A $5 million award from the U.S. Department of Veterans Affairs and collaboration between researcher-clinicians with the Richard L. Roudebush VA Medical Center, the Regenstrief Institute and Indiana University School of Medicine will be used to launch a five-year, multi-site Precision Monitoring (PRIS-M) program.

PRIS-M will use existing VA electronic health data to implement actionable, personalized, timely monitoring to generate data to transform care quality and outcomes, according to an announcement.

Projects will take place in various healthcare environments including the emergency department, inpatient units and outpatient units, and will focus on diverse medical conditions. In addition to studying the technical solutions to precision monitoring, investigators also will study how providing actionable data can be used to activate healthcare providers and teams to engage in improvement activities without drowning in information overload.

"The VA is the single largest provider of healthcare in the United States with a wealth of patient information and a single unified electronic health record. It is ideally poised to apply precision monitoring to transform care and outcomes for veterans and to exert national leadership in this important area," said co-principal investigator of the new program, Linda S. Williams, MD. She is an investigator with the Roudebush VA Medical Center in Indianapolis and Regenstrief, and a professor of neurology at the IU School of Medicine.

"The VA’s expertise and experience with patient-specific electronic medical data may help identify strategies to ensure that patients receive the best care and, importantly, are not lost to follow-up," said study co-principal investigator Dawn Bravata, MD. "Precision monitoring is critical to that care; there are facility, cultural and medical-specialty variations in how data are used which we must overcome." Bravata is an investigator with the Roudebush VA Medical Center and Regenstrief, and a professor of medicine at the IU School of Medicine.

The new grant supports the following four precision monitoring related projects focused on delivering the right information to the right person at the right time:

1. Nationwide implementation of electronic quality indicators for inpatient stroke care
2. Use of patient-specific data and telehealth technology to facilitate improvement in care for veterans with transient ischemic attack
3. Remote monitoring of continuous positive airway pressure for patients with sleep apnea 
4. Reduction of inappropriate carotid artery imaging orders

Research will include assessment and evaluation of how the context of care influences use of data, as well as the identification of how clinical champions help facilitate data sharing and promote ongoing quality improvement.