Center to Improve Veteran Involvement in Care (CIVIC)
Rural Health Spotlight August 2022
Mapping the Road Ahead: The State of VA Rural Health Research
Rural Veteran health care is complex. Rural communities have older, sicker, and poorer residents with limited access to health care and medical resources in comparison to urban residents. Challenges such as lack of internet or broadband access, existing and predicted clinical workforce shortages, and rural hospital closures all add to the challenges rural Veterans face when seeking health care. The Veterans Health Administration (VA) is uniquely positioned to address these disparities. The VA is the largest integrated health care network in the United States and cares for 2.7 million rural Veterans across the nation. Within the VA, legislation like the CHOICE and MISSION Acts, initiatives centered on the delivery of telehealth care services or increasing care access, and rural health research activities all aim to reduce the challenges Veterans face when trying to take care of their health.
In March of 2022, VA Health Services Research & Development (HSR&D) in partnership with the VA Office of Rural Health (ORH) held a State of the Art (SOTA) conference on rural health. Leadership from the Veterans Health Resource Center-Portland, Drs. Sarah Ono and Travis Lovejoy as well as CIVIC's Dr. Denise Hynes and OHSU's Dr. Melinda Davis attend the SOTA conference. The goal of this meeting was to discuss the current landscape of rural health, to identify existing knowledge gaps, and to set a research agenda for rural Veteran health care. Experts at the SOTA were divided into three workgroups tasked with discussing the most pressing topics in rural health: 1. Addressing COVID-19 and public health emergencies or care disruptions more broadly, 2. Improving community care access and care coordination for VA and non-VA services, and 3. Rural clinical workforce development and retention. Over the course of two days, attendees were asked to consider what research is needed and what priorities could result in real, actionable change in VA.
By the conclusion of the meeting, each of the three workgroups had identified priority research questions within their topics. For example, the COVID-19 workgroup focused on identifying ways to best care for rural Veterans during a public health emergency. This included priorities such as leveraging community acute care access and triage, as well as telehealth technologies to prevent care disruptions during a pandemic such as COVID-19. To address workforce shortages, the experts advocated for a focus on better ways to recruit and maintain rural clinicians including gaining a greater understanding of the rural communities in which they will practice and how that specific rural context impacts their view of practice and the unique stressors rural clinicians experience. Lastly, to advance community care and care coordination for rural Veterans, this workgroup stressed the importance of expanding VA partnerships in the community as well as focusing on initiatives to help Veterans understand the care delivery options they have when using VA health care.
The SOTA represents the beginning of the discussion. HSR&D and ORH will take the information and ideas shared during the meeting to create more opportunities for high-quality rural Veteran health research. In the words of Dr. Maria Llorente, the Deputy to the Assistant Undersecretary for Health for Patient Care Services, “rural health care is unique and requires a great deal of information [and] knowledge but also creativity and innovation.” The VA along with HSR&D and ORH is dedicated to leveraging its position as a national health care system and its leading experts in rural health research to improve the lives of rural Veterans.
Learn more about the SOTA on rural health and other topics here.
