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HSR&D Center for Health Information and Communication (CHIC)

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Innovation at Our Center

The vision of the VA HSR&D Center for Health Information and Communication (CHIC) is to improve Veterans' health through innovative applications of health information and health information systems that serve the population-based and interpersonal needs of patients and clinicians. The CHIC’s mission is to generate knowledge about the design and utility of innovative health information technology approaches to improve the quality and outcomes of care.

Our center has several innovative methods and strengths:

  • Expertise in developing patient-reported measures
  • Evaluation of self-management interventions
  • Innovative Mixed Methods techniques and approaches for studying Health Services Research and Informatics
  • Cross-medical center collaboration enables the leveraging of the benefits of collaborative research relationships
  • The oldest Human Computer-Interaction (HCI) & Simulation laboratory in existence within the VA system
  • Being embedded in VA Medical Center allows for research outside focus areas and translating health services research into effective clinical practice 
  • A number of our investigators use novel combinations of quantitative and qualitative methods to explore phenomena in health care delivery

 

Kurt Kroenke, M.D.

Dr. Kroenke’s “Comprehensive vs. Assisted Management of Mood and Physical Symptoms (CAMMPS)” study is a randomized comparative effectiveness trial designed to test the relative effectiveness of a lower-resource vs. a higher-resource enhancement of usual primary care in the management of veterans suffering from pain plus anxiety and/or depression. The study team will partner with both VA primary care physicians/PACTs and psychologists embedded in primary care to monitor and adjust treatments using evidence-based analgesic and antidepressant algorithms, reinforced self-management, and care coordination.


Thomas F. Imperiale, M.D.

Dr. Imperiale’s CONFIRM (Colonoscopy vs. Fecal Immunochemical Test In Reducing Mortality from Colorectal Cancer) is a national study recruiting 50,000 veterans from ages 50-75 at 42 VA facilities. These veterans are due for or have never had colorectal screening. These tests have not been compared in a large study and it is not clear which test is more effective. The purpose of this study is to compare these two types of colon cancer screening tests and determine which is more effective in preventing deaths from colon and rectal cancer.


Richard Frankel, PhD

Dr. Frankel’s research focuses on clinician-patient communication and its effects on quality and safety, the effects of exam room computing on physician patient communication, and effective organizational change strategies. This work has translated into two transfer of care studies: “Improving Transfers of Care in Nursing and Medicine Services” which is in the final stages of paper submissions and the forthcoming “Culture and Context Affect High Reliability in Transfers of Care”. Two other studies are “Understanding Variations in CPRS Use Among Primary Care Clinicians” which is in the final stages of data analysis and “Aligning Transitions of Care for Post-Stroke Patients with Hypertension” which is completing the recruitment of providers and patients.

The transfer of care studies attempt to identify barriers and facilitators to high reliability handoffs by observing physician/physician and nurse/nurse interactions. The attempt is to determine how variations in these interactions impact subsequent care processes and outcomes. Being qualitative studies, direct observation is used; video tape; field notes; handoff artifacts; audio recordings of handoffs; interviews with nurses and interns; and adverse event reports. Contextual, linguistic, and technological barriers and facilitators that impact effective handoffs as well as the outcomes of handoffs on care have and will continue to be studied.

His CPRS study has promoted patient-centered care in outpatient clinics while also using state-of-the-art information technology, decision support tools, and evidence-based communication approaches to improve patient care experiences. His provider/patient post-stroke study is looking at the patient experience in the center of the care process with the goal of enhancing communication in key transitions such as hospital discharge-to-home and home-to-follow-up


Angela Rollins, PhD

The primary objective of Dr. Rollins’ proposed COFAM (A Comparison of Fidelity Assessment Methods) study is to examine the effectiveness of innovative and potentially cost-effective methods to ensure the quality of mental health services for disabled veterans with mental illness. The study will examine the reliability, concurrent validity, predictive validity, and costs of three methods of fidelity assessment: self-report, phone-based remote assessment, and a "gold-standard" on-site fidelity assessment.   BREATHE (Burnout Reduction: Enhanced Awareness, Tools, Handouts, and Education) is an intervention for mental health providers.   The study will recruit mental health staff and randomize participants to intervention groups or control groups and conduct follow-up surveys at baseline, 6 weeks post-training day, and 6-months post-training day. The IDDT IDEA (Integrated Dual Diagnosis Treatment: Implementation during Early Adoption) study is designed to help identify barriers and facilitators to implementing Integrated Dual Diagnosis Treatment (IDDT) in the VA. IDDT integrates mental health and substance abuse interventions into one treatment model. The study will observe implementation in two VA facilities (Cincinnati and Indianapolis) using didactic seminars, training, ongoing coaching, and technical assistance.