Anne Lord Bailey, PharmD, BCPS, Executive Director of VA Strategic Initiatives Lab (Strat Lab),
WASHINGTON, DC – As the executive director of VA’s brand-new Strategic Initiatives Lab (Strat Lab), it is the mission of Anne Lord Bailey, PharmD, BCPS, to encourage VA to play the long shots. Stood up at the end of October, the Strat Lab is an incubator within VA’s Office of Healthcare Innovation and Learning, where Bailey acts as director for clinical tech innovation and immersive technology. The lab’s mission is to foster research projects that have a high risk for failure but a correspondingly high potential for return.
“The Strat Lab will provide a place for disruptive technologies to grow,” Bailey explained. “We’ll be listening to our patients and staff and learning from them what are some of the greatest pain points and problems they’re trying to solve. Listening to leadership, listening to the external market. What we don’t want Strat Lab to be is a place where solutions can come and look for a problem. We want to do a good job in finding problems internally.”
Bailey has made a career of fostering innovation and finding out-of-the-box solutions to clinical problems. She began her career at VA as a pharmacy practitioner at the Asheville, NC, VAMC. While healthcare systems across the country are currently in the process of expanding the role of pharmacists, VA was far ahead of the curve. So when Bailey came to VA, she was able to interact with patients directly, specifically when it came to treating hepatitis C.
“Congress had funded the treatment of hep C, and those antiviral medications had just come out,” Bailey said. “The unique role of pharmacist allowed us to keep up with the pace of treatment. I got to lead clinics and treat patients directly.”
In 2017, the No. 1 provider of hepatitis C medication at VA was a pharmacist, she said. But there were challenges to that, especially for the many veterans who relied on VA’s mail-order pharmacy program.
“One of the pieces of the puzzle for hep C was that the medications were so expensive,” she explained. “We wanted patients to come and pick them up rather than risk them being lost in the mail. But not everybody can make that treatment.”
The hospital had a mobile medical unit that Bailey discovered was not used on Fridays. Seeing a ready solution, Bailey mobilized the unit as a hep C medication delivery service.
“We paid a veteran overtime to go to veterans in the community and hand them their medications,” she said.
In 2017, Bailey began the Innovation Program at the Asheville VA, keeping an eye and ear out for those pain points. In 2018, she was approached by a nurse, Caitlin Rawlins, who had noticed an increased use of opioids and a longer length of stay following knee surgery. She wondered if there were a way to decrease both and get patients out of the hospital sooner.
The two hit upon using virtual reality (VR) to help take patients’ minds off the pain. An early pilot saw a decrease in opioid use, a decreased length of stay, and increased clinician engagement.
“We couldn’t find anyone else using VR in our healthcare system. But we have since learned that there were five or six using it that weren’t telling anybody,” Bailey said. “We saw an opportunity to build a community.”
That community ended up growing into VA’s Extended Reality Network, or XR Network, which has since expanded to 154 medical centers and is being used to treat everything from PTSD, anxiety and depression to spinal cord injuries and provide palliative care.
Bailey said she hopes to extend that reach further with the Strat Lab.
“The first thing we’re going to focus on is our immersive portfolio. Where can we make this how we deliver care? The Strat Lab will be the people who figure out what that looks like,” she explained.
For example, there’s evidence that shows veterans can benefit from peer social support that they find online. The Strat Lab will start examining how VA can leverage that into clinical care.
“We know that there are veterans who are already finding each other in those virtual worlds,” she said. “How can we think about is that something that VA starts to look into. We already have lots of in-person opportunities [for peer support], as well as phone and text. But are there ways to add immersive.”
“We have a lens looking into the future,” she added, “but we don’t have a rigid road map like some of the other programs.”
Asked whether the sheer immensity of the VA healthcare system and the corresponding inertia makes innovation difficult, Bailey related an analogy she’d heard years ago that likens the healthcare landscape to a jungle and the various systems the animals roaming it.
“You have these smaller systems that are fast and agile, and then you have these larger healthcare systems that are more like your elephants,” she explained. “They can’t move quickly or change course quickly, but when they do, you can change the landscape of the entire jungle.”
