Enterprise-Wide Initiatives - Office of Rural Health
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Office of Rural Health


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Enterprise-Wide Initiatives


Enterprise-Wide Initiatives

The Office of Rural Health (ORH) implements programs that deliver increased care and support to rural Veterans nationwide in a more uniform manner. ORH’s programs are in two categories: Rural Promising Practices and Enterprise-Wide Initiatives (EWI). EWIs expand national U.S. Department of Veterans Affairs' (VA) program offices’ health care efforts to sites that serve rural Veterans. Initial funding support is available by ORH to support implementation in VA facilities across the country.

To learn more about these initiatives, visit our EWI menu to read the 2020 EWI descriptions. (Disclaimer: This link directs to an internal VA site. You must have access to the VA network to view this page)

Primary Care
  • Home Based Primary Care expands home-based Patient Aligned Care Team services to rural areas.
  • Medical Foster Home provides an alternative to nursing home for Veterans who need daily assistance, are unable to live independently, and have no available family caregiver.
  • Telephone Lifestyle Coaching promotes change in health behaviors, including unhealthy eating, inactivity, obesity, tobacco use, stress and alcohol use.
Specialty Care
  • Centralized Anticoagulation Services Hub (CASH) provides anticoagulation clinical pharmacy services via highly efficient infrastructure that standardizes clinical processes, employs innovative data tools, and delivers virtual care modalities.
  • Clinical Pharmacy Specialist Providers delivers medication and chronic disease management services to rural Veterans using pharmacists’ expertise through telehealth into Veterans' homes, VAMCs, or CBOCs.
  • Gerofit, Geriatric Fitness Program provides physical activity therapy to elderly rural Veterans using telehealth technology.
  • Lung Cancer Screening provides clinical navigators to support cancer screening at VAMCs serving rural Veterans.
  • Mobile Prosthetic and Orthotic Care (MoPOC) helps to restore function, mobility and independence for rural Veterans with limb loss and movement disorders by bringing artificial limb and bracing care to their communities.
  • National Teleneurology Program establishes telehealth sites to ensure access to neurology in rural areas where providers are unavailable.
  • National Teleoncology Program provides rural Veteran patients access to the latest technology in cancer treatment, including molecular analysis of tumor samples to detect acquired gene mutations in multiple cancer-associated genes.
  • National Telestroke Program provides emergent telehealth care by qualified stroke neurologists to Veterans with stroke symptoms at VA medical centers that do not have stroke neurologists on site.
  • National Video Blood Pressure Visits conducts blood pressure check-ins to Veterans in their homes, reducing clinic no-shows and eliminating travel barriers to care.
  • Oral Telemedicine provides expert telehealth consultation in oral pathology, oral medicine, and oral and maxillofacial surgery to improve early diagnosis rates of oral cancer and thus improve rates of successful treatment of oral disease.
  • Pharmacy Providers Improve Access for Rural Veterans with Opioid Use Disorder delivers greater access to medication assisted treatment for rural Veterans by integrating Clinical Pharmacy Specialist Providers in collaborative care models.
  • Rural Veterans Telerehabilitation Initiative provides physical, occupational and recreational rehabilitation services to Veterans in their homes through secure internet video.
  • Sleep Telemedicine supports diagnosis, care and remote monitoring of Veterans with sleep apnea via web-enabled devices.
  • Technology-based Eye Care Services is a telehealth-based eye screening initiative that places ophthalmology technicians in rural VA clinics to collect information about a patient’s eyes and transmit to VA ophthalmologists for diagnosis and follow-up.
  • Teleaudiology provides audiology remote fittings and aftercare services, remote diagnostic testing, and audiometric testing for rural Veterans.
  • Teledermatology expands store-and-forward tele-dermatology to rural sites; includes primary care training on dermatologic consults and minor procedures.
  • Telediabetes provides specialized diabetes services to rural Veterans with uncontrolled diabetes through secure internet video.
  • Tele-Intensive Care Unit (ICU) connects VA facilities that do not have intensivists on staff with VA intensivists nationwide via telehealth to increase access to ICU services and specialty inpatient care for rural Veterans.
  • Telepain - Empower Veterans Program (EVP) trains active self-care in Veterans with severe chronic pain, with an emphasis on holistic health, mindfulness practices, and acceptance and commitment therapy to successfully live one's own fuller life.
  • Telerehabilitation Services expands an integrated network of specialists who are specifically trained in delivering physical and rehabilitative therapy to rural Veterans using telehealth technology.
Mental Health
  • Advanced Care Planning via Group Visits connects Veterans to advanced care planning experts who help them develop a plan to address how health care decisions will be made if they are unable to communicate.
  • Military Sexual Trauma Web Based Therapy uses telehealth to deliver specialized mental health care directly to Veterans’ homes in caring for those who have experienced military sexual trauma.
  • Rural Access Network for Growth Enhancement provides intensive case management services, including homeless outreach, to seriously mentally ill Veterans in rural areas.
  • Rural Suicide Prevention connects Veterans to comprehensive suicide prevention services and resources through enhanced education, public awareness campaigns, community training, crisis support, firearm safety and care management for high-risk individuals.
  • Social Work in Patient Aligned Care Teams expands the integration of rural social workers into the Patient Aligned Care Team model to improve care coordination for rural Veterans and their interdisciplinary care teams.
  • Vets Prevail Web Based Behavioral Support provides Veterans suffering from depression and/or post-traumatic stress disorder with tools to overcome these challenges. Focus is on returning Veterans from recent conflicts, Operation Enduring Freedom, Operation Iraqi Freedom and Operation New Dawn.
Workforce Training and Education
  • Clinical Skills Training in Women Veterans Health Care trains providers in rural locations in skills unique to the treatment of rural women Veterans.
  • National Mental Health (MH) and Suicide Prevention (SP) Extension for Community Healthcare Outcomes (ECHO) connects rural providers to national MH and SP specialists for regular discussion of clinical cases and targeted skill-building training on suicide prevention and substance use disorder treatment.
  • Rural Interprofessional Faculty Development Initiative (RIFDI) provides training for residency proctors, enabling them to better train, mentor, and monitor residents serving rural areas.
Telehealth Clinical Resource Hubs
  • Clinical Resource Hubs: These Veterans Integrated Service Network hubs provide primary, mental health, and specialty care to Veterans in underserved areas.
    • Teleprimary Care establishes teleprimary care sites to ensure access to primary care in rural areas.
    • Telemental Health connects specialists with rural Veterans to ensure access to mental health care services in rural areas.
    • Medical Specialty connects specialists with rural Veterans to ensure access to specialty care services in rural areas.
    • Rehabilitation and Extended Care connects specialists with rural Veterans to ensure access to rehabilitation services in rural areas.
    • Surgery connects specialists with rural Veterans to ensure access to surgery services in rural areas.
VA Video Connect
  • Patient Tablet Program provides rural Veterans with video telehealth tablets to connect patients with and transmit patient data to a remote VA health care provider through a secure internet connection.
Care Coordination
  • Women Veteran Care Coordination and Management creates, enhances and expands care coordination in the areas of maternity care, mammography, cervical cancer screening and breast cancer care.
  • Center for the Evaluation of Enterprise-Wide Initiatives systematically reviews EWIs to improve evaluation and comprehensively analyze impact while contributing to the field of implementation science.
  • MISSION Act Emergency Room Specialty Care Scribe Program places medical transcription assistants in Specialty Care and Emergency Departments to allow providers to focus on patient care.
  • Rural Innovation Ecosystem supports new service delivery innovations and the national implementation of standardized best practices intended to improve access to care and services for rural Veterans.
  • Transitions Nurse Program improves coordination between tertiary VA and non-VA hospitals and rural PACT sites following hospitalization through a proactive, personalized, nurse-led and Veteran-centered intervention.
  • VA Farming and Recovery Mental Health Services (VA FARMS) provides Veterans with agricultural vocational training and behavioral health care services from licensed providers at eight VHA sites of care.
  • Veteran Transportation Services provides medical transportation services for rural Veterans; and includes leases of vehicles, salaries for drivers and mobility managers.