Evaluation of the medical research program at the department of veterans affairs

The goal of the medical research program at the Department of Veterans Affairs (VA) is to discover knowledge, develop researchers and health care leaders, and advance health care for Veterans and the nation. Abt Associates conducted an independent assessment of the program to examine its strategic planning and management processes, the adequacy of the research supports, and progress toward stated goals. Methodology for the evaluation included 60 interviews, a large-scale survey (N=1,032) of VA-funded researchers, and analysis of numerous program documents (e.g., VA policies, budget spreadsheets, advisory panel reports).

We concluded that the VA research program has many strengths. VA researchers are successful in obtaining additional funding to leverage Congressional appropriations and their research productivity is similar to the NIH-funded investigators. Further, VA researchers stated that the contributions of their research include better patient and provider education, improvements in patient life expectancy and quality of life, reduction in health care costs, and development of new devices to help disabled Veterans. One of the reasons for establishing the research program at VA was to attract academic clinicians to the VA system. Our study revealed that the program is an important recruitment tool: most researchers surveyed believed that research opportunities were important to the recruitment and retention of talented clinicians to VA. In addition, the vast majority of researchers said that research was a factor in their own decision to come to and to remain at VA.

We also identified several program challenges, which included excessive regulatory burden on the research community, dissatisfaction with information technology support, and inefficient contracting and hiring processes. We found, for example, that researchers spend on average 10% of their time on compliance with federal, affiliate, and VA-specific regulatory requirements. Finally, the research community indicated the need for greater funding support.

Based on the study findings, our recommendations to the research program leadership were as follows: (1) Collaborate with the Office of Information Technology to improve IT support services and to simplify policies and procedures for data access and sharing; (2) Improve transparency and inclusiveness of the funding allocation process; (3) Establish a data system to manage grants and to collect information on research outcomes; and (4) Continue to support and possibly increase research funding for the diseases prevalent in women and elderly, two of the growing Veteran populations.