Projects under the Grassroots Portfolio stem from the VHA Employee Innovation Competitions, which gather innovative ideas from VA’s front-line staff to find new solutions to VHA’s challenges, and to improve quality, access and transparency of care for Veterans. In addition to giving VA a way to tap the creativity of the workforce, the competitions provide innovators with funding and support to make their ideas a reality. Successful innovations are transitioned into regular practice for wider deployment.

The competition’s categories are designed to mirror the most critical challenges facing VHA at the time. For example, in 2012 the employee competition focused on patient-centered care, Veteran homelessness, mental health and facilities management among other topics, and resulted in 53 new, active projects.

  • Pharmacy How-to-Videos

    Patient education and patient understanding are critical elements in effectively managing diseases and illnesses. The Innovation Program developed videos to help both patients and providers learn how to properly administer medications. These videos are available via YouTube and the VA website (Spanish versions are coming soon). Visit the Patient Education playlist to see the most currently uploaded videos.

  • Veteran “X”

    Veteran "X" is a peer-led, Veteran-centered group that presents a scenario of a fictitious Veteran who has an abundance of social issues, including mental illness, addiction, poor physical health, homelessness, economic hardships, and family issues. Through the group, Veteran participants role-play to find solutions to the issues the Veteran “X” character faces. Veteran "X" was initially piloted at the Hampton VAMC, and has now expanded to 21 sites, with an additional six planned for 2016. It has been featured by many news outlets over the last few years. Learn more about Veteran "X".

  • Specialty Care/Dementia Care Units

    Wilkes Barre VA specialty care team aims to improve the quality of care Alzheimer’s Disease and Related Dementias (ADRD) patients receive on a daily basis. They created a special program to utilize more therapeutic interventions for ADRD patients.


The Strategic Portfolio includes targeted business opportunities identified by VA leadership as needing solutions. This portfolio manages projects that arise from the VACI Industry Competitions, which give VA the opportunity leverage ideas and creativity from the private sector to solve its most pressing challenges. The Industry Competitions, which have a specific focus each year, seek solutions from all types of organizations – from established leaders in the industry to start-ups, non-profits and academic institutions. Past topics have included maternity care coordination, teleaudiology, treatment of pressure ulcers and prosthetics.

Subject matter experts from VA, other government agencies and applicable industries review the proposals, and selected innovators then work with VACI to design a pilot implementation. After the pilot is completed, each project is evaluated and the most successful projects move forward to broader deployment and eventually national rollout.

  • Ohio Willow Wood Prosthetic Socket System

    prosthetic sockets

    Ohio Willow Wood developed a novel transfemoral (TF) socket system that improves the fit, function and comfort of TF prosthetic sockets. The socket includes an internally sealed prosthetic socket, a sensor enhanced vacuum suspension system, and materials with improved thermal properties for constructing the prosthetic liner and/or socket. Data will be gathered to optimize design conditions and evaluate the effectiveness of the prosthetic system. Patients at the Louis Stokes Cleveland VA Medical Center were fitted with the new socket system for the pilot.

  • Pressure Ulcer Resource Mobile Application

    screenshot of Pressure Ulcer Mobile App

    This application includes educational content with graphics and videos as well as reminders for daily self-care tasks, a portal to self-report wound data to VA so as to improve VA’s monitoring ability for Veterans that live too far from specialty care for routine monitoring. It primarily focuses on at-risk Veterans with spinal cord injuries. Pilot testing is currently being executed at the Philadelphia and Tampa VAMCs, with the goal of including approximately 240 Veterans during its lifecycle.

  • Automated Wearable Artificial Kidney (AWAK)

    AWAK Device diagram

    More than 10,000 Veterans undergo dialysis treatment for end stage renal disease (ESRD), and approximately 3,000 additional Veterans reach ESRD every year. AWAK allows Veterans to receive continuous peritoneal dialysis via a small wearable device (approximately three pounds). This mechanism more accurately mimics kidney function than traditional dialysis, resulting in enhanced care and better health.


The Laboratory Portfolio houses resources available through the Innovation Program, including collaboration tools, VHA’s Innovation Future Technology Laboratory (FTL) and the Innovation Research & Design Center (IRDC). The collaboration tools advance innovation and encourage the building of communities of interest. The FTL is a virtual software development environment that is both source capable and accessible from the Internet. Finally, the IRDC is a physical facility and service that explores technology not yet in use within VHA but that may be applicable to VA in the future.

The FTL is a safe and supported virtual environment where innovators conduct cutting edge innovation work that cannot yet be done in VHA’s production (or live) environments. The FTL consists of a virtualized development and testing area supported by common services. Development and testing areas use a centralized source code repository which allows read access for authenticated users to help facilitate project transparency. The development area of the FTL consists of various tools and utilities used to produce innovative health information technology, such as shared instances of Veterans Health Information Systems and Technology Architecture (VistA). The testing area consists of a shared environment that mimics the production VistA environment.

Typically these areas use a virtualized copy of the VA eHealth University (VeHU) version of VistA or another version of VistA depending on the user’s preferences and availability. The area only comes with a small amount of fabricated data, but additional data may be generated using tools and utilities found in the environment. Innovators can view the virtual machine configurations and build on them for their own work.

The FTL software is available on the Innovation FTL Cloud (ISC). A virtual machine in the ISC is essentially a computer in the internet, accessible by a client piece of software which displays the screen of the remote computer in a window on the local computer. This window is maintained by virtual machine client software, such as the Citrix Receiver for Citrix based virtual machines, or the VMWare View client for VMWare based virtual machine systems. Locally installed client software is required to use virtual machine computing.


In 2013, the VHA Innovation Program and partner VACI launched a major campaign to increase the number of completed, successful innovation projects deployed more broadly and rapidly across VA’s network. This effort resulted in a number of programs being expanded into multiple VA field sites and a continued effort to identify similar programs regularly for advanced deployment. Projects are recommended by the Innovation Selection Board to the Under Secretary for Health for final approval.

Work on implementing the 2013 projects is currently underway, while the 2014 projects were recently finalized. Check back regularly to see updates on projects being deployed across the network. If you are interested in becoming involved in future innovation deployment projects, please contact VHA Innovation for more information or with questions.

  • Alert Watch and Response Engine (AWARE)

    The AWARE prototype tracks and monitors follow-up actions and identifies certain critical lab and imaging test result alerts that lack timely follow-up. The prototype consists of two main components: the Alert Tracker (also known as the Follow-up Action Tracker) and the Quality Improvement Tool (also known as the Critical Alert Reporting Engine). The AWARE prototype software application will be implemented at the Louis Stokes VA Medical Center, Cleveland, OH as the beta site, followed by national deployment to the other VAMCs.

  • Automated Radiology (RAPTOR)

    RAPTOR is an automated, electronic tool for capturing medical device data from VistA that is needed by radiologists to optimize advanced medical imaging protocols including computed tomography, magnetic resonance imaging and nuclear medicine. The objective of the RAPTOR implementation effort is to install and beta test the application in a production environment at four clinical sites: Palo Alto, Fresno, Seattle and Tucson VAMCs.

  • Chemotherapy Mechanized Ordering and Management System (COMS)

    COMS is an automated tool that enables end-to-end tracking of chemotherapy regimen including pharmacy orders, order templates, provider notes, end of treatment summaries and a database of relevant information. Clinicians can use the tool to access and query the chemotherapy-related clinical data needed to meet a variety of reporting needs. The objective of this implementation effort is to pilot COMS in a production environment at three beta sites, of which two have been identified, the Durham and Seattle VAMCs.

  • Remote Mental Health Intake and Assessment

    The remote mental health intake and assessment project will accelerate the process for enrolling patients in mental health care. The project will create and deploy a web-based intake form for mental health assessments to be used for returning Operation Enduring Freedom/Operation Iraqi Freedom Veterans and enable clinicians to do mental health screening in remote settings. The purpose of the implementation effort is to deploy this innovation in a production environment at five clinical sites.

  • Advanced Environmental Controls for Severely Disabled Veterans

    Man and Woman in business suit pointing and discussing about a medical device

    The Advanced Environmental Controls project improves the quality of life for severely disabled Veterans by providing them with tools that enable them to have better control over their surroundings. The project leverages voice activation technology, sip n’ puff straws, and head/eye pupil movement technologies to enable patients to call for the nurse, adjust bed position, dial/receive telephone calls, control television settings, control lights, and access electronic entertainment such as e-books and computer games.

  • Multi-Sensory Environment for Special Care Units

    The Multi-Sensory Environment for Special Care Units project developed a new set of policies and procedures for the treatment of dementia and Alzheimer’s disease in Special Care Units. The project leverages Snoezelen therapy, which has been shown to have a calming effect on anxious or agitated persons and a stimulating effect on those who are difficult to access through verbal and tactile approaches. The deployment team will coordinate the installation of the necessary equipment at clinical sites and coordinate two user training modules at each site, an equipment training module and a dementia care training module.

  • After Visit Summary (AVS)

    AVS form

    AVS is a user-friendly tool that summarizes key medical information from outpatient appointments by automatically populating a patient-centered print out with orders, instructions and medications.

  • Hazardous Pharmaceuticals (HazPharm)

    HazPharm seeks to modify necessary VA systems to properly identify hazardous pharmaceuticals for handling precautions and disposal instructions. This will serve to protect the Veterans, VA staff, and environment.

  • Park a Prescription

    Park prescription form

    Park a Prescription provides a method for providers to be able to “PARK” a prescription placing it in a status of “hold until requested by patient or provider.” The provider would be able to write for the medication order or edit current medication orders and then choose whether the medication should be sent immediately (current functionality) or to wait for the patient to request the medication (parking).

  • Mobile Hearing Aid Distance Fitting Application (HADFA)

    The HADFA project aims to develop and oversee the enterprise implementation of an application that will allow VA care teams to adjust a patient’s hearing aids from a distance, without requiring them to come into the medical center. This included developing the application for iOS and Android smartphones, and ensuring it is available in the VA App Store.

  • Remote Veteran Apnea Management Portal (REVAMP)

    REVAMP screenshot

    REVAMP creates the ability for VA to remotely diagnose and treat sleep apnea by establishing an innovative clinical pathway for the diagnosis and treatment of Veterans with obstructive sleep apnea who live in remote and rural areas, utilizing web technologies.

  • Automated Audiology Clinical Extenders (AACE)

    Audiology store-it-forward and automated audiometry, used in traditional clinical settings, are the focus for an initiative to provide Automated Audiology Clinical Extenders (AACE) to enhance current tele-audiology services. AACE has as its objectives to provide training and the tools necessary for selected clinical staff to do the following: Provide services that have the potential to increase patient access to audiological services, reduce costs and inconveniences associated with medical travel, minimize stress on family Caregivers who often provide transportation to appointments, reduce the amount of time patients and Caregivers take off work, increase the ability to rapidly respond to hearing related issues. Additionally, there is the potential to decrease the demand burden on busy providers and clinics and to increase patient satisfaction by increasing capacity and timely accessibility, and quality of care.

Media Library
Media Library
  • FSU Socket in lab

    Florida State University SOCAT

  • veteran male walking on new prosthetic leg

    Cleveland-area Veteran and his new prosthetic socket

  • caucasian male with prosthetic leg walking with crutches

    Cleveland VAMC Gait Lab test of new prosthetic socket

  • GE instrument sterilization machine in lab

    GE instrument sterilization robot

  • asian male using pressure ulcer assessment cart

    Pressure ulcer assessment cart

  • close up view of pressure ulcer chemical sensor device

    Pressure ulcer chemical sensor

  • close view of two males' prosthetic leg

    Ohio Willow Wood prosthetic socket systems

  • Ohio Willow Wood team

    Ohio Willow Wood and Cleveland VAMC prosthetic project team

  • male and female getting ready to hi-five

    Memphis VAMC Innovator and Secretary Bob McDonald

  • staff member in open office space facing each other

    VACI, MIT and SRI prosthetics project staff

  • screenshot of After Visit Summary form

    After Visit Summary screenshot

  • screenshot of prescription form

    Park a Prescription in CPRS

  • male and female next to hospital bed looking at monitor

    Environmental Control Units, Innovator and Secretary McDonald

  • LEAF Dashboard screenshot

    LEAF Dashboard

  • Pressure Ulcer Mobile Application Screenshot

    Pressure Ulcer Resource Mobile Application

  • VG Bio data collection technology next to a quarter and 1 half inch width measurement display

    VG Bio Data Collection Technology

  • Veteran Assessment Details

    Escreening Assessment Tool Screenshot

Handsfree Restrooms

The Hands Free Restrooms Innovation implemented hands-free technology for shared restrooms (patients, staff and guests) to reduce the spread of microorganisms. The innovation project successfully installed hands-free devices in 42 restrooms at the Robley Rex VAMC in Louisville, Kentucky.

Colorectal Cancer Risk Assessment Kiosks

To engage their local patient population and raise awareness of colorectal cancer, the innovators developed an interactive, touch screen kiosk. Northport VAMC physicians took advantage of a colorectal cancer risk assessment algorithm developed by the National Cancer Institute.


A Pittsburgh VA team developed Voogle; a simple, clean Google-like interface that can be used immediately with little or no training. It is used by clinicians and non-medical staff in a very adaptable and dynamic way.


This innovation enabled the use of context-sensitive infobuttons in VA's Electronic Health Record (EHR) as a way of anticipating the information needs of clinicians. This has a major impact because context-specific knowledge has been identified as a key requirement for VA's EHR.


A Houston VA-based team developed decision support software to improve system- and individual-level measurement and tracking of cancer-related diagnostic test results reported through the VA EHR.

Care Units

A Wilkes Barre VA specialty care team aims to improve the quality of care Alzheimer’s Disease and Related Dementias (ADRD) patients receive on a daily basis. They created a special program to utilize more therapeutic interventions for ADRD patients.

YouTube Video