For fiscal year 2015, VA Research recognized appropriations that approximated some $588 million encompassing some 2,200 research projects. To fulfill the commitment to provide superior health care to our veterans and their beneficiaries, VA is requesting $618 million in direct appropriations in 2016, which is an increase of $29 million, or 5 percent, over the 2015 level. The estimated direct research program employment level is 3,531 full-time equivalents (FTEs); all VA researchers are VA employees.
Over the years, we have followed some of the more interesting and impressive R&D efforts by VHA into everything from prosthetic development to MRSA abatement. Can you please give us a preview of what is coming out of your R&D personnel/facilities in the near future?
VA Office of Research and Development works continually to ensure that the research portfolio is appropriately rebalanced to meet the most pressing needs of veterans. In 2016 and 2017, VA’s research priorities will emphasize ensuring continued care for veterans throughout their life span. A robust health services research program will continue to improve the way VA delivers health care and the methods through which veterans can access VA services. VA will also support a wide array of research and development in engineering and technology to improve the lives of veterans with disabilities. Work includes both prosthetic systems that replace lost limbs and those that activate residual or paralyzed nerves, muscles, and limbs. Some VA research and development highlights we anticipate to generate innovative discoveries and advancements in veterans’ health care include:
Genomics
Enhancing research on genomic medicine and continuing the Million Veteran Program (MVP) remain major goals for VA Research in 2016 and 2017. MVP, a groundbreaking genomic medicine program, seeks to collect genetic samples and general health information from 1 million veterans in the next five years. The program is on track to establish one of the largest genomic and health information research resources available in the world, which will help provide answers to many pressing medical questions and lead to improvements in care and prevention to veterans and the nation. As of Sept. 18, 2015, MVP had enrolled more than 411,000 veterans, and is conducting initial genetic analysis of these specimens at the rate of more than 10,000 per week. These data are available to VA investigators starting in FY 2015; studies that will use these data, concentrating on posttraumatic stress disorder and chronic multisymptom illness in 1990-1991 Gulf War veterans, are in development.
VA works closely with other federal research agencies to assure effective use of scarce taxpayer resources in executing its research mission. We carry out joint programmatic reviews with the Department of Defense and National Institutes of Health to ensure that our research efforts are complementary and not overlapping. Under the auspices of the President’s National Research Action Plan, VA has worked with DOD to create two research consortia for traumatic brain injury and posttraumatic stress disorder, at a combined investment of $107 million over five years. This tight coordination has become routine for all three agencies, with benefits that accrue to veterans and the American public at large.
Women’s Health
A comprehensive research program supports VA’s commitment to the health and care of the increasing number of women veterans. Recent areas of inquiry include studying how VA provides for women veterans’ general and gender-specific health care needs, and understanding the experiences of women veterans while in service and their health risk factors later in life.
Recognizing the dramatic increase in the number of women veterans, VA Research established the Women’s Health Research Network to accelerate research that addresses needs of women veterans. This innovative network is building capacity to develop research that will benefit women veterans of all ages, including studies on women’s health during and after deployment, reproductive health, primary care, and prevention. The network also fosters large multisite studies through a group of 37 VAMCs [VA Medical Centers] that work together to facilitate research-clinical partnerships. The overall goal is to develop, test, implement, and disseminate effective innovations in care.
Gulf War Veterans
Some 1990-1991 Gulf War veterans are affected by a debilitating cluster of medically unexplained chronic symptoms that may include fatigue, headaches, joint pain, indigestion, insomnia, dizziness, respiratory disorders, and memory problems – referred to by VA as chronic multisymptom illness (CMI). VA researchers are dedicated to learning more about these problems and identifying the best ways to diagnose and treat them.
Two new studies that may benefit this cohort involve functional magnetic resonance imaging of the brains of Gulf War veterans. One study is designed to understand the mechanism of cognitive fatigue by giving memory tests to patients while the images are being collected. The other will examine patients with cognitive difficulties who might have been exposed to nerve agents in Iraq and compare their brain images with those from Gulf War veterans who are unlikely to have been exposed.