The Center for Access and Delivery Research and Evaluation (CADRE) renewed its five-year status as a Center of Innovation (COIN) within the VA Health Services Research & Development (HSRD) in late 2018. A multidisciplinary and nimble band of researchers, educators, and clinicians, CADRE investigators are transforming the way health care is delivered, improving quality and increasing patient safety. Their discoveries, though getting their start and their evidence of efficacy from within the VA Health Care System, often become standardized within the larger US health care system.
One associate investigator not mentioned in last year’s snapshot of CADRE’s activities is Peter Kaboli, MD, MS, FACP, FHM, professor in General Internal Medicine. Kaboli is currently working on two research projects focused on increasing and strengthening the Veterans Health Administration (VHA) workforce and improving appointment attendance.
Under the first of two HSRD grants, Kaboli began a three-year study last October with Alan Teo, MD, of the Portland VA and Oregon Health Sciences University. The two are examining the effect on rates of appointment attendance when principles of behavioral economics are applied to appointment reminders. Missed appointments in any healthcare setting wastes time and resources that could be applied to another patient in need. Based on past, smaller studies, Kaboli and Teo predict that veterans attend scheduled appointments if it is believed to be the social norm for veterans as a whole. To activate this belief, the PIs will send four enhanced appointment reminders that are relevant to treatment access and evaluate the different responses to these enhanced reminders.
Kaboli also serves as Co-Investigator on a study with Edwin Wong, PhD, of the VA Puget Sound and University of Washington. This three-year HSRD-funded study aims to identify quality improvement approaches to strengthen the workforce of VA physicians, with a focus on the rural provider. Rural areas have historically had challenges with recruitment and retention of physicians and, because 35% of veterans live in these areas, it is important to ensure they have easy access to care. Kaboli and Wong’s study analyzes the recruiting and hiring processes to attract high quality candidates and looks at individual, economic, and job-related factors that could increase the number of primary care physicians working in rural areas. These factors include compensation, academic affiliation, clinic integration, and workplace climate. The ultimate goal is to identify modifiable factors that can ensure appropriate access to healthcare, regardless of where one lives.
Learn more about CADRE projects by following @IC_CADRE on Twitter. Some of their partners include Iowa Infection Prevention @uiowaIPC, the VA Quality Scholars program @qualityscholar, and the University of Iowa College of Public Health @UIowaCPH.