2020 VHA Shark Tank Competition finalists announced for VHA Innovation Experience

In preparation for the live Shark Tank event at this year’s VHA Innovation Experience (iEX), Diffusion of Excellence announced its annual VHA Shark Tank Competition’s 15 Finalists. The Competition shines a spotlight on employees who are passionate about solving some of the toughest challenges across VHA. It also provides them with an opportunity to replicate and scale their practices further, while also elevating their platform to all levels of leadership for buy-in.

This year’s practices help address needs in six priority areas for VHA: Access, Health Care After COVID-19, High Reliability Culture Change: Commit to Zero Harm; Rural Women Veterans: A Diverse Community; Veteran and Employee Experience, and Upstream Suicide Prevention.

These 15 practices were developed by frontline employees who saw the challenges and needs that Veterans and their colleagues were facing and created new ways to solve and address them. At the facilities where the practices were developed, they have already impacted Veteran lives for the better. Now they have the chance to spread further throughout the Veterans Health Administration.

[accordion][accordion_section title=”EPIQ-Stress: E-Consult Protocoling to Improve the Quality of Cardiac Stress Tests”]

Finalist: Nishant Shah

Facility: Providence VA Medical Center (VAMC)

VHA Shark Tank Priority: Access

EPIQ-Stress shortens wait times for cardiac stress tests for Veterans by using a structured, electronic consult for all outpatient cardiac stress test orders. EPIQ-Stress shortens the time between test order entry and test scheduling by instituting a time limit (48 hours), discouraging inappropriate order entry by primary care physicians using real-time electronic decision support, and streamlining the process of changing/canceling inappropriate orders. In the first six months after EPIQ-Stress implementation, the median order-to-report wait time for cardiac stress tests at the Providence VAMC decreased from 26 to 20.5 days. In addition, the proportion of Veterans who experienced order-to-report wait times longer than 28 days significantly decreased from 39% to 15%. [/accordion_section][accordion_section title=”Virtual Integrated Primary Care Mental Health Integration (PCMHI) Hub”]

Finalist: Kevin Kelly

Facility: Philadelphia VA Medical Center

VHA Shark Tank Priority: Access

PCMHI integrates mental health staff into each patient aligned care team (PACT), allowing care teams to provide services for depression, anxiety, post-traumatic stress disorder (PTSD), and substance use without needing a separate consult. The Virtual Integrated PCMHI Hub is a 100% virtual program that can be deployed through a hub-and-spoke model to remote facilities struggling with PCMHI implementation. This provides rural Veterans equitable standards of behavioral health care, such as same day access. The Virtual Integrated PCMHI Hub is important in the era of COVID-19 because it allows for uninterrupted availability of all PCMHI services.[/accordion_section][accordion_section title=”VISN 4 Tele Urgent Care (TUC)”]

Finalist: Laurie Conti

VA Healthcare – VISN 4

VHA Shark Tank Priority: Access

PCMHI integrates mental health staff into each patient aligned care team (PACT), allowing care teams to provide services for depression, anxiety, post-traumatic stress disorder (PTSD), and substance use without needing a separate consult. The Virtual Integrated PCMHI Hub is a 100% virtual program that can be deployed through a hub-and-spoke model to remote facilities struggling with PCMHI implementation. This provides rural Veterans equitable standards of behavioral health care, such as same day access. The Virtual Integrated PCMHI Hub is important in the era of COVID-19 because it allows for uninterrupted availability of all PCMHI services.[/accordion_section][accordion_section title=”Increasing Access to Clinical Research Using an Innovative Mobile Recruitment Approach: The (MoRe) Concept”]

Finalist: Marcus Johnson

Durham VA Medical Center

VHA Shark Tank Priority: Access

Mobile Recruitment (MoRe) units are a strategy to expand Veteran access to clinical research and enhance enrollment in VA-sponsored studies. MoRe utilizes digital technology that allows research teams to meet with Veterans in areas of their preference and convenience, as opposed to putting the onus on them to travel to research teams to participate in studies. Each MoRe unit includes a laptop, printer, portable cart with storage space, and cooler/ice packs for biospecimen storage and transport. Through MoRE, overall enrollment in clinical research studies increased by 38.9% over 18 months.[/accordion_section][accordion_section title=”Voluntary Service Curbside Delivery (VSCD)”]

Finalist: Sue Kerver

Facility: Ralph H. Johnson VA Medical Center

VHA Shark Tank Priority: Veteran and Employee Experience

To meet the growing needs resulting from unexpected economic and physical hardships during the COVID-19 pandemic, VSCD was created. A first-of-its-kind in the VA health care system, the program uses vans from Disabled American Veterans (DAV), which normally transport patients, to transport food pantry, hygiene items, and household cleaning items to vulnerable Veteran patients who are sequestered and unable to leave their homes. Since it was operationalized on April 1, 2020, the program has served over 125 Veterans while simultaneously keeping volunteers safely engaged.[/accordion_section][accordion_section title=”Drive-Thru Vaccination Clinic”]

Finalist: Kelli Crews

Facility: North Florida/South Georgia Veterans Health System

VHA Shark Tank Priority: Health Care After COVID-19

The Drive-Thru Flu Vaccination Clinics provide Veterans safe and easy access to vaccinations. It contributed to an increase in flu vaccinations compared to previous seasons during the month of October for Fiscal Year (FY) 19 and FY 20.[/accordion_section][accordion_section title=”Beta Lactam Allergy Assessments: Saving Lives one Assessment at a Time”]

Finalist: Jarred Bowden

Facility: Memphis VA Medical Center

VHA Shark Tank Priority: High Reliability Culture Change: Commit to Zero Harm

Beta Lactam are a type of antibiotic that is commonly prescribed; unfortunately, nearly 10% of patients report being allergic to it. However, 90% of these patients do not demonstrate a true allergic reaction and are actually able to use Beta Lactam antibiotics. This program is an allergy assessment and skin test clinic that detects if allergic patients have a reaction to the antibiotic. Preliminary results have shown that 99% of patients are cleared for beta lactam use, making preferred antibiotics far more accessible. The predicted cost savings is $1,238.07 per assessment due to utilization of appropriate antibiotics, reduced length of stay, and decreased morbidity.[/accordion_section][accordion_section title=”Telelactation Program (TLP)”]

Finalist: Cody Giovannetti

Facility: Memphis VA Medical Center

VHA Shark Tank Priority: Access and Rural Women Veterans: A Diverse Community

Despite the benefits associated with breastfeeding, many barriers prevent women from being able to breastfeed as long as is recommended or from initiating breastfeeding at all. Lactation services are not routinely offered through VA, making it unclear whether Veterans were receiving the support, education and tools to successfully breastfeed. Telelactation provides this support to Veterans through easy-to-access telemedicine tools. Since FY16, 90% of pregnant Veterans initiated breastfeeding, 36.8% exclusively breastfed for three months, 26.3% exclusively breastfed for six months, 44.7% breastfed until six months of age, and 25% breastfed until one year of age, outstripping most of Tennessee’s rates.[/accordion_section][accordion_section title=”Remote Temperature Monitoring in Amputation Prevention through Telehealth”]

Finalist: Kyle Nordrum

Facility: Cincinnati VA Medical Center

VHA Shark Tank Priority: Health Care After COVID-19

One in four Veterans receiving VA health care have diabetes. Over the last year, VA treated 75,000 patients with diabetic foot ulcers (DFU), which lead to 80% of VA’s non-traumatic amputations. The remote temperature monitoring technology allows VA to identify 97% of DFU in their earliest stages and take action to prevent severe complications that lead to amputation. The remote monitoring data prompts targeted Virtual Video Connect visits for preventative clinical care.[/accordion_section][accordion_section title=”Environmental Management Service (EMS) CLEAN Covers”]

Finalist: Robert Bankston

Facility: VA Northeast Ohio Healthcare System

VHA Shark Tank Priority: Veteran and Employee Experience

Environmental Management Service (EMS) in a medical center operates on the front lines of disease prevention. EMS “CLEAN Covers” offers an easily used, clear-to-read and easily deployable short- or long-term cleanliness solution that can be used throughout a medical center or outpatient clinic. The implementation of this simple, yet tremendously effective “CLEAN Cover” can aid a medical center in achieving an increase in the level of cleanliness and infection control, an increase in patient satisfaction, and a decrease in the spread of hospital born illnesses by providing visual indicators for when large medical equipment has been sanitized and is ready for use.[/accordion_section][accordion_section title=”Acute Recovery Center (ARC) Program”]

Finalist: Peter Chien

Facility: Edward Hines Jr. VA Hospital

VHA Shark Tank Priority: Upstream Suicide Prevention

ARC provides Veterans who are struggling with intense distress and suicidality immediate access to intensive therapeutic programming. The programming is specifically designed to reduce hospital days in risk-sensitive, VA environments. Suicide prevention is VA’s top priority. For providers, this may cause a low threshold to hospitalize suicidal or symptomatic Veterans for thorough care. For Veterans, this can lead to fear of involuntary hospitalization or treatment which limits their freedoms. ARC provides a solution to avoid these issues and properly care for the Veteran. Over seven years of serving approximately 100 Veterans annually in the three-week program, 98% of Veterans indicate high satisfaction with their experience. Suicidality, depression, cross-diagnostic symptoms, and quality of life each improve for 80% of Veterans, with almost all Veterans improving in at least one of the aforementioned criteria.[/accordion_section][accordion_section title=”VISN 20 Centralized Lung Cancer Screening Program”]

Finalist: Christopher Slatore

Facility: VA Portland Health Care System

VHA Shark Tank Priority: Access

Veterans, due to high rates of smoking and military exposures, have higher death rates from lung cancer than non-Veterans. The Centralized Lung Cancer Screening program provides Veterans a highly inclusive, safe, Veteran-centric process that minimizes the burden for primary care providers and increases access to life-saving annual lung cancer screenings. The centralized, high-quality Lung Cancer Screening Program has received >3,500 consults, screened >2,076 Veterans, and detected and treated 62 patients with early stage lung cancers.[/accordion_section][accordion_section title=”TeleCOVID”]

Finalist: Gauri Behari

Facility: Phoenix VA Health Care System

VHA Shark Tank Priority: Health Care After COVID-19

TeleCOVID implements a new process for direct referral of patients with symptoms consistent with COVID-19. Patients who self-isolated at home are managed virtually with regular follow-up calls or VA Video Connect (VVC) visits over 7-10 days to ensure their safety, wellbeing, and resolution of symptoms. Patients can also be enrolled into the home telehealth program for monitoring of their temperature, pulse oxygenation, and blood pressure. In the first two months of TeleCOVID, 845 patients were seen through 1,912 encounters. Of these, 800 patients were managed by self-isolation through virtual care.[/accordion_section][accordion_section title=”Open House Initiative for Mental Health Service Connection”]

Finalist: Danielle DeMailo

Facility: Southern Arizona VA Health Care System

VHA Shark Tank Priority: Access

The in-person and virtual Open House for Mental Health Service spread the word to Veterans that VA has evolved and improved evidence-based services since many un-engaged Veterans last sought VA mental health services. Invited Veterans receive a mental health services brochure and, during the Open House, Veterans have the opportunity to meet with clinicians to discuss concerns, ask questions, and receive mental health screening with the option to schedule an appointment for the most beneficial services. The program saw a marked increase in patients engaged in mental health services as a result of Open House attendance.[/accordion_section][accordion_section title=”Embedding Physical Therapy in PACT”]

Finalist: Amanda Simone

Facility: VA Midwest Health Care Network

VHA Shark Tank Priority: Access

Through this program, physical therapists were embedded within primary care clinics throughout VISN 23 as part of a strategic initiative targeted at improving access, reducing costs, and improving the Veteran and staff experience. New patient wait times for physical therapy were reduced by 37% from preferred date and 34% from create date.[/accordion_section][/accordion]

Since 2016, Shark Tank has identified 59 Promising Practices which impact Veterans’ lives every day. These Finalists will vie for the opportunity to be in the next cohort of Diffusion of Excellence Promising Practices on Oct. 28, at the VHA Innovation Experience (iEX), virtually broadcast from the National Press Club.

Finalists will pitch their practices to leadership Sharks during the Competition at the virtual iEX. In just three minutes, they will have to demonstrate how their practice makes a difference, what it takes to implement, and – most importantly – why the Sharks should choose their practice. As the Sharks learn about each practice, they will bid resources – such as equipment, staff, or time – to win the chance to implement the practice in their facility(ies).

Do not miss a moment of iEX 2020. Register today to receive access to the event platform and app the moment they launch! Mark your calendars for Oct. 27-29!