Table 2.
MHV PHR Research Agenda by RE-AIM Domain
| RE-AIM domain | MHV program goal | Research priorities |
|---|---|---|
| Reach: the number, proportion, and representativeness of individuals who utilize the MHV PHR | Increase enrollment of the veteran population served by the MHV program | • Assess level of awareness in the veteran population and identify effective improvement strategies |
| • Characterize users in comparison with the veteran and VA patient populations | ||
| • Identify target populations who can most benefit from use | ||
| Effectiveness: the impact of MHV PHR utilization on users, outcomes, performance, and organizational systems | Utilize MHV to enhance access to services, improve behavioral and health outcomes, improve quality, increase satisfaction, and enhance system efficiency | • Validate and extend initial analytic findings from user surveys |
| • Examine cohorts of users to evaluate impact on utilization management (access), behavioral and clinical outcomes (quality), cost (value), and satisfaction | ||
| • Identify how MHV can enhance access to services for rural or special populations | ||
| • Evaluate impact on workflow, workload, VA performance measures, and organizational processes | ||
| Adoption: use of the MHV PHR by veterans and their caregivers, healthcare providers, and healthcare teams | Increase adoption of MHV by veterans, providers, and healthcare teams | • Elicit perceptions of veteran and provider nonadopters |
| • Identify barriers to adoption and develop strategies to address | ||
| • Examine the current authentication process and identify ways to improve | ||
| Increase levels of engagement and activation with MHV among patients and providers | • Demonstrate clinical utility of MHV components | |
| • Compare clinical adoption across settings | ||
| • Identify communication and process strategies for integration of MHV within clinical practice | ||
| Implementation: the efforts and costs involved in implementing the MHV Program | Implement the MHV program nationwide in the most equitable, effective, and efficient manner; enhance program value | • Examine how to prevent further health disparities by exploring issues of access, health literacy, and computer literacy |
| • Evaluate cost/benefit impact of MHV use | ||
| • Identify optimal implementation strategies | ||
| Maintenance: the long-term effects of MHV PHR use and program sustainability | Utilize MHV to enhance and sustain desirable long-term outcomes | • Track long-term impacts on targeted outcomes (access, quality, value, satisfaction) |
| • Identify effective engagement strategies to support sustained MHV use | ||
| • Explore program enhancements (usability) and expansion (interoperability) | ||
| • Analyze MHV program sustainability |