CHSR Research

 

Our research is outcomes-based, requirements-driven, innovative and directly relevant to DoD, the American Warfighter, and the Uniformed Services community. Our research focuses on:

  • Population Health Research, focusing on improving the overall health and health outcomes of service members, their families, and other priority populations.
  • Health Policy Research, the development, application and evaluation of knowledge around which effective policy can be based.
  • Thought Leadership, providing recognized expertise in Health Services Research and enabling the MHS to adopt an outcomes-based, measurement driven approach to peacetime healthcare that aligns with the approach it employs during wartime.

The CHSR has the following strategic objectives for research:

  • Conduct research that measurably supports MHS strategic goals/objectives
  • Conduct research that contributes to learning and policy across the MHS
  • Expand USU’s military HSR capacity through recruiting, training, and developing health services researchers
  • Become recognized as the thought leader in military HSR throughout MHS, DoD, and US Healthcare/research communities

 

Current Research

In-House Research

  • COVID-19
  • Military Health System Response to COVID-19: A Health Services Research Approach to Sustainable Process Improvements (MiHReC19)
  • Framework Synthesis of Self-Reported Symptom Trackers
  • Morale, Manpower, and Military Medicine (M3) in partnership with University of Minnesota
  • Global Burden of Disease in the MHS
  • National Intrepid Center of Excellence
  • The Development and Application of an Integrated Practice Unit at the NICoE
  • Intrepid Spirit Centers: Future Considerations for Active Duty, National Guard, Reserves, and Retirees
  • Application of Kotter’s 8 Principles of Change Management to Transform the MHS

Management of HSR in the NCR Portfolio

The CHSR manages the Health Services Research in the National Capitol Region portfolio. This portfolio specifically includes Readiness and Financial Impacts of Consolidating Complex Care; the study of Low Value Care in the MHS (EPIC 3.0); Evaluation of DoD/VA Joint Pain Education Program; and Primary Care by Remotely Supervised Medics and Corpsmen.

Project Spotlight: Low Value Care in the MHS/The Comparative Effectiveness and Provider-Induced Demand Collaboration (EPIC) Project: A Clinical and Economic Analysis of Variation in Healthcare (EPIC 3.0)

The EPIC project is a joint collaboration between USUHS and Brigham and Women’s Hospital (BWH) Center for Surgery and Public Health (CSPH). The project established a health services research cell and uses the MHS Data Repository (MDR) for secondary analysis of claims data to answer pertinent health services questions.

The EPIC project has six core areas of study and five methodological focus areas.

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EPIC PROJECT Star Chart

publications chart
An overview of the EPIC Project's published manuscripts across core and theme.

 

Direct Research Support to DoD, MHS, DHA

CHSR provides direct research support to its partner agencies.

Funding Intramural Partnerships

CHSR has implemented two calls for proposal to build capacity for HSR while expanding the base of knowledge to inform decision making on high priority areas for the MHS. In Round 1 six proposals were selected and completed, all of which resulted in publications or publications in progress. Round 2 is currently in progress.

Round 1 Projects

First-round Call for Proposals completed; six studies funded.

  • Improving Treatment and Outcomes among Soldiers Identified with Severe Alcohol Use after Return from an OEF/OIF/OND deployment (Eric Dietrich/Joshua Gray, USU)

  • Looking at MHS Surgical Procedures through the Lens of an Episode Grouper (Eric Dietrich/Beth Hawks, USU)

  • Anesthesia Resident Training in Relation to Combat Casualty Care Readiness in the Military Health System (Krista Highland, DVCIPM)

  • Range of Practices, Cost and Outcomes of Shoulder Dysfunction across the Military Health System (Jeffery Leggit, USU)

  • Understanding Provider Influence on Initiating Opioid Prescriptions (Patrick Richard, USU)

  • Contraceptive Access during Basic Training (Joshua Smalley, USU)

 

Knowledge Products:

  • Roberts TA, Smalley JM, Weir LF, Adelman WP. Contraceptive use and childbirth rates by service branch during the first 24 months on active duty in the United States military from 2013 to 2018: a retrospective cohort analysis. Contraception. 2019 Aug;100(2):147-151. doi: 10.1016/j.contraception.2019.04.002. Epub 2019 Apr 15.

  • Roberts TA, Smalley JM, Baker LL, Weir LF, Adelman WP. Am J Obstet Gynecol. 2020 Aug;223(2):223.e1-223.e10. doi: 10.1016/j.ajog.2020.01.060. Epub 2020 Feb 8.

  • Bauer MR, Larson MJ, Moresco N, Huntington N, Walker R, Richard P. Association between 1-year patient outcomes and opioid-prescribing group of emergency department clinicians: A cohort study with Army active-duty soldiers. Acad Emerg Med. 2021 Nov;28(11):1251-1261. doi: 10.1111/acem.14331. Epub 2021 Aug 25.

  • Richard P, Bauer MR, Moresco N, Walker R, Bowser D, Reed D, Larson MJ. Opioid prescribing for surgical dental procedures in dental clinics of military treatment facilities. J Am Dent Assoc. 2021 Feb;152(2):94-104.e18. doi: 10.1016/j.adaj.2020.09.020. Epub 2020 Dec 24.

  • Gray JC, Larson MJ, Moresco N, Ritter GA, Dufour S, Milliken CS, Adams RS. The association of engagement in substance use treatment with negative separation from the military among soldiers with post-deployment alcohol use disorder. Drug Alcohol Depend. 2021 Apr 1;221:108647. doi: 10.1016/j.drugalcdep.2021.108647. Epub 2021 Feb 22.
  • Jaffe E, Patzkowski MS, Hodgson JA, Foerschler DL, Gonzalez SC, Giordano NA, Scott-Richardson MP, Highland KB. Practice Variation in Regional Anesthesia Utilization by Current and Former U.S. Military Anesthesiology Residents. Mil Med. 2020 Oct 10:usaa269. doi: 10.1093/milmed/usaa269. Epub ahead of print.

 

Round 2 Projects

  • Continued administration of the 7 projects chosen in March 2020 and listed below: Continuation - A methodology to understand quality and efficiency of care: Adapting the Episode Grouper for Medicare (EGM) to the Military Health System (MHS) (Beth Hawks, USU)
  • Continuation--Healthcare utilization and readiness outcomes among soldiers with post-deployment at-risk drinking, by comorbidity clusters (Joshua Gray, USU)
  • The Economic Burden of Traumatic Brain Injury in the Military Health System (Patrick Richard, USU)
  • Exploring outcomes for military family units who have received care in the Army Warrior Care and Transition Program (WCTP) (Elizabeth Hisle-Gorman, USU)
  • The individual and systemic costs associated with behavioral health clinic processes that negatively impact delivery of effective psychotherapy (David Riggs, USU)
  • Impact of DoD Service HIV Policies on Quality and Cost of Care (Brian Agan, USU)
  • A comparative analysis of healthcare utilization and cost of multi-drug-resistant Gram-negative bacilli infections (MDRGN-I) following battlefield injury (David Tribble, USU)
  • Topal S, Richard P, Young J, Ganesan A, Gleeson T, Blaylock J, Okulicz J, Chu X, Agan B. Impact of DoD Service HIV policies on quality and cost of care. Presented at the Conference on Retroviruses and Opportunistic Infections, February 13-16, 2022.
  • Above study also presented as a USU PMB Seminar
  • Two trainee papers through Dr. Agan’s funded project, by Lt Col Charla Geist, USAF MC:
    • Three care delivery models targeting HIV-positive US Service Members
    • Association between proximity to military treatment facility with infectious disease specialty capability and HIV quality of care and cost for active-duty service members
  • HSR IG Presentations by new PIs in September 2020:
    • Dr. Elizabeth Hisle-Gorman, PhD: “Exploring outcomes for military family units who have received care in the Army Warrior Care and Transition Program (WCTP)”.
    • Dr. Brian Agan, MD: “The Impact of DoD Service HIV Policies on Quality and Cost of Care”.
    • Dr. David Riggs, MD: “The individual and systemic costs associated with behavioral health clinic processes that negatively impact delivery of effective psychotherapy”.
    • Dr. Laveta Stewart on b/o Dr. David Tribble: “A comparative analysis of healthcare utilization and cost of multi-drug-resistant Gram-negative bacilli infections (MDRGN-I) following battlefield injury”.