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Principal Investigator: BARBARA G. BOKHOUR
Organization: VA BOSTON HEALTH CARE SYSTEM
Fiscal Year: 2024
Funding agency: Veterans Affairs
Created in 2013 from the merger of two successful Boston-area HSR&D Centers of Excellence, CHOIR –
the Center for Healthcare Organization and Implementation Research – now has the scientists, the
environment, and the resources to respond and contribute to the challenges that Veterans' healthcare will
face in the years to come. CHOIR's MISSION is to conduct organizationally-partnered, and Veteran-
partnered research in order to develop, implement, and evaluate evidence-based and innovative practices
that improve VA healthcare. Our VISION is that CHOIR serve as a large, vibrant, multi-campus Center
which engages the healthcare- and university-rich environment of Greater Boston to enhance VA services
and contribute to health services research (HSR) nationally and internationally. Our PRIORITY GOALS
are: (1) to advance the field of HSR by sustaining, developing, and growing our existing, scientific focus
areas, and growing our evolving and emerging scientific areas; (2) to enrich VA's cadre of world-class HSR
investigators, by supporting training and education across the career spectrum; (3) to grow and support
innovation, to maintain VA at the cutting edge of HSR and adapt to meet VA's ever-changing needs.
CHOIR's three main Scientific Focus Areas have developed from collaborations with key VA partners.
Enhancing Recovery-Oriented Care for Vulnerable Populations [Major Partners: Office of Mental
Health and Suicide Prevention, Center for Homelessness Among Veterans] seeks to understand and
implement models of care to develop Veterans' independence, particularly in those with behavioral
vulnerabilities such as mental health challenges, homelessness and involvement with the justice system.
Medication Management & Outcomes [Major Partner: Pharmacy Benefits Management] addresses best
practices for pharmaceutical use, including studies of the quality, safety, and value of prescribing and
studies to engage Veterans in medication decision-making and improve adherence. Healthcare
Communications [Major Partners: Office of Connected Care, Office of Patient-Centered Care & Cultural
Transformation] conducts research on communicating adverse events to patients, on communicating with
patients using connected care technologies, and on patient-centered communication and care
coordination. In addition to these, CHOIR's Evolving Scientific Areas, first germinated as new emerging
areas 5 years ago, are now mature: Long-Term Care is partnered with the VA Office of Geriatrics and
Extended Care and studies Community Living Centers, models of Geriatric primary care, and team-based
care for the elderly, and Patient Safety, partnered with the VA National Center for Patient Safety, improves
measurement of patient safety by facilitating standardization and integration across existing patient safety
measures, developing and testing new measures to improve on traditional approaches.
CHOIR research has had major impacts on research and on VA systems of care. Just two out of many
examples are Dr. Elwy's work, which has changed how VA surgeons are taught to talk to their patients
about surgical adverse events; and Dr. Bokhour's development of metrics to assess the impact of the VA
Whole Health Initiative on patient reported outcomes.
CHOIR's future success will be built upon a strong commitment to successful mentoring and career
development throughout the career trajectory from post-doctoral to senior investigator levels. Our
successful post-doctoral programs, our career development award (CDA) support program, and our post-
CDA transition mentoring are all integral to CHOIR's mission and are essential elements of the Center
moving forward. Important new Emerging Areas are the Veteran Engagement in Research initiative,
bringing Veterans into the research process as stakeholders, and the CHOIR Innovation Incubator, in
which we both study the process of diffusing innovation within VA and support innovative HSR&D projects.
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