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Ralph H. Johnson VA Medical Center


Center of Innovation: promoting health care equity

Provider with a minority patient.

As a funded VHA Center of Innovation, Charleston’s Health Equity and Rural Outreach Innovation Center (HEROIC), is helping to eliminate geographic, racial/ethnic, and gender-based disparities in the provision of health care.

By Jenny Stripling, Public Affairs Specialist
Friday, March 20, 2015

The Ralph H. Johnson VA Medical Center is on a mission to improve access and equity in healthcare for all Veterans.

As one of 19 nationally funded VHA Centers of Innovation (COIN), Charleston’s COIN, called Health Equity and Rural Outreach Innovation Center (HEROIC), is helping to eliminate geographic, racial/ethnic, and gender-based disparities. Charleston COIN conducts research on the delivery and cost of care, focusing on how best to ensure every Veteran receives the same quality of health care.

"One of the greatest strengths of Charleston's HEROIC is the dynamic team of young researchers who are passionate about their work and dedicated to eliminating disparities," said Dr. Leonard Egede, director of the Charleston COIN program.

"As a result, we are a diverse group across expertise, race/ethnicity and gender, leading to our ability to develop innovative ideas with relevance to the field. Our diversity of disciplines and integration with clinical operations provides balance and insight, and creates an environment where we can investigate and impact real world problems."

How did COIN come about at the Charleston VA?

Charleston was originally funded as a small center called a TREP (Targeted Research Enhancement Program) and after four years transitioned to a mid-size center called a REAP (Research Enhancement Award Program). In 2012, Charleston's investigators, led by Egede, and Associate Director, Ken Ruggiero, applied for and were awarded one of 19 center grants in the nation. Only two of these 19 center grants focus on health equity issues placing Charleston in a great position to investigate and impact VA policies, health care practices and health outcomes for Veterans.

How does COIN benefit Veterans and stakeholders?

Health care disparities are well documented across a wide range of clinical areas and service types, with rural, racial/ethnic minorities and female Veterans experiencing poorer health care outcomes. Access to high-quality care is a key barrier, particularly for rural-dwelling Veterans. Addressing these disparities has been a major and ongoing priority for the VA, so the COIN's research will have tremendous impact on how Veterans receive care. There have also been methods developed to train VA providers, such as PE-Web, a web-based training for prolonged exposure for PTSD, and have tested online training for assessment and management of suicidality against the standard in-person training.

In what ways are Veterans getting involved with COIN?

Veterans can participate through specific studies, though each project has specific criteria. Currently patients are being enrolled for studies investigating questions related to delivery of PTSD treatment, care for Veterans with heart failure, use of My HealtheVet for Veterans with diabetes, mobile application for caregivers of Veterans with dementia, housing stability for homeless Veterans with substance use disorders, screening for lung cancer in Veterans, and perspectives on collection of race/ethnicity data by the VA.

"Our mission is to honor America's Veterans by providing exceptional healthcare that improves their health and well-being. We are doing just that with the research we are conducting," said Egede.

Veterans interested in participating in research projects or an investigator interested in studying health-related issues in diverse Veteran populations, should call 843-789-6875.

For more information on Charleston VA's COIN visit, and for an overview of the COIN program, visit


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