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Center for Healthcare Organization & Implementation Research

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Care Coordination

In VA, Care Coordination defined as facilitating integration of, and navigation through, health care services, within and across care settings, to help patients receive the care they need and want without unnecessary duplication of services or avoidable inconvenience. Care coordination ideally is patient-centered, but research may focus on other aspects such as patient safety, duplication of services, health care costs, etc.

CHOIR is leading several projects focused on examining care coordination, including:

  • Study of the application of technology to facilitate care coordination for patients with complex chronic disease, with an interest in improving clinician relationships and communication by supporting formal and informal mechanisms of coordination through the electronic health record.
  • Survey method studies to measure coordination as experienced by patients, caregivers, primary care providers, and specialists. CHOIR investigators use these findings to identify the antecedents and outcomes of coordinated care.
  • Examining the impact of the Choice Act on access, utilization, quality, and cost. CHOIR investigators are using data-driven approaches to answer questions such as: has Choice improved access to care? How does quality of care compare between VA and VA-purchased care? What are the implications for VA as it continues to expand access to Community Care? Should it make vs. buy essential services, such as mental health, surgery, and medical services?
  • CHOIR is evaluating how VA and Community Care patient safety staff are using the recently developed Patient Safety Guidebook which was designed to foster standardization of patient safety practices across VA and Community Care (PEC-18-204)
  • Bridging the Care Continuum (Bridge QUERI) program. Bridge QUERI improves health outcomes associated with mental health and substance use disorders by expanding access to and engagement in prevention, treatment and supportive services for Veterans most impacted by social determinants of health.
  • Behavioral Health QUERI Program (BH QUERI) program. This program aims to improve the delivery of evidence-based, well-coordinated mental health care, consistent with the collaborative chronic care model (CCM).