VHA:IE U.S. Department of Veterans Affairs

On this episode of the Veteran’s Health Administration’s Innovation Ecosystem (VHA:IE) podcast, we focus on “hackathons”, which are events where students, engineers, and entrepreneurs get together to engage in programming, innovation, and an engineering challenges. This past year, the VA teamed up with GeorgeHacks to help veterans with some human-centered design challenges.

Suzy Shirley, the Entrepreneur in Residence at the VHA Innovation Ecosystem, is this episode’s first guest. Suzy explains why hackathons are an unexplored mine full of potential and innovation. She also explains how you can take an everyday problem and give it to hundreds of students, entrepreneurs, engineers, and free-thinkers in order to solve the issue.

The 2019 GeorgeHacks event brought people together and encouraged them to think outside the box and come together to solve a problem. Even with the enormous expertise within the VA system, they’re bound by the issues that limits VA healthcare. One of the ways they have overcome some of those issues is through the GeorgeHacks event, which paired the VA with MIT students.

The second segment centers around Caitlyn Pratt who is the rising junior studying biomedical engineering at the George Washington University and is the new director of Georghacks at the George site. Georgehacks funds students to go to various hackathons in the DNB area. She talks about how she had the opportunity to chat with some of the veterans and people they help at hackathons and the most exciting results from some of the hackathons she participated in.

Kayla Burkholder is pursuing a masters in product innovation at Virginia Commonwealth University and co-founded a company called Pocket Innovations LLC which aims to prevent pocket hematomas after pacemaker/ICD implantation. She also talks about being able to empower other individuals to work through the problems they see in their community.

Next up we talked with Matthew Rowley, innovation specialist at the VA Pittsburgh Healthcare System. He joined with the GeorgeHacks because, just as it is good for the VA in that it generates solutions and partnerships, it is also a great way to show the academic community that the VA values innovation. He shares an anecdote of a team that helped a veteran with a prosthesis.

After that, we chatted with Brynn Cole director of programming for the VHA Innovators Network (or I-Net). They teamed up with Suzy Shirley’s VHA Innovation Ecosystem to pitch problems and come up with solutions during the GeorgeHack 2019 event.

Lastly, Army Veteran Cathy Davis, and Lucile Lisle (a recreation therapist with the Recreation Service and Polytrauma program at the Washington DC Veterans Affairs Medical Center) talks with us about their experience with GeorgeHacks. Cathy talks about how she was able to talk to the students who wanted to help her solve her problems. Both Cathy and Lucile share their experiences working with VA hospitals and what they hope for in the future.

Welcome to the VHA Innovation Ecosystem podcast! Today’s episode focuses on women Veterans, who comprise nearly 15% of all active duty military and 18% of all National Guard and Reserves. There are about 2.2 million women Veterans who make up nearly 7% of all VA health care users. Women are the fastest growing group within the Veteran population, and VA expects the number of women Veterans using VA care to increase dramatically as more women serve in the armed services. During this episode, we offer three segments that introduce programs that help women Veterans take charge of their reproductive rights, creatively tell their service stories, and connect as a community.

Our first segment is with Dr. Lori Gawron at the VA Salt Lake City Health Care System. Dr. Gawron’s practice trains primary care providers in the One Key Question algorithm, which starts with a simple question: “Would you like to become pregnant in the next year?” Patient responses facilitate further conversation, and this assessment provides critical information for care, ranging from neonatal vitamins to hormonal contraceptives.

Next, we speak with Carey Russ of the White River Junction VA Medical Center. In 2015, the White River Junction VAMC and the Center for Cartoon Studies came together to create the comic anthology “When I Returned,” which captures the experiences of Veterans coming home from war. However, no women Veterans were interviewed or featured in the anthology. In response to this lack of representation, Carey made it a priority and mission to collaborate on a second comic anthology with the purpose of capturing the experiences of women Veterans.

Our final segment is with Deborah Harmon-Pugh and Barbara Pittman, the National Campaign Chair and the DC Metro/Capitol Region State President, respectively, of Women Veterans ROCK! A coalition of organizations supporting women Veterans and military families, Women Veterans ROCK! provides resources for housing, employment, education, financial stability, and health and wellness to enable women Veterans to excel in their post-military lives. In this segment, Deborah and Barbara explain the goals of Women Veterans ROCK! and how they fit into the organization and its community.

Episode Resources:
US Department of Veteran Affairs
VA Salt Lake City Healthcare System
The Center for Cartoon Studies
White River Junction VA Medical Center
Women Veterans Rock
Women Veterans Civic Leadership Institute
Women Veterans Rock 2020 Delegation to Capitol Hill

Key Episode Quotes:
"When you're at the VA and regularly care for women, you might need extra training on the importance of these topics to feel comfortable with the response that the woman may give." -- Dr. Lori Gawron, VA Salt Lake City Healthcare System

"People have been, I think, really just awed, and surprised, and impressed about the women's willingness and ability to share, but also the art. It is really beautiful." -- Carey Russ, White River Junction VA Medical Center

"At Women Veterans Rock, we are dedicated to engaging and empowering women Veterans primarily through post military civic engagement." -- Deborah Harmon-Pugh, National Campaign Chair of Women Veterans Rock

Welcome to VHA Innovation Ecosystem podcast! On this episode, we cover advanced care planning and programs that help Veterans have difficult conversations with their care providers and families.

Dr. Kimberly Garner and Laura Taylor speak to Advanced Care Planning via Group Visits (ACP-GV). ACP-GV uses interactive, patient-centered group sessions led by health care professionals to engage Veterans in thinking about and planning for future medical decisions. Participation in the group discussions often leads to better management of chronic disease and increased access to primary care, along with enhanced communication, decision-making, and satisfaction.

The second practice featured in today’s episode is the Life Sustaining Treatment Veteran Education Video. This practice aims to create a video explaining life-sustaining treatments for Veterans who are visual learners to optimize their decision-making. The video is under development by Elizabeth Williams, an Innovation Specialist and a Clinical Nurse Leader at the Gulf Coast Veterans Health Care System.

In the final segment, Dr. Marvin Swartz, the co-director of the National Resource Center on Psychiatric Advance Directives (NRC-PAD) discusses psychiatric advance directives, or PADs. PADs are legal documents that record a person’s preferences for future mental health treatment. NRC-PAD serves as a place for consumers to access the timeliest PAD documentation for their jurisdiction. NRC-PAD also advocates for the implementation of laws that support patient-centered mental health care.

Episode Resources:
VHA Innovators Network
Diffusion of Excellence Initiative
U.S. Department of Veterans Affairs
Gulf Coast Veterans Health Care System
Little Rock Geriatric Research, Education, and Clinical Center
National Resource Center on Psychiatric Advance Directives

Key Episode Quotes:
"A Veteran told me, ‘Thank you for caring enough about us to share this with us or to tell us about this.’ I hear fairly frequently from Veterans that they appreciate being told proactively about things and not having to hunt that information down themselves.” – Dr. Kimberly Garner, Associate Director of VISN 16, Little Rock Geriatric Research, Education and Clinical Center

“We just celebrated serving 10,000 Veterans through the program, and our long-term plan is really for Advanced Care Planning via Group Visits to be offered in every VA facility, nationwide.” – Laura Taylor, National Director of Social Work Care Management and Social Work

"He said if he knew that this was what the provider were talking about, he would have said no on the front end…There was a learning gap between conversations about these important things and what Veterans understood or took from that.” – Elizabeth Williams, Innovation Specialist and Clinical Nurse Leader in Acute Care at Gulf Coast Veterans Healthcare System

"When a person can't consent to treatment, then treatment has to be administered involuntarily, and that can have consequences that's distressing to a person with severe mental illness…these mechanisms are out there, these legal tools are out there, but not that many people know about them. We'd like more widespread knowledge and tools to use them to be available." – Dr. Marvin Swartz, Co-Director of the National Resource Center on Psychiatric Advance Directives

Today’s episode of the VHA Innovation Ecosystem podcast will focus on the recent VHE Aungrial talks that took place on August 29th and 30th of 2018. Over 70 VA employees attended this event and shared their struggles and successes within their respective VA programs. 13 of these professionals gave presentations about their work.

Among the presenters was Dr. Ellina Seckel, Associate Chief, Ambulatory and Specialty Care - Pharmacy Service at William S. Middleton Memorial Veterans Hospital in Madison Wisconsin. Dr. Seckel is in charge of implementing the Increasing Access to Primary Care Through Clinical Pharmacy Specialists program. The doctor will explain why the facility felt the need to create a new pharmaceutical position for their primary care teams and the overwhelmingly positive effects it has done for both physician and patient satisfaction.

During this special mini-episode you will learn about:

What makes a Clinical Pharmacy Specialist different from a traditional pharmacist?
How hiring a pharmacist specialist help care access for veterans?
How Dr. Seckel implemented the program and achieved such impressive results!
The culture shock that had to be overcome before the program could really work.
A Clinical Pharmacy Specialist’s role within a primary care team.
The feedback from providers and patients.
How Dr. Seckel and her team measure the success rate of the program.
Dr. Seckel’s hopes for the next five years.
Dr. Seckel’s final thoughts.

RESOURCES & MENTIONS

William S. Middleton Memorial Veterans Hospital
The VHA Innovation Experience
VA Innovators Network
Diffusion of Excellence
U.S. Department of Veterans Affairs
VHA: IE Podcast


Quotes from today’s episode:

"Imagine every veteran having same-day access to care. Imagine every veteran being on only the medications they need, and their chronic conditions well controlled, and imagine every veteran feeling well and whole." -- Dr. Seckel

"How the pharmacist provider or clinical pharmacy specialist works within the team, we do have weekly team meetings, for example on my team, once a week, I sit down with our primary care provider, our RN, the LPN, and our scheduler and we talk about the patients that might be facing so unique challenges and we strategize together on how each of us can be most supportive to that patient." -- Dr. Seckel

"So pharmacist providers in Madison in 2015, recognized that we had an access issue. Wait times were greater than 30 days in primary care and we wanted to do something about it." -- Dr. Seckel

"VA pharmacists providers have been able to hold scopes of practices federally since 1995, and in fact, today there are over 4000 pharmacists practicing under scopes of practices allow them these privileges today." -- Dr. Seckel

Thank you for joining us for the VHA Innovation Ecosystem podcast. If you know a veteran who may need a little help or you are that veteran, please call the VA’s crisis line at 1-800-273-8255 and press 1.

The fifth episode of the VHA Innovation Ecosystem podcast, VHA:IE, focuses on how VA is helping Veterans reflect on and share their stories with their health providers, loved ones, and the community at large. On this episode, you will hear from the team behind a program that personalizes the healthcare experience by including a Veteran’s life story in their medical file, along with a project that aims to address how Veterans may confront death. You’ll also hear from a non-profit dance group that is helping restore Veterans' physical, mental, and emotional strength through workshops and public performances.

The first program, My Life, My Story, is building a network of employees and volunteers who sit down with Veterans and then craft written life stories for inclusion in Veterans’ medical records. This allows Veterans to feel seen and heard and enables doctors to better understand the lives of those they care for. The program originated at the William S. Middleton Memorial Veterans Hospital in Madison, Wisconsin, and is being spread across VA as it gains popularity with both Veterans and caregivers. Dr. Ryan Vega, Director of the Diffusion of Excellence Initiative, speaks with Thor Ringler about My Life, My Story, including the challenges with sustaining the program and his future vision for it.

Before I Die, the second program featured in the episode, is a worldwide community art project that is being implemented at the Tomah VA Medical Center. The facility will erect an eco-friendly recycled paper wall that will allow patients and visitors to write their answer to the question, “Before I die, I want to…” The project is meant to help patients and their loved ones begin an important discussion about death. John D’Adamo, Acting Director of the VHA Innovators Network, talks with Amanda Meinke about the wall’s ability to connect Veterans with their community and loved ones.

The final segment features an interview with Jacques Heim and Chris Loverro from the non-profit dance troupe DIAVOLO. Through the Veterans Project: A Long Journey Home, DIAVOLO helps Veterans reconnect with their bodies and mental and emotional strengths. John D’Adamo sits down to discuss the program with Heim, who is DIAVOLO’s founder and artistic director, and Loverro, who is a performer and Army Veteran.

Episode Resources:
US Department of Veteran Affairs
VHA Innovators Network
Diffusion of Excellence Initiative
Before I Die
DIAVOLO
My Life, My Story

Key Episode Quotes:
"We want you to talk about what's comfortable for you to share with your VA care team. We don't actually have a set of questions that we ask. We have topics that we cover." -- Thor Ringler, William S. Middleton Memorial Veterans Hospital

"Some people look at death as a negative, and this way, people can write down their hopes and dreams and aspirations and build our relationship with death and one another by sharing these things." -- Amanda Meinke, Tomah VA Medical Center

"I really believe the more we can bring closer the Veterans and the civilians together, for the civilians to really understand who are the Veterans, what they are about, who are they – the better we can help the Veterans." -- Jacques Hines, DIAVOLO founder and artistic director

"Don't be intimidated by the dance component. It's not about learning to be a dancer, it's about coming together in a tribe and learning how to move and create." -- Chris Loverro, Army Veteran and DIAVOLO performer