# STORM Implementation Program Evaluation

> **NIH VA I01** · VETERANS HEALTH ADMINISTRATION · 2020 · —

## Abstract

Background and significance: To mitigate the risks of adverse outcomes of opioid therapy, the VA Office of
Mental Health Operations (OMHO) and the National Pain Management Program developed a tool to estimate
and display the risk of adverse outcomes among patients prescribed opioids. Known as the Stratification Tool
for Opioid Risk Management (STORM), the data dashboard displays individual patients’ level of risk, specific
clinical risk factors, use of recommended risk mitigation strategies, and pain treatments. STORM is available
for use by the field, but there is uncertainty about how to achieve consistent utilization across VA Medical
Centers (VAMCs) and maximize its effectiveness in reducing opioid-related adverse events.
The overall objective of this service-directed project is to perform, in collaboration with OMHO and the
Partnered Evidence-Based Policy Resource Center (PEPReC), a randomized program evaluation that will allow
the VA to randomize VAMCs to different STORM rollout conditions using a stepped-wedge design. This
innovative feature will allow the VA to evaluate the impact of different rollout conditions on STORM uptake
and clinical impact. Methodology and expected results: All VAMCs will receive a policy memorandum mandating
STORM-facilitated case reviews of patients at high risk for opioid-related adverse events. VAMCS will be
randomized to a policy that has consequences for not meeting target case review completion rates versus a
policy without consequences. Subsequently, facilities will be randomized to perform case reviews on patients
at the top 1% versus 5% of STORM risk scores in a stepped-wedge fashion. In this partnered evaluation,
PEPReC will use VA administrative and clinical data to examine the effects of the randomized rollout on
patient-level clinical outcomes. In parallel, a team of investigators from the Center for Health Research and
Promotion (CHERP) will conduct facility-level quantitative and qualitative analyses to identify strategies used
to implement STORM-facilitated case reviews across VAMCs nationally, as well as implementation barriers
and facilitators at a subset of facilities.
The CHERP evaluation consists of two overall aims. Aim 1a is to describe the number and type of strategies
VAMCs used to implement the STORM policy and compare implementation strategies across the
consequences and no consequences rollout arms. Aim 1b is to examine whether the number and type of
STORM implementation strategies used by VAMCs predict achievement of the target case-review completion
rate outlined in the STORM policy. These Aims will be achieved by conducting an online survey of
implementation strategies used across all VAMCs. Regression techniques will be used to compare the number
and types of strategies across rollout arms (Aim 1a) and examine their associations with case review
completion rates (Aim 1b). Aim 2 is to identify barriers and facilitators to implementing the STORM policy and
compare these barriers and ...

## Key facts

- **NIH application ID:** 9955051
- **Project number:** 5I01HX002389-03
- **Recipient organization:** VETERANS HEALTH ADMINISTRATION
- **Principal Investigator:** Walid F. Gellad
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2017-10-01 → 2020-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9955051

## Citation

> US National Institutes of Health, RePORTER application 9955051, STORM Implementation Program Evaluation (5I01HX002389-03). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/9955051. Licensed CC0.

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