Skip to main content
SpringerLink
Log in

Using the Veterans Health Administration as a Laboratory for Integrated Decision Tools for Patients and Clinicians

  • Chapter
  • First Online:
Handbook of Health Decision Science

  • 1676 Accesses

Abstract

The Department of Veterans Affairs (VA) healthcare system emphasizes patient-centered, evidence-based, collaborative health care in a system that seeks continuous quality improvement. Integrated decision support is central to realizing this vision. Decision support systems provide a platform to engage clinicians and patients in making health decisions that incorporate the best evidence on diagnostic and treatment options, the patient’s clinical information and risk factors, and patient values, goals, and preferences for care. The early adoption of health information technology systems in the VA, such as the electronic health record (EHR), has provided the infrastructure for highly innovative research on applied decision making. This chapter highlights contributions of VA investigators using these technologies to advance clinical decision support tools and improve shared decision making in the VA healthcare system and beyond.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 54.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Advani, A., Goldstein, M., Shahar, Y., & Musen, M. A. (2003). Developing quality indicators and auditing protocols from formal guideline models: Knowledge representation and transformations [Research support, U.S. Gov’t, Non-P.H.S. research support, U.S. Gov’t, P.H.S.]. AMIA… Annual Symposium proceedings/AMIA Symposium. AMIA Symposium (pp. 11–15).

    Google Scholar 

  • Advani, A., Jones, N., Shahar, Y., Goldstein, M. K., & Musen, M. A. (2004). An intelligent case-adjustment algorithm for the automated design of population-based quality auditing protocols [Research support, N.I.H., Extramural research support, U.S. Gov’t, Non-P.H.S. research support, U.S. Gov’t, P.H.S.]. Studies in Health Technology and Informatics, 107(Pt 2), 1003–1007.

    PubMed  Google Scholar 

  • Advani, A., Tu, S., O’Connor, M., Coleman, R., Goldstein, M. K., & Musen, M. (1999). Integrating a modern knowledge-based system architecture with a legacy VA database: The ATHENA and EON projects at stanford [Research support, U.S. Gov’t, Non-P.H.S. research support, U.S. Gov’t, P.H.S.]. Proceedings/AMIA … Annual Symposium. AMIA Symposium (pp. 653–657).

    Google Scholar 

  • Anderson, J. A., Godwin, K. M., Saleem, J. J., Russell, S., Robinson, J. J., & Kimmel, B. (2013). Accessibility, usability and usefulness of a web-based clinical decision support tool to enhance provider-patient communication around self-management to prevent (STOP) stroke. Health Informatics Journal. doi:10.1177/1460458213493195

    Google Scholar 

  • Atkins, D., & Kupersmith, J. (2010). Implementation research: A critical component of realizing the benefits of comparative effectiveness research. American Journal of Medicine, 123(12 Suppl 1), e38–e45. doi:10.1016/j.amjmed.2010.10.007

    Google Scholar 

  • Bennett, C. L., Chapman, G., Elstein, A. S., Knight, S. J., Nadler, R. B., Sharifi, R., et al. (1997). A comparison of perspectives on prostate cancer: Analysis of utility assessments of patients and physicians [Comparative Study]. European Urology, 32(Suppl 3), 86–88.

    Google Scholar 

  • Bosworth, H. B., Olsen, M. K., Dudley, T., Orr, M., Goldstein, M. K., Datta, S. K. … Oddone, E. Z. (2009). Patient education and provider decision support to control blood pressure in primary care: A cluster randomized trial [Randomized Controlled Trial]. American Heart Journal, 157(3), 450–456. doi:10.1016/j.ahj.2008.11.003

    Google Scholar 

  • Bosworth, H. B., Powers, B. J., Olsen, M. K., McCant, F., Grubber, J., Smith, V. … Oddone, E. Z. (2011). Home blood pressure management and improved blood pressure control: Results from a randomized controlled trial. Archives of Internal Medicine, 171(13), 1173–1180. doi:10.1001/archinternmed.2011.276

    Google Scholar 

  • Charters, K. G., & Nazi, K. (2007). Personal health record evaluation: My HealtheVet and RE-AIM. AMIA Annual Symposium proceedings (p. 899).

    Google Scholar 

  • Chumbler, N. R., Haggstrom, D. A., & Saleem, J. (2010). Implementation of health information technology in veterans health administration to support transformational change: Telehealth and personal health records. Medical Care. doi:10.1097/MLR.0b013e3181d558f9

    Google Scholar 

  • Costanza, M. E., Luckmann, R. S., Rosal, M., White, M. J., LaPelle, N., Partin, M. … Foley, C. (2011). Helping men make an informed decision about prostate cancer screening: A pilot study of telephone counseling [Research Support, N.I.H., Extramural]. Patient Education and Counseling, 82(2), 193–200. doi:10.1016/j.pec.2010.05.011

    Google Scholar 

  • Cox, M., Kupersmith, J., Jesse, R. L., & Petzel, R. A. (2011). Commentary: Building human capital: Discovery, learning, and professional satisfaction. Academic Medicine, 86(8), 923–924. doi:10.1097/ACM.0b013e3182223b8e.

    Google Scholar 

  • Damush, T. M., Jackson, G. L., Powers, B. J., Bosworth, H. B., Cheng, E., Anderson, J. … Plue, L. (2010). Implementing evidence-based patient self-management programs in the Veterans Health Administration: Perspectives on delivery system design considerations. Journal of General Internal Medicine, 25(Suppl 1), 68–71. doi:10.1007/s11606-009-1123-5

    Google Scholar 

  • Elstein, A. S., Chapman, G. B., Chmiel, J. S., Knight, S. J., Chan, C., Nadler, R. B. … Bennett, C. L. (2004). Agreement between prostate cancer patients and their clinicians about utilities and attribute importance [Research support, U.S. Gov’t, Non-P.H.S.]. Health Expectations: An International Journal of Public Participation in Health Care and Health Policy, 7(2), 115–125. doi:10.1111/j.1369-7625.2004.00267.x

    Google Scholar 

  • Elstein, A. S., Chapman, G. B., & Knight, S. J. (2005). Patients’ values and clinical substituted judgments: The case of localized prostate cancer. Health psychology: Official journal of the Division of Health Psychology, American Psychological Association, 24(4 Suppl), S85–S92. doi:10.1037/0278-6133.24.4.S85.

    Article  Google Scholar 

  • Fraenkel, L. (2013). Incorporating patients’ preferences into medical decision making [Research support, N.I.H., Extramural]. Medical Care Research and Review: MCRR, 70(1 Suppl), 80S–93S. doi:10.1177/1077558712461283

    Google Scholar 

  • Fraenkel, L., Bodardus, S., & Wittnik, D. R. (2001). Understanding patient preferences for the treatment of lupus nephritis with adaptive conjoint analysis [Multicenter study research support, Non-U.S. Gov’t research support, U.S. Gov’t, Non-P.H.S.]. Medical Care, 39(11), 1203–1216.

    Article  PubMed  Google Scholar 

  • Fraenkel, L., Bogardus, S., & Concato, J. (2002). Patient preferences for treatment of lupus nephritis [Research support, Non-U.S. Gov’t research support, U.S. Gov’t, Non-P.H.S.]. Arthritis and Rheumatism, 47(4), 421–428. doi:10.1002/art.10534.

    Google Scholar 

  • Fraenkel, L., Bogardus, S. T., Concato, J., Felson, D. T., & Wittink, D. R. (2004a). Patient preferences for treatment of rheumatoid arthritis [Comparative study research support, U.S. Gov’t, Non-P.H.S.]. Annals of the Rheumatic Diseases, 63(11), 1372–1378. doi:10.1136/ard.2003.019422

    Google Scholar 

  • Fraenkel, L., Bogardus, S. T, Jr., Concato, J., & Wittink, D. R. (2004b). Treatment options in knee osteoarthritis: The patient’s perspective [Comparative study research support, Non-U.S. Gov’t research support, U.S. Gov’t, Non-P.H.S.]. Archives of Internal Medicine, 164(12), 1299–1304. doi:10.1001/archinte.164.12.1299

    Google Scholar 

  • Fraenkel, L., Chodkowski, D., Lim, J., & Garcia-Tsao, G. (2010). Patients’ preferences for treatment of hepatitis C [Research support, N.I.H., extramural research support, U.S. Gov’t, Non-P.H.S.]. Medical Decision Making: An International Journal of the Society for Medical Decision Making, 30(1), 45–57. doi:10.1177/0272989X09341588

    Google Scholar 

  • Fraenkel, L., Constantinescu, F., Oberto-Medina, M., & Wittink, D. R. (2005). Women’s preferences for prevention of bone loss [Research support, U.S. Gov’t, Non-P.H.S.]. The Journal of Rheumatology, 32(6), 1086–1092.

    PubMed  Google Scholar 

  • Fraenkel, L., & McGraw, S. (2007). Participation in medical decision making: The patients’ perspective [Research support, N.I.H., extramural research support, Non-U.S. Gov’t]. Medical decision making: An international journal of the Society for Medical Decision Making, 27(5), 533-538. doi:10.1177/0272989X07306784

    Google Scholar 

  • Fraenkel, L., Rabidou, N., & Dhar, R. (2006). Are rheumatologists’ treatment decisions influenced by patients’ age? [Multicenter study research support, N.I.H., Extramural]. Rheumatology, 45(12), 1555–1557. doi:10.1093/rheumatology/kel144

    Google Scholar 

  • Fraenkel, L., Rabidou, N., Wittink, D., & Fried, T. (2007). Improving informed decision-making for patients with knee pain [Randomized controlled trial research support, N.I.H., extramural research support, Non-U.S. Gov’t]. The Journal of rheumatology, 34(9), 1894–1898.

    PubMed  Google Scholar 

  • Goldstein, M. K., Coleman, R. W., Tu, S. W., Shankar, R. D., O’Connor, M. J., Musen, M. A. … Hoffman, B. B. (2004). Translating research into practice: Organizational issues in implementing automated decision support for hypertension in three medical centers [Research support, U.S. Gov’t, Non-P.H.S. research support, U.S. Gov’t, P.H.S.]. Journal of the American Medical Informatics Association: JAMIA, 11(5), 368–376. doi:10.1197/jamia.M1534

    Google Scholar 

  • Haggstrom, D. A., Saleem, J. J., Russ, A. L., Jones, J., Russell, S. A., & Chumbler, N. R. (2011). Lessons learned from usability testing of the VA’s personal health record [Research support, Non-U.S. Gov’t research support, U.S. Gov’t, Non-P.H.S.]. Journal of the American Medical Informatics Association: JAMIA, 18(Suppl 1), i13–i17. doi:10.1136/amiajnl-2010-000082

    Google Scholar 

  • Henry, S. G., Czarnecki, D., Kahn, V. C., Chou, W. Y., Fagerlin, A., Ubel, P. A. … Holmes-Rovner, M.(2013). Patient-physician communication about early stage prostate cancer: Analysis of overall visit structure. Health Expectations: An International Journal of Public Participation in Health Care and Health Policy,. doi:10.1111/hex.12168

    Google Scholar 

  • Hurdle, J. F., Weir, C. R., Roth, B., Hoffman, J., & Nebeker, J. R. (2003). Critical gaps in the world’s largest electronic medical record: Ad Hoc nursing narratives and invisible adverse drug events [Research support, U.S. Gov’t, Non-P.H.S.]. AMIA Annual Symposium proceedings/AMIA Symposium. AMIA Symposium (pp. 309–312).

    Google Scholar 

  • Hynes, D. M., Cowper, D., Kerr, M., Kubal, J., & Murphy, P. A. (2000). Database and informatics support for QUERI: Current systems and future needs. Quality enhancement research initiative [Review]. Medical care, 38(6 Suppl 1), I114–I128.

    Google Scholar 

  • Hynes, D. M., Weddle, T., Smith, N., Whittier, E., Atkins, D., & Francis, J. (2010). Use of health information technology to advance evidence-based care: Lessons from the VA QUERI program [Comparative study multicenter study research support, U.S. Gov’t, Non-P.H.S.]. Journal of General Internal Medicine, 25(Suppl 1), 44–49. doi:10.1007/s11606-009-1144-0

    Google Scholar 

  • Jha, A. K., Perlin, J. B., Kizer, K. W., & Dudley, R. A. (2003). Effect of the transformation of the veterans affairs health care system on the quality of care [Comparative Study]. The New England Journal of Medicine, 348(22), 2218–2227. doi:10.1056/NEJMsa021899

    Google Scholar 

  • Kerr, E. A., & Hayward, R. A. (2013). Patient-centered performance management: Enhancing value for patients and health care systems [Research support, N.I.H., extramural research support, U.S. Gov’t, Non-P.H.S.]. JAMA, the Journal of the American Medical Association, 310(2), 137–138. doi:10.1001/jama.2013.6828

    Google Scholar 

  • Kerr, E. A., Krein, S. L., Vijan, S., Hofer, T. P., & Hayward, R. A. (2001). Avoiding pitfalls in chronic disease quality measurement: A case for the next generation of technical quality measures [Research support, U.S. Gov’t, Non-P.H.S.]. The American Journal of Managed Care, 7(11), 1033–1043.

    PubMed  Google Scholar 

  • Kim, S. P., Knight, S. J., Tomori, C., Colella, K. M., Schoor, R. A., Shih, L. … Bennett, C. L. (2001). Health literacy and shared decision making for prostate cancer patients with low socioeconomic status [Research support, Non-U.S. Gov’t research support, U.S. Gov’t, Non-P.H.S.]. Cancer investigation, 19(7), 684–691.

    Google Scholar 

  • Kizer, K. W., & Dudley, R. A. (2009). Extreme makeover: Transformation of the veterans health care system [Review]. Annual Review of Public Health, 30, 313–339. doi:10.1146/annurev.publhealth.29.020907.090940

    Google Scholar 

  • Knight, S. J., Nathan, D. P., Siston, A. K., Kattan, M. W., Elstein, A. S., Collela, K. M. … Golub, R. M. (2002). Pilot study of a utilities-based treatment decision intervention for prostate cancer patients [Comparative study research support, U.S. Gov’t, Non-P.H.S.]. Clinical Prostate Cancer, 1(2), 105–114.

    Google Scholar 

  • McInnes, D. K., Solomon, J. L., Bokhour, B. G., Asch, S. M., Ross, D., Nazi, K. M., et al. (2011). Use of electronic personal health record systems to encourage HIV screening: An exploratory study of patient and provider perspectives. BMC Research Notes, 4, 295. doi:10.1186/1756-0500-4-295

  • McQueen, L., Mittman, B. S., & Demakis, J. G. (2004). Overview of the veterans health administration (VHA) quality enhancement research initiative (QUERI). Journal of the American Medical Informatics Association, 11(5), 339–343. doi:10.1197/jamia.M1499

    Google Scholar 

  • Michel, M., Trafton, J., Martins, S., Wang, D., Tu, S., Johnson, N., et al. (2008). Improving patient safety using ATHENA-decision support system technology: The opioid therapy for chronic pain experience. In K. Henriksen, J. B. Battles, M. A. Keyes & M. L. Grady (Eds.), Advances in patient safety: New directions and alternative approaches (Vol. 4: Technology and medication safety). Rockville, MD.

    Google Scholar 

  • Midboe, A. M., Lewis, E. T., Cronkite, R. C., Chambers, D., Goldstein, M. K., Kerns, R. D., et al. (2011). Behavioral medicine perspectives on the design of health information technology to improve decision-making, guideline adherence, and care coordination in chronic pain management. Translational Behavioral Medicine, 1(1), 35–44. doi:10.1007/s13142-011-0022-6

    Google Scholar 

  • Musen, M. A., Tu, S. W., Das, A. K., & Shahar, Y. (1996). EON: A component-based approach to automation of protocol-directed therapy [Research support, U.S. Gov’t, Non-P.H.S. research support, U.S. Gov’t, P.H.S.]. Journal of the American Medical Informatics Association: JAMIA, 3(6), 367–388.

    Article  PubMed  PubMed Central  Google Scholar 

  • Nazi, K. M., Hogan, T. P., Wagner, T. H., McInnes, D. K., Smith, B. M., Haggstrom, D. … Weaver, F. M. (2010). Embracing a health services research perspective on personal health records: Lessons learned from the VA My HealtheVet system. Journal of General Internal Medicine, 25(Suppl 1), 62-67. doi:10.1007/s11606-009-1114-6

    Google Scholar 

  • Partin, M. R., Nelson, D., Radosevich, D., Nugent, S., Flood, A. B., Dillon, N. … Wilt, T. J. (2004). Randomized trial examining the effect of two prostate cancer screening educational interventions on patient knowledge, preferences, and behaviors [Clinical Trial Randomized Controlled Trial Research Support, U.S. Gov’t, Non-P.H.S.]. Journal of General Internal Medicine, 19(8), 835–842. doi:10.1111/j.1525-1497.2004.30047.x

    Google Scholar 

  • Piette, J. D., Holtz, B., Beard, A. J., Blaum, C., Greenstone, C. L., Krein, S. L. … Kerr, E. A. (2011). Improving chronic illness care for veterans within the framework of the patient-centered medical home: Experiences from the ann arbor patient-aligned care team laboratory [Review]. Translational Behavioral Medicine, 1(4), 615–623. doi:10.1007/s13142-011-0065-8

    Google Scholar 

  • Rochon, D., Eberth, J. M., Fraenkel, L., Volk, R. J., & Whitney, S. N. (2012). Elderly patients’ experiences using adaptive conjoint analysis software as a decision aid for osteoarthritis of the knee. Health Expectations: An International Journal of Public Participation in Health Care and Health Policy,. doi:10.1111/j.1369-7625.2012.00811.x

    Google Scholar 

  • Schapira, M. M., Gilligan, M. A., McAuliffe, T., Garmon, G., Carnes, M., & Nattinger, A. B. (2007). Decision-making at menopause: A randomized controlled trial of a computer-based hormone therapy decision-aid [Randomized controlled trial research support, U.S. Gov’t, Non-P.H.S.]. Patient Education and Counseling, 67(1–2), 100–107. doi:10.1016/j.pec.2007.02.007

    Google Scholar 

  • Schapira, M. M., Meade, C., & Nattinger, A. B. (1997). Enhanced decision-making: The use of a videotape decision-aid for patients with prostate cancer [Research support, U.S. Gov’t, Non-P.H.S.]. Patient Education and Counseling, 30(2), 119–127.

    Article  PubMed  Google Scholar 

  • Schapira, M. M., & VanRuiswyk, J. (2000). The effect of an illustrated pamphlet decision-aid on the use of prostate cancer screening tests [Clinical trial randomized controlled trial research support, U.S. Gov’t, Non-P.H.S.]. The Journal of Family Practice, 49(5), 418–424.

    PubMed  Google Scholar 

  • Solberg, L. (2009). Lessons for non-VA care delivery systems from the U.S. department of veterans affairs quality enhancement research initiative: QUERI series. Implement Science, 4, 9. doi:10.1186/1748-5908-4-9

  • Souchek, J., Stacks, J. R., Brody, B., Ashton, C. M., Giesler, R. B., Byrne, M. M. … Wray, N. P. (2000). A trial for comparing methods for eliciting treatment preferences from men with advanced prostate cancer: Results from the initial visit [Clinical trial randomized controlled trial research support, U.S. Gov’t, Non-P.H.S.]. Medical care, 38(10), 1040–1050.

    Google Scholar 

  • Stetler, C. B., Mittman, B. S., & Francis, J. (2008). Overview of the VA quality enhancement research initiative (QUERI) and QUERI theme articles: QUERI series. Implement Science, 3, 8. doi:10.1186/1748-5908-3-8

  • Sudore, R. L., Knight, S. J., McMahan, R. D., Feuz, M., Farrell, D., Miao, Y., et al. (2014). A novel website to prepare diverse older adults for decision making and advance care planning: A pilot study [Research support, Non-U.S. Gov’t research support, U.S. Gov’t, Non-P.H.S.]. Journal of Pain and Symptom Management, 47(4), 674–686. doi:10.1016/j.jpainsymman.2013.05.023

    Google Scholar 

  • Trafton, J., Martins, S., Michel, M., Lewis, E., Wang, D., Combs, A. … Goldstein, M. (2010). Evaluation of the acceptability and usability of a decision support system to encourage safe and effective use of opioid therapy for chronic, noncancer pain by primary care providers [Evaluation studies research support, Non-U.S. Gov’t]. Pain Medicine, 11(4), 575–585. doi:10.1111/j.1526-4637.2010.00818.x

    Google Scholar 

  • Walter, L. C., Davidowitz, N. P., Heineken, P. A., & Covinsky, K. E. (2004). Pitfalls of converting practice guidelines into quality measures: Lessons learned from a VA performance measure [Research support, Non-U.S. Gov’t research support, U.S. Gov’t, Non-P.H.S. research support, U.S. Gov’t, P.H.S.]. The Journal of the American Medical Association, 291(20), 2466–2470. doi:10.1001/jama.291.20.2466

    Google Scholar 

  • Walter, L. C., Eng, C., & Covinsky, K. E. (2001). Screening mammography for frail older women: What are the burdens? [Research support, Non-U.S. Gov’t research support, U.S. Gov’t, P.H.S.]. Journal of General Internal Medicine, 16(11), 779–784.

    Article  PubMed  PubMed Central  Google Scholar 

  • Walter, L. C., Fung, K. Z., Kirby, K. A., Shi, Y., Espaldon, R., O’Brien, S. …. Hoffman, R. M. (2013). Five-year downstream outcomes following prostate-specific antigen screening in older men [Research support, N.I.H., extramural research support, U.S. Gov’t, Non-P.H.S.]. JAMA Internal Medicine, 173(10), 866–873. doi:10.1001/jamainternmed.2013.323

    Google Scholar 

  • Weiner, S. J., Kelly, B., Ashley, N., Binns-Calvey, A., Sharma, G., Schwartz, A., et al. (2014). Content coding for contextualization of care: Evaluating physician performance at patient-centered decision making [Research support, U.S. Gov’t, Non-P.H.S.]. Medical Decision Making: An International Journal of the Society for Medical Decision Making, 34(1), 97–106. doi:10.1177/0272989X13493146

    Google Scholar 

  • Weiner, S. J., Schwartz, A., Cyrus, K., Binns-Calvey, A., Weaver, F. M., Sharma, G., et al. (2013a). Unannounced standardized patient assessment of the roter interaction analysis system: The challenge of measuring patient-centered communication [Research support, U.S. Gov’t, Non-P.H.S.]. Journal of General Internal Medicine, 28(2), 254–260. doi:10.1007/s11606-012-2221-3

    Google Scholar 

  • Weiner, S. J., Schwartz, A., Sharma, G., Binns-Calvey, A., Ashley, N., Kelly, B. … Harris, I. (2013b). Patient-centered decision making and health care outcomes: An observational study [Research support, U.S. Gov’t, Non-P.H.S.]. Annals of Internal Medicine, 158(8), 573–579. doi:10.7326/0003-4819-158-8-201304160-00001

    Google Scholar 

  • Weiner, S. J., Schwartz, A., Weaver, F., Goldberg, J., Yudkowsky, R., Sharma, G. …Abrams, R. I. (2010). Contextual errors and failures in individualizing patient care: A multicenter study [Case reports multicenter study randomized controlled trial research support, U.S. Gov’t, Non-P.H.S.]. Annals of Internal Medicine, 153(2), 69–75. doi:10.7326/0003-4819-153-2-201007200-00002

    Google Scholar 

  • Weiner, S. J., Schwartz, A., Yudkowsky, R., Schiff, G. D., Weaver, F. M., Goldberg, J., et al. (2007). Evaluating physician Performance at individualizing care: A pilot study tracking contextual errors in medical decision making [Randomized controlled trial research support, Non-U.S. Gov’t research support, U.S. Gov’t, Non-P.H.S.]. Medical Decision Making: An International Journal of the Society for Medical Decision Making, 27(6), 726–734. doi:10.1177/0272989X07306113

    Google Scholar 

  • Wenzel, G. R. (2002). Creating an interactive interdisciplinary electronic assessment. Computers, Informatics, Nursing: CIN, 20(6), 251–260.

    Article  PubMed  Google Scholar 

  • Yano, E. M., Simon, B. F., Lanto, A. B., & Rubenstein, L. V. (2007). The evolution of changes in primary care delivery underlying the Veterans Health Administration’s quality transformation [Multicenter study research support, U.S. Gov’t, Non-P.H.S.]. American Journal of Public Health, 97(12), 2151–2159. doi:10.2105/AJPH.2007.115709

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Health Services Research and Development Program, Birmingham VA Medical Center, Birmingham, AL, USA

    Sara J. Knight

  2. Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, MT 638, 1720 2nd Ave S, Birmingham, 35294, AL, USA

    Sara J. Knight

Authors
  1. Sara J. Knight
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sara J. Knight .

Editor information

Editors and Affiliations

  1. Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA

    Michael A. Diefenbach

  2. Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA

    Suzanne Miller-Halegoua

  3. Department of Community Health Sciences, Boston University, Boston, Massachusetts, USA

    Deborah J. Bowen

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer Science+Business Media New York

About this chapter

Cite this chapter

Knight, S.J. (2016). Using the Veterans Health Administration as a Laboratory for Integrated Decision Tools for Patients and Clinicians. In: Diefenbach, M., Miller-Halegoua, S., Bowen, D. (eds) Handbook of Health Decision Science. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-3486-7_17

Download citation

Publish with us

Policies and ethics

Search

Navigation