HEROIC Service

HEROIC investigators provide key services at the local, regional, and national levels. Some examples are below:

Dissemination of Research

Dr. Ruggiero oversaw the dissemination of PE-Web (http://pe.musc.edu), a VA provider training site in prolonged exposure for PTSD, funded by HSR&D, which is now launched and widely available for use (it has been used already by hundreds of VA providers). Thus far, it has been used by hundreds of VA providers nationwide and is being used as a training resource in Cooperative Studies Program 591. Dr. Ruggiero is currently collaborating with the National Center for PTSD to integrate PE-Web into their national dissemination efforts. Dr. Ruggiero is also a site PI on a Department of Defense grant building on the success of PE-Web to develop and evaluate resources for supervisors and providers on prolonged exposure via a smartphone resource to track fidelity and provide automated feedback designed to improve fidelity and address barriers.

Dr. Acierno has published and provided VA trainings in implementation of evidence based psychotherapy via telemedicine, and has been regularly contacted regarding methods and operational protocols for initiating and sustaining telemental health programs. As a result of Dr. Tuerk, Acierno, and Ruggiero's demonstration of telehealth feasibility within VA settings, the model of home based telemental health is now in place at clinical sites in 10 medical centers.

Dr. Tanner is the site lead for the lung cancer screening demonstration project; implementing a multi- disciplinary process for screening and gathering information to be combined with 7 other national sites to inform further implementation efforts across the VA. Her work as a site lead included developing a screening process within the RHJ VAMC and overseeing collection of data, which will be pooled with other sites to direct future lung screening efforts.

Dr. Egede worked with staff from HSR&D's Center for Health Equity Research and Promotion (CHERP) and VA Office of Health Equity to develop a VA Health Equity Supplement for the American Journal of Public Health (AJPH). The supplement includes over 20 articles, comprising editorials and peer reviewed research articles on improving the understanding of health care disparities and reducing/eliminating disparities among vulnerable Veteran populations. Several of the articles from the supplement were among the highest read papers in 2014 for AJPH issues and the supplement issue was the second most-read issue of 2014, accessed 15,000 times since August 2014.

Service to VA

Dr. Santa Ana provides training, consultation and clinical support services on substance abuse and treatment for homeless Veterans including multi- day workshops at the RHJ VAMC and webinars through the Home Telehealth National Training Center for nursing and social work staff. Clinical services include working with the VISN 7 Homeless Program to develop a motivational interviewing HUD-VASH orientation for homeless Veterans and serving on the Veteran Telehealth Suicide Disease Management Program (Suicide-DMP) Committee. Dr. Santa Ana also participated in the Development of a Care Coordination Home Telehealth Housing Urban and Development VA Supported Housing (HUD-VASH DMP) Disease Management Program committee, which assists HUD-VASH Veterans receiving VA housing services to stabilize them in their new homes.

HEROIC investigators provide support to clinicians and clinical researchers interested in conducting health services research both locally and regionally. Dr. Egede initiated discussion around collaborative projects with researchers in facilities in VISN7. As a result, Drs. Dismuke, Hunt and Lynch are working with Dr. April Maa in Atlanta on a tele-health initiative funded through VA ORH. Drs. Pope and Dismuke are also assisting Dr. Michael Saenger in Atlanta on a demonstration project in opioid reduction. Dr. Pope assists a multi-disciplinary perioperative team looking at post-operative delirium in Veterans who have substance use disorder. Her service on the PACT Steering Committee, the Nursing Leadership Committee, and as one of the 6 Chiefs for Nursing has provided opportunities to give feedback on clinical operations performance indicators needing attention and the local Strategic Plan. Dr. Hunt provided supportive statistical and epidemiologic services for basic scientists within the RHJ VAMC and Dr. Dismuke provided mentorship on economics, data acquisition, merging, cleaning, analyzing and writing of manuscripts to facility researchers. Dr. Dismuke also conducted cost-benefit analyses for local and regional projects, including an analysis for mobile neurology EEG cost savings.

Drs. Dismuke and Pope serve on the RHJ VAMC women's health advisory group, Veteran Health Female Leadership Advisory Group (VHFLAG), comprised of women veterans, providers/staff, and the Women's Health Program Coordinator to: (1) identify opportunities to make the VA more responsive to women's needs; 2) develop and monitor implementation of action plans to improve the health of women veterans; and 3) improve communication between women veterans, women's health providers, and RHJ Leadership. Dr. Pope also serves as the site lead for the VA Women's Health Practice-Based Research Network. Dr. Acierno's demonstration of reach extension and cost savings of telehealth use in delivery of evidence based PTSD treatment resulted in a second Department of Defense grant to use home based telehealth to offer evidence based treatment for PTSD in Military Sexual Trauma female victims who otherwise avoid VA service sites.

Dr. Pope leads our Implementation and Partner Research core and is well integrated with local and national implementation projects and initiatives. She helped write the original eConsults program grant, serves as advisor to the eConsult and SCAN ECHO telemedicine technology consultation programs, sits on the PACT Steering Committee, and evaluates PACT integration into VA Services. She also serves on the Nursing Research Advisory Group (NRAG) to Office of Nursing Services.

Dr. Axon served on the VA HSR&D Scientific Merit Review Board (SMRB), Dr. Hunt served on the VA HSR&D Career Development Award (CDA) study section, and Dr. Pope served as a VA National QUERI proposal reviewer in FY2014. Dr. Egede serves on the steering committees for two VA HSR&D Centers: Center for Health Equity Research and Promotion (CHERP) and VA Information Resource Center (VIReC). Dr. Dismuke serves on the VINCI user group committee. Dr. Hunt reviewed a proposal for the VA Office of Rural Health. Dr. Ruggiero was a reviewer on an HSR&D grant to evaluate health services research fellowships.

Service to Other Agencies

HEROIC investigators perform a very high volume of service related to reviewing manuscripts and serving on editorial boards for top tier journals such as the American Journal of Medicine, Annals of Internal Medicine, Journal of General Internal Medicine, Addiction, Clinical Psychology Review, Journal of Traumatic Stress, Journal of Anxiety Disorders, and Behavior Research and Therapy. In addition serving as editors/deputy editors for journals such as Journal of General Internal Medicine, Medical Care, Psychology of Additive Behaviors, Personality Disorders: Theory, Research, and Treatment.

Center investigators serve on NIH scientific review committees and guideline development committees. Dr. Halbert-Hughes is on the Board of Scientific Advisors for the National Cancer Institute, the National Advisory Council for the Human Genome Research Institute, and is Chair of the Minorities in Cancer Research Council for the American Association for Cancer Research. Dr. Horner is a scientific grant reviewer for the American Academy of Family Physicians, the American Heart Association, and the Agency for Health Care Policy Research. Dr. Pope served on the Health Resources and Services Administration (HRSA) Scientific Review Group. Dr. Acierno served on the Treatment Guidelines Core Committee for the Department of Defense (DOD): Post Traumatic Stress Disorder. Dr. Ruggiero is a review committee member for the NIMH’s Mental Health Services Committee. Dr. Egede is a standing member of the NIH Dissemination and Implementation Research in Health study section. Dr. Tuerk has served on grant review panels including: DoD Telemedicine & Advanced Technology Research Center (TATRC), and the US Army Medical Research and Materiel Command (USAMRMC).