Enterprise-Wide Initiatives - Office of Rural Health
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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
  • Home Based Primary Care expands home-based Patient Aligned Care Team services to rural areas.
  • Medical Foster Home provides an alternative to nursing home for Veterans who need daily assistance, are unable to live independently, and have no available family caregiver.
  • Telephone Lifestyle Coaching Promotes change in health behaviors, including unhealthy eating, inactivity, obesity, tobacco use, stress and alcohol use.
Specialty Care
  • 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 medication and chronic disease management services to rural Veterans using pharmacists’ expertise through telehealth into Veterans' homes, VAMCs, or CBOCs.
  • 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 audiometric testing for rural Veterans.
  • 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
  • Sleep Telemedicine supports diagnosis, care and remote monitoring of Veterans with sleep apnea via web-enabled devices.
  • Technology-based Eye Care Services is a telehealth-based eye screening initiative that places ophthalmology technicians in rural VA clinics to collect information about a patient’s eyes and transmit to VA ophthalmologists for diagnosis and follow-up.
  • Pharmacy 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.
  • National Teleneurology Program establishes telehealth sites to ensure access to neurology in rural areas where providers are unavailable.
  • National Teleoncology Program 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.
Mental Health
  • 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 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.
  • 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-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.
  • Rural Interprofessional Faculty Development Initiative (RIFDI) provides training for residency proctors, enabling them to better train, mentor, and monitor residents serving rural areas.
Telehealth Clinical Resource Hubs
  • Clinical Resource Hubs: These Veterans Integrated Service Network hubs provide primary, mental health, and specialty care to Veterans in underserved areas.
  • Teleprimary Care establishes teleprimary care sites to ensure access to primary care in rural areas.
  • • Telemental Health connects specialists with rural Veterans to ensure access to mental health care services in rural areas.
  • Telespecialty Care connects specialists with rural Veterans to ensure access to specialty care services in rural areas.
  • 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.
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.
  • 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.
  • Center for the Evaluation of Enterprise-Wide Initiatives systematically reviews EWIs to improve evaluation and comprehensively analyze impact while contributing to the field of implementation science.
  • Project ATLAS Rural Telehealth National Evaluation Innovation evaluates VA efforts to provide telehealth in partner governmental and community locations such as Federally Qualified Health Centers, community retailers, and Veterans Service Organization facilities.
  • VA Farming and Recovery Mental Health Services (VA FARMS) provides Veterans with agricultural vocational training and behavioral health care services from licensed providers at nine VHA sites of care.
  • Rural Innovation Ecosystem supports new service delivery innovations and the national implementation of standardized best practices intended to improve access to care and services for rural Veterans.
  • 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.
  • MISSION Act Emergency Room Specialty Care Scribe Program places medical transcription assistants in Specialty Care and Emergency Departments to allow providers to focus on patient care.
  • Veteran Transportation Services provides medical transportation services for rural Veterans; and includes leases of vehicles, salaries for drivers and mobility managers.