A research center at a Veterans Administration medical center just outside Chicago has captured the flag to coordinate the VA's farflung medical and health services research efforts, MODERN HEALTHCARE has learned.
The new VA Information Resources Center (VIREC) is setting up shop on the campus of the Edward Hines Jr. VA Hospital, across the street from Loyola University Medical Center in Maywood, Ill. Its mission is to offer centralized knowledge about VA research projects and to disseminate information about the various databases available within the VA system.
The VA is expected to make a formal announcement next month about the center's creation.
"We are an information conduit," said Diane Cowper, a demographer who, with health economist Denise Hynes, is co-director of the VIREC. "We will have a Web site. People can see what's new, what's going on. Our primary customers are VA researchers."
The center has 10 employees and is funded at $350,000 per year for three years.
Foremost among its tasks will be continuation of the Blue Books series, which catalogs the VA's inpatient database, outpatient database, costing methodology and decentralized hospital computing programs. A VA facility in Indianapolis had been doing this for years; in addition to taking it over, the Hines group will develop new user manuals.
Two big databases also will be ready for rollout shortly: a national patient-care database and a decision support system. The VIREC will coordinate their dissemination.
Some recent work has allowed researchers at the local level to do different types of aggregations at different levels of analysis---by department or by groups of patients. For instance, Cowper said, "if you wanted to know costs incurred by all your congestive heart failure patients, you can aggregate that."
The VA does a tremendous amount of research, divided into the categories of medical research, cooperative studies, health services research and rehabilitation research. The agency has sophisticated databases throughout the system, said Cowper, but researchers in one location frequently don't know that a database related to their project exists elsewhere.
"We're going to be talking to database custodians and get people to tell us how to get access to their data," Cowper said.
"They've had blinders on, been very myopic," Cowper said. "They like to hang on to what they're doing, and they are reticent to share. There's been a lot of redundancy. We are trying to create a more sharing environment."
A typical research database might include Current Procedural Terminology codes, X-ray and laboratory information, patient demographics, diagnostic information, patient admission and discharge data, procedures patients underwent in the hospital, their prescriptions and clinic usage.
It would also include information specific to a patient's veteran status, such as eligibility for benefits and exposure to Agent Orange or radiation. There also are registries for spinal cord injuries, Gulf War veterans, women and various other subdivisions.
Altogether the VA has 150 research databases.
In addition, the VIREC will help scientific review boards throughout the nation review research proposals. The Hines group will function as a data consultant service for VA investigators.
For years individual VA hospitals have set up their computer systems any way they wanted. That worked well on a local level but impeded gathering information for national studies.
The center at the Hines hospital won the VIREC designation through a national competitive process. It reports directly to the VA's Health Services Research and Development Service in Washington. "We are the one, the only place that does this in the country," Cowper said.