Projects Aim to Improve the Health of Veterans

Participants in the VA projects meet at the VA Medical Center in Martinsburg, W.Va.

Many experts specialize in veterans health care issues. Others focus on rural health issues. But it is difficult to find individuals who combine both of these fields.

Ryung Suh, M.D., assistant professor of health systems administration at Georgetown University and a senior fellow at the National Opinion Research Center (NORC) at the University of Chicago, says he plans to change that reality through two new projects funded by the U.S. Department of Veterans Affairs (VA).

The first multimillion-dollar project—housed in the Department of Health Systems Administration at NHS—has created a veterans health education and outreach initiative with the VA Medical Center in Martinsburg, W.Va.

Gary Filerman, Ph.D., professor of health systems administration, and Suh serve as principal investigators. Project partners include the American College of Preventive Medicine; Atlas Research LLC (Atlas), of which Suh is a member; and the Nakamoto Group.

The second major effort—a five-year $26 million sponsored contract—is a policy and planning group on veterans health in rural areas.

Suh serves as the director of the policy and planning group, and Robert Friedland, Ph.D., associate professor of health systems administration, serves as a principal investigator for Georgetown's part of the project. Partners include NORC, Atlas, the University of North Dakota Center for Rural Health, and the National Rural Health Association.

"The overarching goal of these projects is to improve quality and access to care for veterans in geographically isolated areas," said Suh, who noted that almost 40 percent of veterans come from rural communities.

Currently, according to VA statistics, there are about 23.4 million veterans in the United States. The department operates 153 medical centers across the country. In 2008, 5.5 million veterans received care in a VA facility.

"It's a common storyline," Suh said. "When veterans come back into their rural communities, they face unique challenges that their rural health system may not be able to handle."

Major health concerns, he said, include traumatic brain injury, post-traumatic stress disorder, substance abuse, mental health issues, disability and rehabilitation, and the management of acute and chronic conditions across substantial geographical barriers.

"Through both of these projects, faculty and students are building capacity within the department and the school to really be able to help the VA in dealing with these challenging issues," said Suh.

Participating departmental faculty include Suh, Filerman, Friedland, Bernard Horak, Ph.D., professor, and Farrokh Alemi, Ph.D., professor. In addition, several master's degree candidates in health systems administration are also working on the projects as graduate assistants and research assistants.

"A major reason I came to Georgetown was to be involved in the program,” said Lauren Fishkin (G’10), who earned her undergraduate degree in brain and cognitive sciences at Massachusetts Institute of Technology.

"I find this fascinating," she said. "I have worked in a lot of different health care settings. I have never seen the military approach. The VA must contend with a lot of mental health issues, and that is my interest."

Fishkin is currently collaborating with Filerman and Horak on the portion of the project that focuses on developing workforce competencies to handle the special needs of veterans in rural areas.

Jonathan Duxbury (G'10), who earned his bachelor's degree in history and English from Miami University of Ohio, says the project has been a good learning experience. He is helping to develop a graduate-level course on veterans rural health topics that will be taught in VA facilities, as well as online mechanisms to disseminate related information and research.

"The project requires critical thinking and creativity," Duxbury said.

Other education and outreach efforts involve the development of a cardiovascular disease primary prevention program, a community-based patient navigator system, and a repository for educational materials.

The policy and planning group is involved in a large number of policy analyses, pilot programs, demonstration projects, studies and analyses, and dissemination efforts to identify and share best practices across a number of key areas.

"We're fortunate to be at the forefront of this as a department and to have wonderful partners," said Suh.

"We're an idea engine," he said. "And we will need to collaborate across a broad range of health systems, community-based organizations, health services researchers, policymakers, and other stakeholders to make meaningful, sustainable improvements. It is a tremendous opportunity for our institution to play a leadership role in making a lasting difference for our nation's veterans."