MITRE Showcases Latest Solutions for Improving Veterans' Health

Significant problems such as anxiety, post-traumatic stress disorder (PTSD), depression, and substance use are among the top health concerns for veterans. Simultaneously, there are issues surrounding the ability of veterans to receive care and for their caregivers to discover the best treatments among mountains of research. MITRE is helping the Department of Veterans Affairs (VA) tackle some of those tough challenges.

This year MITRE again joined the Veterans Health Administration (VHA), a component of VA, at its 2019 Innovation Experience (VHA iEx). The Innovation Experience brought more than 100 VA innovators from around the country together with industry, academic, and government partners, all in the name of saving and improving veterans’ lives.

Three MITRE experts were among those chosen by the VHA to present their research at the event. Hundreds of key stakeholders in attendance had the opportunity to learn about their work.

“Each featured research project explores a different challenge related to veterans' health and provides practical, innovative solutions,” says Beth Meinert, vice president and director of MITRE’s Center for Enterprise Modernization FFRDC.

“Our goal is to help VA solve these complex problems that our nation’s veterans face every day.”

Medication Assisted Treatment of Opioid Abuse

Statistics show the U.S. opioid use disorder (OUD) rate is far greater than our current treatment capacity. In 2015, 68,000 veterans were diagnosed with OUD. By 2017, only 35% of patients diagnosed had received medication.

This continues to be a significant problem. What can we do to close this gap?

In 2000, Congress passed a Drug Addiction Treatment Act (DATA) that allows qualified physicians to treat narcotic dependence with narcotic controlled substances. Jaya Tripathi, a MITRE principal scientist with extensive experience in this area, is exploring that legislation and the effectiveness of Medication Assisted Treatment (MAT) on individuals affected by substance abuse disorder.

“We are using hybrid simulation models on real data to study the effectives of DATA policies,” Tripathi says.

The Opioid Policy Simulator tool, created by Tripathi and her team, draws on rich data sources—such as prescription drug data, death records and income data—to address important questions about adequacy and effectiveness of treatment.

This can help providers identify patients at risk of OUD, detect prescription drug fraud schemes, and increase acceptance of MAT treatment.

As the largest provider of substance use disorder treatment in the nation, the VA can use this tool to better serve its patients and get treatment to those who need it.

Simulating Impact of Alternative Healthcare Delivery Models

Providing timely access to patient-centered, high-quality care is an ongoing challenge in the healthcare industry. One of the challenges: Not everyone can access VA healthcare easily, especially if they live far from the nearest treatment center. One possible answer: increased use of telehealth.

Telehealth allows long-distance contact between a patient and provider using telecommunications technologies that allow virtual face-to-face interaction. MITRE has been pioneering the related technologies for five decades. Telehealth could fill a huge gap for veterans in rural settings or for those who lack mobility or transport. It could provide a bridge to a clinician for care, advice, education, monitoring, intervention, and even remote hospital admissions.

Deborah Ercolini, MITRE principal collaboration software and human centered engineer, presented on the project “Modeling VA HealthCARE.” The goal is to use modeling and simulation to understand the potential impact of alternative healthcare delivery models, such as telehealth.

The five-step framework uses synthetic data to map out the patient’s journey. It allows providers to analyze outcomes using traditional healthcare delivery and explore alternative options.

Outcomes are presented in a way that helps decision makers make more informed choices on new healthcare delivery models. It can take the guesswork out of identifying how changes would affect their veteran patients, providers and the VHA healthcare system.

For example, initial research results demonstrate how telehealth can improve access to care for veterans through reduced travel and wait times. Using MITRE's framework, decision makers can identify potential capacity requirements and potential gaps in resources, such as personnel, equipment, and key technologies, related to telehealth implementation.

“Planning new healthcare delivery solutions is difficult,” Ercolini says. “Modeling VA HealthCARE is designed to make it a little easier to navigate and understand new requirements for capacity and access.

"By demonstrating the effectiveness of alternatives to traditional care, we can increase access to high-quality healthcare for our veterans and help improve their lives.”

Platform for Accelerating Knowledge Capture

There are now over 30 million biomedical abstracts and 300,000 clinical trial studies available to study. Needless to say, keeping up with all the latest research and literature is virtually impossible for healthcare providers and clinical researchers.

Tonia Korves, MITRE health and life science lead, has presented an approach that addresses the need for experts to have better ways to efficiently capture relevant information from large volumes of text.

Korves and her colleagues have prototyped a system that accelerates the capture of information from scientific documents by combining state-of-the-art machine reading with human subject matter expertise.

The prototype curation platform applies machine reading to extract relevant information, leverages redundancy and context to prioritize results, and includes a user interface for efficient expert review.

By leveraging state-of-the-art machine reading, subject-matter experts could more easily stay up to date with the latest information and trends in their fields.

Why is this significant? “This approach could be applied to health-related documents, such as electronic health records, to help healthcare providers identify more effective treatment approaches for veterans' health conditions,” Korves says.

Tripathi notes, “It was an honor to be chosen to present our work among leaders and key stakeholders invested in the health and wellbeing of veterans.

"As we continue our partnership with VA, we look forward to expanding our research, connecting with others in the industry, and solving the complex problems our veterans face every day.”

—by Danielle Coates