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Office of Rural Health


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Enterprise-Wide Initiatives


Enterprise-Wide Initiatives

The Office of Rural Health (ORH) implements programs that deliver increased care and support to rural Veterans nationwide in a more uniform manner. ORH’s programs are in two categories: Rural Promising Practices and Enterprise-Wide Initiatives (EWI). EWIs expand national U.S. Department of Veterans Affairs' (VA) program offices’ health care efforts to sites that serve rural Veterans. Initial funding support is available by ORH to support implementation in VA facilities across the country.

To learn more about these initiatives, visit our EWI menu to read the 2018 EWI descriptions. (Disclaimer: This link directs to an internal VA site. You must have access to the VA network to view this page)

Primary Care
  • Teleprimary Care Hubs establishes teleprimary care hubs with spoke sites to ensure access to primary care in rural areas where providers are unavailable.
  • Home Based Primary Care expands home-based Patient Aligned Care Team services to rural areas within a VA medical center or VA health care system service area.
  • Medical Foster Home provides an alternative to nursing home for Veterans who need daily personal assistance, are no longer able to live independently, and do not have an available family caregiver.
  • Telephone Lifestyle Coaching supports health-coaching intervention to promote change in health behaviors, including unhealthy eating, physical inactivity, obesity, tobacco use, stress and unhealthy alcohol use.
Specialty Care
  • National Teleradiology Program provides rural VA facilities with 24-hour diagnostic image interpretation, including access to sub-specialty radiologists within the VA.
  • Rural Veterans Telerehabilitation Initiative provides physical, occupational and recreational rehabilitation services to Veterans in their homes through secure internet video.
  • Tele-Intensive Care Unit (ICU) connects VA facilities that do not have intensivists on staff with VA intensivists nationwide via telehealth to increase access to ICU services and specialty inpatient care for rural Veterans.
  • Clinical Pharmacy Specialist Providers delivers greater access to medication and chronic disease management services to rural Veterans using telehealth technology to bring experts into the Veterans home, within a VA medical center, or to VA community based outpatient clinics.
  • Genomic Counseling Services for Rural Facilities uses telehealth to increase rural access to genomic services including comprehensive genetic testing. This program includes provider education to recognize genetic cancer and connective tissue disease.
  • Telerehabilitation Services expands an integrated network of specialists who are specifically trained in delivering physical and rehabilitative therapy to rural Veterans using telehealth technology.
  • National Telestroke Program provides emergent telehealth care by qualified stroke neurologists to Veterans with stroke symptoms at VA medical centers that do not have stroke neurologists on site.
  • Teleaudiology provides audiology remote fittings and aftercare services, remote diagnostic testing, and automated audiometric testing in a store-and-forward model.
  • Teledermatology expands store-and-forward tele-dermatology to rural sites; includes primary care training on dermatologic consults and minor procedures.
  • Gerofit, Geriatric Fitness Program provides physical activity therapy to elderly rural Veterans using telehealth technology.
  • Lung Cancer Screening provides clinical navigators to support cancer screening at VAMCs serving rural Veterans
  • Precision Oncology provides rural Veteran patients access to the latest technology in cancer treatment, including molecular analysis of tumor samples to detect acquired gene mutations in multiple cancer-associated genes.
  • Sleep Telemedicine supports diagnosis, care and remote monitoring of Veterans with sleep apnea via web-enabled devices.
  • State Veterans Homes (SVH) Telehealth Initiative expands existing telehealth programs to Veterans in SVH facilities located far from VA facilities, expanding access to direct VA health care services for rural Veterans.
  • Technology-based Eye Care Services is a telehealth-based eye screening initiative that places ophthalmology technicians in rural VA clinics that lack ophthalmology services to collect information about a patient’s eyes and transmit to VA ophthalmologists for diagnosis and follow-up.
Mental Health
  • Telemental Health Hubs connects mental health specialists with rural sites where Veterans require same-day or urgent access to mental health services, where access is limited due to provider shortages or other barriers.
  • 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.
  • Rural Access Network for Growth Enhancement provides intensive case management services, including homeless outreach, to seriously mentally ill Veterans in rural areas.
  • Vets Prevail Web Based Behavioral Support provides Veterans suffering from depression and/or post-traumatic stress disorder with tools to overcome these challenges. Focus is on returning Veterans from recent conflicts, Operation Enduring Freedom, Operation Iraqi Freedom and Operation New Dawn.
  • Military Sexual Trauma Web Based Therapy uses telehealth to deliver specialized mental health care directly to Veterans’ homes in caring for those who have experienced military sexual trauma.
  • Social Work in Patient Aligned Care Teams expands the integration of rural social workers into the Patient Aligned Care Team (PACT) model to improve care coordination for rural Veterans and their interdisciplinary care teams.
  • Advanced Care Planning via Group Visits connects Veterans to Advanced Care planning experts who help them develop a plan to address how health care decisions will be made if they are unable to communicate.
Workforce Training and Education
  • Clinical Skills Training in Women Veterans Health Care trains providers in rural locations in skills unique to the treatment of rural women Veterans.
  • Simulation Based Learning for Suicide Prevention uses the VA SimLEARN infrastructure to train rural clinicians and improve identification, interaction and treatment of rural Veterans at risk for suicide.
  • Rural Health Training Initiative provides rural clinical training sites for health professions students and clinical residents. Trainees include social workers, nurse practitioners, pharmacists, psychiatrists, optometry students, and dental and family medicine residents.
  • Simulation Learning, Education, and Research Network Rural Coordinators develops a simulation based training infrastructure to improve rural clinicians' technical skills without leaving their home clinic.
  • VA-Extension for Community Health Outcomes (ECHO) Transgender Program trains rural providers on providing treatment to transgender Veterans through online didactic training and case-based consultation.
  • VA-ECHO Expansion in Specialty Care uses telehealth to train providers in a wide variety of specialties, including treatment for chronic kidney disease, hepatitis C and pain management.
Care Coordination
  • Women Veteran Care Coordination and Management creates, enhances and expands care coordination in the areas of maternity care, mammography, cervical cancer screening and breast cancer care.
  • Rural Health Community Coordinator Health Information Exchange provides personnel who facilitate secure and effective data exchange between VA and community providers.
Health IT Modernization
  • Telehealth Equipment Modernization updates and upgrades aging telehealth equipment in rural-serving VA facilities.
  • VA Video Connect CVT Patient Tablet Program provides rural Veterans with video telehealth tablets to connect patients with and transmit patient data to a remote VA health care provider through a secure internet connection.
  • VHA Rural Needs Assessment gathers VISN and VAMC perspectives to better understand rural Veteran health care access needs and help in determining future ORH program offerings.
  • Rural ChooseVA Access Evaluation evaluates VA efforts to improve access to care across the enterprise.
  • VA Farming and Recovery Mental Health Services (VA FARMS) provides Veterans with agricultural vocational training and behavioral health care services from licensed providers at ten VHA sites of care.
  • Telemedicine for PTSD in Small Rural CBOCs provides rural Veterans with PTSD remote access to virtual psychotherapy and related services.
  • Rural VA Innovators Network supports health care delivery innovations to improve access to care and services for rural Veterans.
  • Under Secretary for Health Rural Diffusion of Best Practices supports the national implementation of standardized best practices to benefit rural Veterans.
  • Patient Aligned Care Teams Health Advocate, Scribe places patient advocates/medical transcription assistants in medical centers serving rural Veterans to allow providers to focus on patient care rather than data entry.
  • Transitions Nurse Program improves coordination between tertiary VA and non-VA hospitals and rural PACT sites following hospitalization through a proactive, personalized, nurse-led and Veteran-centered intervention.
  • Support for Caregivers of Veterans provides caregivers of medically vulnerable rural Veterans with Resources for Enhancing All Caregivers’ Health (REACH VA), including telephone support essential for caregivers of Veterans.
  • Veteran Transportation Services provides medical transportation services for rural Veterans, and includes salaries for drivers and mobility managers and leases of vehicles.