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VA Center for Clinical Management Research

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QUERI Program: PeRsonalizing Options through Veteran Engagement (PROVE)

"One size does not fit all" in healthcare. No two Veterans are alike, nor are any two VA medical centers or community-based outpatient clinics (CBOCs). Decisions in healthcare delivery too often are based on "average" effects. Current guidelines and performance measures frequently recommend prescribing the same treatments to many different types of patients based on the average result of a clinical trial without considering important differences between patients. This QUERI, led by Julie Lowery, Angela Fagerlin and Ann-Marie Rosland, will build on an extensive body of work by the VA HSR&D's Center for Clinical Management Research (CCMR) and the Quality Enhancement Research Initiative (QUERI) on individualizing prevention strategies and treatments to optimize care delivered to Veterans.

The overall goal of PROVE is to improve the prevention and management of chronic conditions by supporting Veterans and providers in making personalized healthcare decisions that take into account individual patient risk and preferences. Investigators will work to improve the appropriateness of care (e.g., decrease overuse and underuse), increase Veteran engagement in their healthcare, and enhance Veterans' experiences. Specific aims include implementing: 1) Patient-centered performance management systems that enhance appropriateness of care and incorporate shared decision-making; and 2) Personalized self-management programs that promote health and prevent disease.