# EXTEND:  EXpanding expertise Through E-health Network Development

> **NIH VA I50** · RLR VA MEDICAL CENTER · 2021 · —

## Abstract

Background and Specific Aims: The signature focus of the proposed EXTEND QUERI will be to support and
advance a key tenet of VA modernization: “providing high-quality care to Veterans, Anywhere to Anywhere.”
Working in the VA service lines of Primary and Specialty Care, the EXTEND QUERI’s specific aims are to:
Aim 1. Expand the reach and effectiveness of VA care to improve Veteran outcomes by delivering high-quality
evidence-based telehealth care services “Anywhere to Anywhere”;
Aim 2. Identify and apply successful strategies for optimizing shared care between telehealth, specialty, and
primary care services for Veterans served by telehealth services;
Aim 3. Identify factors that influence adaptation, adoption, and sustainment of VA telehealth services; and
Aim 4. Assess the business case for implementing, scaling, and sustaining telehealth care services.
Methods: With the ongoing input of our key partners, these aims will be accomplished via core quality
improvement projects that cover multiple conditions and care settings. Our projects focus on: 1)
TeleNeurology: We propose an EXTEND TeleNeurology clustered randomized trial of standard video
TeleNeurology consultation compared to a “TeleNeurology to Local” (T2L) teleconsultation program where
local providers are trained to provide initial consultation for Veterans post-acute stroke/transient ischemic
attack (TIA) with specialty e-consultation backup. 2).TelePain: We will focus on implementation of
collaborative care for chronic pain in primary care. National scale-up of this program will focus on embedding
the practice within newly established primary care VISN telehealth clinical resource hubs. 3).TeleGRACE: We
will extend the reach of an existing multidisciplinary care program that delivers home-based geriatric care
management to older Veterans by making it available to a new group of Veterans: those who (a) live at a
distance from a VA facility and (b) have an inpatient stay at a VA or non-VA facility. The Geriatric Resources
for Assessment and Care of Elders (GRACE) program involves geriatricians, social workers, nurses, and
primary care providers working together to care for aging Veterans in their own homes.
These projects are supported by an Implementation and Data Core that works across all projects to facilitate
efficient models of telehealth delivery and shared care; usability testing of new reports, tools, and products;
and standardized use of implementation measures, methods, and analytic approaches.
Our overarching implementation bundle of four key implementation strategies includes: Systems Redesign
methodology; external facilitation; precision monitoring with feedback; and local adaptation. We will use the
RE-AIM and CFIR framework to plan data collection and analyses across projects to identify core
implementation strategies and contextual factors that impact effective telehealth delivery.
Anticipated EXTEND program impacts include: (1) expanding Veteran access to evidence-based...

## Key facts

- **NIH application ID:** 10069989
- **Project number:** 1I50HX003205-01
- **Recipient organization:** RLR VA MEDICAL CENTER
- **Principal Investigator:** Dawn Marie Bravata
- **Activity code:** I50 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2020-10-01 → 2025-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10069989

## Citation

> US National Institutes of Health, RePORTER application 10069989, EXTEND:  EXpanding expertise Through E-health Network Development (1I50HX003205-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10069989. Licensed CC0.

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