Background: The Veterans Health Administration (VHA) is the nation’s largest integrated health system and serves more than one million hospitalized Veterans annually at a cost of approximately $19 billion/year. Given the scope and complexity of this care, a centralized team was needed to provide data-centric support, access, and knowledge to hospital medicine leadership and front-line providers at the VHA’s 128 hospitals across the country.
Purpose: The VHA Hospital Medicine Analytics Team (HMAT) is a research and analytics team with the mission of providing rapid data, analytic, and research support to VHA Hospital Medicine leaders and clinicians.
Description: HMAT is funded through a partnership between the VHA Office of Rural Health and the VHA Hospital Medicine Program Office. Current members include health services researchers, epidemiologists, implementation scientists, data scientists, and practicing hospitalists from seven VHA sites across the US. To accomplish its goals, HMAT has structured itself around two separate cores: Data and Evaluations.The HMAT Data Core works to harmonize and validate established VHA data streams that contain hospital and hospital medicine-specific data (e.g. administrative data, hospital capacity and flow, and facility outcomes). Datasets will include Veteran, ward, facility, and healthcare system levels and allow granular analyses down to each day of hospitalization for every Veteran in the country. The Data Core builds systematic processes to rigorously support and evaluate operations, quality improvement, and research work across the VHA enterprise. The HMAT Evaluations Core helps to plan and rigorously evaluate enterprise-wide quality improvement initiatives with a special focus on rural settings. Current projects and proposals focus on tele-hospitalist care, care transitions, and the standardization of alcohol withdrawal treatment in the inpatient setting.HMAT also funds and supports investigator-initiated pilot evaluations to grow the capacity of VHA investigators to improve inpatient care. Currently funded one-year pilots focus on (1) investigating sex-based differences in rural VHA hospital admissions, and (2) evaluating rural-urban differences in VHA hospital admission trends following the implementation of the VA MISSION Act.Internal efforts include development of Hospital Medicine Data Briefs, which aim to synthesize individual questions about VHA Hospital Medicine care such as the top diagnoses seen across VHA hospitalizations and characteristics of the hospital medicine workforce for VHA clinicians, operations leaders, and researchers.
Conclusions: The VHA’s newly created HMAT is uniquely positioned to guide evaluations of the quality and safety of inpatient care across VHA and lead multi-site efforts improving inpatient care across the nation’s largest integrated health system.