of other Federal agencies as well as VA's own regulations. VA works closely with the National Institutes of Health (NIH) and the Department of Health and Human Services on joint studies funded by NIH. Similarly, VA works closely with the Food and Drug Administration on human studies funded by pharmaceutical companies in support of a new drug or device application. Achievement of this performance goal is partly contingent on the cooperation of other government and non-government agencies VA partners with on some research projects.

Data Quality

Please refer to the Key Measures Data Table.