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Office of Rural Health

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Rural Mentored Implementation

 

Mentored Implementation

Historically, the Office of Rural Health (ORH) provided seed funding for innovative local projects that sought to address rural Veterans’ health care and access issues. Building on the findings of this work, ORH identified projects that showed significant impact based on select criteria. These proven models of care—known as Rural Mentored Implementations (RMI) —are now being implemented nationwide.

Mentored implementation is accomplished when ORH and VRHRC project managers work with subject matter experts to assist U.S. Department of Veterans Affairs (VA) sites across the country in adopting RMIs. This assistance may include training, ongoing technical consultation, and initial funding. These programs:

  • Increase access to care and services for rural Veterans and their families in the communities where they live
  • Share clinical and operational knowledge among health care delivery professionals who serve rural Veterans
  • Mentor program champions so they can successfully implement these strong practices
  • Contribute to long-term improvements in the rural health care delivery system

RMIs are nominated through the Veterans Rural Health Resource Centers (VRHRCs) and undergo a rigorous review to earn the "ORH Rural Mentored Implementation" designation. A third-party objective review ensures the nominated project meets the six RMI criteria:

  • Increased Access – The approach brings about measurable increases in access to care or services, for example, by reducing wait time or missed appointments.
  • Strong Partnerships – The approach creates partnerships and maximizes efficiency.
  • Clinical Impact – Results of the approach are proven and positive on the health of rural Veterans.
  • Return on Investment – The approach reduces the per capita costs of delivering care or services, while maintaining or improving outcomes.
  • Operational Feasibility – Implementation of the approach is feasible and strategies for success can easily be shared.
  • Customer Satisfaction – The approach demonstrates Veteran, provider, partner, and caregiver satisfaction.

VRHRC staff provide mentored implementation to help new sites establish the program through training, supporting documents, ongoing technical consultation and initial funding through ORH. The following RMIs, formerly known as ORH Rural Promising Practices, are in place in various VA sites of care throughout the country:

Remote Home-Based Delivery of Cardiac Rehabilitation uses telehealth to connect patients with a cardiac rehab professional to provide counseling sessions from their home on exercise prescription, heart health, nutrition, tobacco cessation, stress management and medication adherence.

Remote, Home-Based Delivery of Pulmonary Rehabilitation uses telehealth to connect patients with a pulmonary rehab professional to provide counseling sessions on exercise prescription, heart health nutrition, tobacco cessation, stress management, and medication adherence.

Telehealth Collaborative Care for Rural Veterans with HIV Infection uses video telehealth to deliver HIV specialty care to rural Veterans.

The Geriatric Scholars Program addresses the shortage of specialized geriatric skills and knowledge in rural VA clinical settings by training VA general clinicians in the treatment of older rural Veterans.

Geriatric Research Education and Clinical Centers (GRECC) Connect Project trains VA providers to manage medically complex cases through case-based conferences, electronic consultations, virtual meetings, and clinical video telehealth.

Advanced Comprehensive Diabetes Care (ACDC) leverages VA's home telehealth program to provide effective telemonitoring, self-management support, and medication management for Veterans whose Type 2 diabetes does not respond to standard care.

Direct Implementation

In addition to Rural Promising Practices that offer mentored implementation support, ORH offers additional Rural Promising Practices that can be implemented directly without additional support.

Caring for Older Adults and Caregivers at Home (COACH) educates rural community clergy on available VA health care resources and trains rural clergy to recognize common symptoms of posttraumatic stress disorder, military sexual trauma, and readjustment issues in Veterans returning to their rural communities upon separation from military service.

Geriatric Walking Clinic: Meeting Rural Veterans Where They Are

IMPROVE: Integrated Management and Polypharmacy Review of Vulnerable Elders

Interdisciplinary Clinical Video-Telehealth for Geriatrics and Dementia

Osteoporosis Risk Assessment Using Osteoporosis Self-Assessment Tool (OST)

Rural OsteoPorosis Evaluation Service (ROPES)

Transforming Advance Care Planning into an Atmosphere of Support and Communication

A Coordinated Transitional Care (C-TraC) Program

Lessons Learned: Rural Case Study Challenges Increasing Access to Dental Care Among Rural Veterans

Please contact the appropriate Veterans Rural Health Resource Center for more information.

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