Grant Number:	3P50CA271358-04S1 Interpret this number
Primary Investigator:	Sherman, Scott
Organization:	New York University School Of Medicine
Project Title:	Telehealth Research and Innovation for Veterans with Cancer (THRIVE)
Fiscal Year:	2025

PROJECT SUMMARY: The rapid uptake of telehealth since the coronavirus pandemic has highlighted not only the potential for telehealth to improve access and quality of care for some but also how telehealth can leave some populations behind, increasing differences in care quality and highlighting the need to focus high quality care for all patients. Population level factors account for 30-50% of the variance in health outcomes, far more than the 10-20% ascribed to health care. To improve health outcomes, it is crucial to target these factors. We will particularly focus on factors of rurality, poverty and other personal characteristics and their effects on the use and uptake of telehealth. The Veterans Health Administration (VA) is the largest integrated health care system in the US, providing care to 9 million patients across 171 medical centers and 1,112 outpatient sites. VA provides a unique opportunity to examine how these key factors affect use of telehealth for cancer across a health care system that offers access without focus on reimbursement. We propose an administrative supplement to the Telehealth Research and Innovation for Veterans with Cancer (THRIVE) Center. The goals are to: 1) define the extent to which telegenetic counseling is integrated into an individual’s breast or ovarian cancer care; 2) understand the relationship between key factors above and clinically-indicated genetic testing among women Veterans with cancer and 3) explore telehealth care coordination pathways leading to surgical referrals for risk-reducing (“prophylactic”) surgery for women with an identified germline cancer mutation. Within the framework of the Parent award, our specific aims are to: 1) Quantify the impact of integration of a telegenetics platform in improving rates of genetic testing for women Veterans with breast or ovarian malignancies; and 2) Characterize the impact of key factors upon completion of downstream risk-reducing surgery following positive genetic testing results. This supplement proposal addresses key NIH and NCI priorities, with a particular focus on women Veterans, their cancer treatment and management, as well as differences in cancer outcomes and care. It leverages the VA’s national integrated health care system research infrastructure focused on improving quality of cancer care and complements the goals of THRIVE to understand and improve differences in access to and outcomes of oncology care. Additionally, the proposed work will provide preliminary data informing the development of future implementation initiatives with the VA National Oncology Program and VA National TeleOncology Program to improve telehealth initiatives and care coordination pathways addressing women’s health oncology needs and care gaps among women Veterans with cancer.





None. See parent grant details.