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ORH Enterprise-Wide Initiatives (EWIs)
There are approximately 18 million living U.S. Veterans. Of the 9.3 million Veterans enrolled with VHA, ORH works to improve health care access and the health of America’s 3 million enrolled rural Veterans. ORH’s reaches rural Veterans through its innovative Enterprise-Wide Initiatives (EWIs). These nationwide programs were developed to rapidly address health care and access challenges rural Veterans experience. They provide a consistent standard of care, regardless of where Veterans live.
ORH EWIs are hospital and clinic-based solutions that have been tested in multiple locations and proven as effective and efficient methods to standardize care delivery. ORH leverages existing knowledge and personnel resources to research, innovate, and disseminate EWIs through local and national collaborations. EWI program managers work with ORH VA Central Office to provide oversight, mentorship, and continuous program evaluation support.
EWI programs include: [Click Category to Expand List]
- Home Based Primary Care expands home-based Patient Aligned Care Team services to rural areas.
- Supporting Community Outpatient, Urgent Care & Telehealth Services (SCOUTS) is a post-emergency department complementary service that utilizes intermediate care technicians to support care transitions.
- Advanced Comprehensive Diabetes Care (ACDC) is a telehealth program which augments remote patient monitoring-home telehealth telemonitoring with self-management support and specialist-guided medication management for Type 2 diabetes.
- CARDIO-VET Network: Cardiology Access and Resources for Delivery of Integrated Outreach to VETerans provides rural Veterans streamlined access to invasive cardiovascular procedure care in high-complexity VA medical centers (hubs) through initial access to VA cardiology services close to home, nurse navigation, and travel support to and from hub VA facilities.
- Centralized Anticoagulation Services Hub (CASH) provides anticoagulation clinical pharmacy services via highly efficient infrastructure that standardizes clinical processes, employs innovative data tools, and delivers virtual care modalities.
- Clinical Pharmacy Specialist Providers deliver medication and chronic disease management services to rural Veterans through telehealth in Veterans' homes, VA medical centers, or community based outpatient clinics.
- High Risk Eye and Limb Preservation Program (HELPP) aims to enhance the delivery of telehealth care to Veterans with HIV living in rural areas and to create a sustainable linkage to care network using telehealth services to Veterans who otherwise would have difficulty accessing high quality, comprehensive, and VA connected care provides rural Veterans with access to VA telehealth services..
- HIV Telehealth Collaborative Care Program: Treatment and Prevention of HIV for Underserved Veterans utilizes telemedicine and remote technology to deliver foot health services (nail and callus care) and eye screening to rurally located patients, effectively reducing the risk of limb amputation and blindness while providing the soonest and best care to Veterans.
- Improving Rural Veterans' Access to Rheumatology Care Nationwide provides access to rheumatology care for Veterans living in rural areas with systemic autoimmune diseases and other complex rheumatic conditions.
- Increasing Access for Rural Veterans by Leveraging Clinical Pharmacist Providers (CPPs) to Deliver Chronic Obstructive Pulmonary Disease (COPD) Care utilizes CPPs to increase patient access, improve quality of care, and decrease provider burden through the delivery of comprehensive medication management and COPD care for rural Veterans within primary care teams.
- Mobile Prosthetic and Orthotic Care (MoPOC) helps to restore function, mobility, and independence for rural Veterans with limb loss and movement disorders by bringing artificial limb and bracing care to their communities.
- National Subspecialty Ophthalmology Network (NSON) Program sets up a Tele-Ophthalmology hub with national reach to provide subspecialty Ophthalmology eye services (retina, glaucoma, neuro-op) to rural Veterans.
- National Telecritical Care Program connects VA facilities that do not have intensivists on staff with VA intensivists nationwide via telehealth to increase access to TCC services and specialty inpatient care for rural Veterans.
- National Tele-Hospital Medicine Program is a hub and spoke telehealth program that provides access to hospital medicine services and expertise for rural and under-provided VA medical centers with acute care needs that cannot be met by the local workforce.
- National Telenephrology Hub and Spoke Network works with local providers to offer specialty nephrology services to Veterans in rural areas with kidney disease or difficult-to-control hypertension.>
- National Teleneurology Program (NTNP) establishes telehealth sites to ensure access to neurology in rural areas where providers are unavailable.
- National Teleurology Program offers urologic care to Veterans both virtually and through in-person site visits.
- NouRISH (Nutrition, Resources, and Integrated Support for Health) The NouRISH (Nutrition, Resources, and Integrated Support for Health) initiative utilizes an interdisciplinary framework to improve rural Veterans access to reliable food resources – specifically medically-tailored groceries – and comprehensive wrap around services that address health related social needs.
- Pharmacist Providers Improve Access for Rural Veterans with Opioid Use Disorder delivers greater access to medication assisted treatment for rural Veterans by integrating clinical pharmacy specialist providers in collaborative care models.
- Physical Therapy Embedded into Rural Primary Care Patient Aligned Care Teams (PT-PACT) will improve access, improve Veteran and employee satisfaction, improve functional outcomes for Veterans, and positively impact healthcare costs.
- Teledermatology expands store-and-forward teledermatology to rural sites; it includes primary care training on dermatologic consults and minor procedures.
- Care Coordination and Integrated Case Management (CCICM) are Veterans Integrated Service Network sites that provide primary, mental health, medical specialty, and rehabilitation and extended care, as well as surgery services, to Veterans in underserved areas.
- Internet-Based Computerized Cognitive Behavioral Therapy for Depression in Collaborative Care implements internet-based cCBT for depression, which increases PCMHI capacity by using stepped care approaches that first engage Veterans in patient-self-delivered treatments, across CRHs and rural CBOCs.
- Rural Access Network for Growth Enhancement (RANGE) provides intensive case management services, including homelessness outreach, to seriously mentally ill Veterans in rural areas.
- Rural Suicide Prevention connects Veterans to comprehensive suicide prevention services and resources through enhanced education, public awareness campaigns, community training, crisis support, firearm safety, and care management for high-risk individuals.
- Acute Inpatient Medicine - High Reliability, Learning Environment and Workforce Development Initiative (AIM-HI) allows rural hospitals to enhance learning, teamwork, and reliability for rural health care teams.
- Clinical Skills Training in Women Veterans Health Care trains providers in rural locations in skills unique to the treatment of rural women Veterans.
- Maximizing Ongoing Development and Educational Leadership (MODEL) for VHA Hospitalists is an interactive faculty development series tailored to the unique needs of VA hospital medicine providers. It utilizes a facilitation-based format to promote collaboration among participants.
- National Mental Health (MH) and Suicide Prevention (SP) Extension for Community Healthcare Outcomes (ECHO) connects rural providers to national MH and SP specialists for regular discussion of clinical cases and targeted skill-building training on suicide prevention and substance use disorder treatment.
- Rural Interprofessional Faculty Development Initiative (RIFDI) provides training for residency proctors, enabling them to better train, mentor, and monitor residents serving rural areas.
- VA-ECHO Expansion in Specialty Care provides live/virtual, case-based learning to a wide variety of clinical team members in over 20 medical specialty areas, including nephrology, pain management, pulmonology, and diabetes.
- The Highly Rural Transportation Grants Program (HRTG) expands transportation access for healthcare services to Veterans living in highly rural areas.
- Veterans Transportation Service (VTS) provides medical transportation services for rural Veterans and includes leases of vehicles, salaries for drivers, and mobility managers.
- Clinical Resource Hubs are Veterans Integrated Service Network sites that provide primary, mental health, medical specialty, and rehabilitation and extended care, as well as surgery services, to Veterans in underserved areas.
Rural Health - Navigation
- Office of Rural Health Home page:
https://www.ruralhealth.va.gov/index.asp - Enterprise-Wide Initiatives (EWI) page:
https://www.ruralhealth.va.gov/Enterprise-Wide-Initiatives-EWI.asp - Veterans Rural Health Resource Centers (VRHRC) page:
https://www.ruralhealth.va.gov/Veterans-Rural-Health-Resource-Center-VRHRC.asp
*Link will take Veterans outside of the Department of Veterans Affairs (VA) website. VA does not endorse and is not responsible for the content of the linked websites. The link will open in a new window for the content of the linked websites.
VA Employees can visit the ORH SharePoint (internal VA only) for more information about the EWI Request for Applications.
