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Systems Engineering to Improve Traumatic Brain Injury Care in the Military Health System: Workshop Summary Appendixes
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Systems Engineering to Improve Traumatic Brain Injury Care in the Military Health System: Workshop Summary Appendix A Biographical Information NORMAN R. AUGUSTINE (NAE) (co-chair) retired in 1997 as chair and chief executive officer (CEO) of Lockheed Martin Corporation. Previously, he was chair and CEO of Martin Marietta Corporation. Upon his retirement, he joined the faculty of the Department of Mechanical and Aerospace Engineering at Princeton University. Earlier in his career, he had been under secretary of the Army and assistant director of defense research and engineering. Mr. Augustine has been chair of the National Academy of Engineering (NAE) and, for nine years, was chair of the American Red Cross. He has also been president of the American Institute of Aeronautics and Astronautics, chair of the Jackson Foundation for Military Medicine, a trustee of the Massachusetts Institute of Technology, a member of the U.S. Department of Homeland Security Advisory Council, chair of the Defense Science Board, a member of the boards of Black and Decker, Lockheed Martin, Procter and Gamble, and Phillips Petroleum, and chair of the Business Roundtable Task Force on Education. Mr. Augustine has received the National Medal of Technology and, five times, the highest award given by the U.S. Department of Defense, the Distinguished Service Medal. He has a B.S.E. and M.S.E. in aeronautical engineering, both from Princeton University, and has received 22 honorary degrees. He is the author or coauthor of four books, and was selected by Who’s Who in America and the Library of Congress as one of “Fifty Great Americans” on the occasion of the 50th anniversary
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Systems Engineering to Improve Traumatic Brain Injury Care in the Military Health System: Workshop Summary of Who’s Who. He has traveled to more than 100 countries and has stood on both the North and South Poles. DENIS CORTESE (co-chair from April 2008) is president and CEO of the Mayo Clinic in Rochester, Minnesota, chair of the Mayo Clinic Board of Governors, and a member of the Board of Trustees. A graduate of Temple University Medical School, he did his residency in internal medicine and pulmonary diseases at the Mayo Clinic. After serving in the U.S. Navy, he joined the staff of the Mayo Clinic in 1976 as professor of medicine. In 1993, he moved to the Mayo Clinic in Jacksonville, Florida, and from 1999 to 2002 he was CEO of the Mayo Clinic and chair of the Board of Directors of St. Luke’s Hospital, both in Jacksonville. In 2003, he returned to Rochester. His major research interests have been in interventional bronchoscopy, including the appropriate administration of photodynamic therapy, endobronchial laser therapy, and endobronchial stents. Dr. Cortese is a member of the Institute of Medicine (IOM) and chair of the Roundtable on Evidence-Based Medicine and the Healthcare Leadership Council (2007–2009). He is also a former president of the International Photodynamic Association. Dr. Cortese is a member of the Harvard/Kennedy Healthcare Policy Group; Academia Nacional de Medicina (Mexico); the Royal College of Physicians (London); FRESH-Thinking (Focused Research on Efficient, Secure Healthcare); Advisory Board, World Community Grid; Chairs/Presidents/CEOs Council, American Medical Group Association; and Division on Engineering and Physical Science of the National Research Council. He received the Ellis Island Award in 2007. JEROME H. GROSSMAN (co-chair until his untimely death in April 2008), was senior fellow and director of the Kennedy Health Care Delivery Project and chairman and CEO of Lion Gate Management Corporation. He was Chairman Emeritus of the New England Medical Center, adjunct professor of medicine at Tufts University School of Medicine, and Honorary Physician at Massachusetts General Hospital. Dr. Grossman chaired the Academic Medical Center Consortium, a cooperative of 12 leading academic medical centers that pioneered the use of health services research techniques to develop and implement effective and efficient health care delivery strategies. He was a member of IOM and a member of the IOM Committee on Quality of Health Care in America. He co-chaired the joint NAE/IOM study in 2007
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Systems Engineering to Improve Traumatic Brain Injury Care in the Military Health System: Workshop Summary on engineering and the health care delivery system. His career-long focus was on the use of information technology to improve health care delivery. He developed the first automated medical record system and founded Meditech, which serves more than 1,600 hospitals and integrated delivery systems, and Transition Systems Inc., which integrated clinical care algorithms with financial costs. He was a director/trustee of a number of organizations, including the Mayo Clinic Foundation, Penn Medicine (University of Pennsylvania Medical School and Health System), Stryker Corporation, Eureka Medical Inc., and the Committee for Economic Development. SETH BONDER, president of the Bonder Group, is former chairman, CEO, and founder of Vector Research Inc. (VRI). Dr. Bonder has an international reputation in the field of policy and operations analysis for his development of new procedures that are used in the public and private sectors. Prior to starting VRI, he was a full-time faculty member in the Department of Industrial and Operations Engineering at the University of Michigan. During the past 40 years he has directed many force-planning, system-acquisition, readiness, and arms-control analyses for the Office of the Secretary of Defense, CINCS of the Unified Commands, Joint Chiefs of Staff, and U.S. Department of the Army. He has served as a consultant and advisor to the senior leadership of many of these agencies. His recent research has been focused on the growing problems of rising costs and reduced access to health care and the development of enterprise-level models and their use in prospective analyses of the reengineering of health care systems and management of chronic diseases. In 2000, Dr. Bonder proposed, and Congress authorized, a demonstration program by the Military Health System to test the utility of these models in evaluating alternative delivery policies, processes, budget development, and disease management protocols. Among the awards he has received are the Jacinto Steinhardt Memorial Award from the Military Applications Society of INFORMS and the Award for Patriotic Civilian Service from the Secretary of the Army. He has served on the U.S. Army Science Board, consulted for the Defense Science Board, and is a past president of the Military Operations Research Society and the Operations Research Society of America. Dr. Bonder received his Ph.D. in industrial engineering (operations research) from Ohio State University in 1965. He is a member of NAE.
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Systems Engineering to Improve Traumatic Brain Injury Care in the Military Health System: Workshop Summary PATRICIA FLATLEY BRENNAN is professor and chair, Department of Industrial and Systems Engineering, and the Lillian Moehlman-Bascom Professor of Nursing, School of Nursing, University of Wisconsin-Madison. Dr. Brennan is also affiliated with the university’s Biomedical Engineering Center for Translational Research and the School of Education. Her fields of interest are health informatics, community health, information systems, computer-mediated clinical practice, and health services research. Her research has been focused on designing and evaluating home-care community computer systems for use by patients. Her work ranges from the development and evaluation of computer networks as a mechanism for delivering nursing care to homebound people and their caregivers to assessing the impact of patient-centered computer technology on the health outcomes of patients who have had coronary-artery bypass graft surgery. Her current projects are Project HealthDesign: Rethinking the Power and Potential of Personal Health Records (www.projecthealthdesign.org) and the healthsystems LAB (http://healthsystems.engr.wisc.edu/), which links the School of Nursing with the College of Engineering. These projects are exploring how individuals and families manage health information in their homes, studying the usability of secure e-mail in clinics, and developing information tools and resources to support self-care and health self-management. Dr. Brennan received her Ph.D. in industrial engineering in 1986 from the University of Wisconsin-Madison, her M.S.N. in nursing from the University of Pennsylvania in 1979, and her B.S.N. in nursing from the University of Delaware in 1975. She is a member of the Institute of Medicine, American Nurses Association, Wisconsin Nurses Association, Sigma Theta Tau, Alpha Mu, and Beta Eta. She is a fellow of the American College of Medical Informatics and American Academy of Nursing and associate editor of the Journal of the American Medical Informatics Association. THOMAS F. BUDINGER is chair and professor of bioengineering and the Henry Miller Professor of Medical Research at the University of California at Berkeley; head of the Department of Nuclear Medicine and Functional Imaging at Lawrence Berkeley National Laboratory; and professor of radiology at the University of California-San Francisco. Dr. Budinger has made many contributions to a variety of scientific disciplines, ranging from polar ice exploration and space exploration medicine to the development of advanced technologies in the imaging
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Systems Engineering to Improve Traumatic Brain Injury Care in the Military Health System: Workshop Summary sciences for the quantitative study of how the human heart and brain function in health and disease. He has received many grants from the National Institutes of Health (NIH), National Science Foundation, and U.S. Department of Energy. Dr. Budinger is a founder and past president of the Society of Magnetic Resonance, chair of the NIH Study Section on Diagnostic Radiology, and a member of the Scientific Review Committee for the Whitaker Foundation. He has chaired three NAE and IOM committees and is a member of both IOM and NAE; a fellow of the American Institute for Medical and Biological Engineering; and a member of the Society of Nuclear Medicine, American Association for the Advancement of Science, Sigma Xi, Society of Magnetic Resonance in Medicine, North American Society for Cardiac Radiology, and Alpha Omega Alpha. Other honors and awards include the American Nuclear Society Team Award for Special Achievement in Nuclear Technology for Medical Diagnostics, the Louise and Lionel Berman Foundation Award for Scientific Contributions in the Peaceful Uses of Atomic Energy, the Ernst Jung-Preis fur Medizin from Jung-Stiftung fur Wissenschaft und Forschung, the Paul C. Aebersold Award for Basic Science, the Hevesy Pioneer Award from the Society of Nuclear Medicine, a Distinguished Service Medal from the Society of Magnetic Resonance in Medicine, an NIH Merit Award for his contributions to Alzheimer’s research, and an award for contributions to the NASA Apollo-Soyuz Project. Dr. Budinger is the author of more than 400 papers and three encyclopedia entries. His current interests include mathematics, chemistry, and instrumentation involved in imaging biological function and biomonitoring wireless technology for public health. He received a B.S. in chemistry from Regis College in 1954, an M.S. in physical oceanography from the University of Washington in 1957, an M.D. from the University of Colorado in 1964, and a Ph.D. in medical physics from the University of California at Berkeley in 1971. BARRETT S. CALDWELL is an associate professor in the School of Industrial Engineering at Purdue University, where his research is on human-factors engineering approaches to how people get, share, and use information in complex environments. His work focuses on information flow, task coordination between and among team members, and team performance as affected by information and communications technology systems. His current research program is on advancing the state of the art in three specific domains of information system performance
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Systems Engineering to Improve Traumatic Brain Injury Care in the Military Health System: Workshop Summary enhancement: (1) defining the quantitative characteristics of information flow in individual and team performance; (2) describing the effects of tasks, situations, and technologies on effective information exchange in organizations; and (3) making information more accessible for users working with computer system interfaces. Prof. Caldwell’s research to date has focused on how information technology implementations and sociotechnical constraints affect the acceptance (in terms of timeliness and validity), use, and effectiveness (in terms of timeliness and the need for additional processing) of information flow and work processes at individual, group, and organizational levels. Approximately 10 projects since 1996 have been on information and document flow paths, time constraints affecting resource and provider coordination, human information needs, and adverse event paths in health care activities. Student projects, consulting, and NIH grants have included work in improvements in health care delivery in anesthesiology, blood services, cardiac recovery, clinical research management, laboratory, pharmacy, radiotherapy, rural health clinic operations, and surgical teams. Facilities in Ohio, Texas, and Wisconsin have been included in these studies. More than 10 peer-reviewed journal and conference papers, five student theses, and at least five seminars and presentations have been based on his research. A recent project on resource foraging and task coordination among teams of health care providers, funded by the Regenstrief Center for Healthcare Engineering, is a study of clinic operations in Indianapolis and East Chicago, Indiana. He is currently working on studies of workload transitions that affect inpatient pharmacy operations. MICHAEL P. DINNEEN has been director of the Office of Strategy Management for the Military Health System since he retired from the U.S. Navy in January 2005. Following his medical training, he was a staff psychiatrist. He then transferred to the National Naval Medical Center, where he was first a director of residency training, then chairman of the Department of Psychiatry, and finally director of medical services. When Congress threatened to outsource all military mental health care in the National Capital Area, he developed and implemented a strategic plan to reduce psychiatric hospital beds from 200 to 60 while actually increasing the military’s share of the mental health market. Subsequent changes resulted in an integrated training and service-delivery program that provided expanded child and adolescent services. At the same time, overall operating expenses were reduced by more than 30 percent.
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Systems Engineering to Improve Traumatic Brain Injury Care in the Military Health System: Workshop Summary Dr. Dinneen was also a special psychiatric consultant to the Secret Service and U.S. State Department, the attending physician to Congress, National Organization for Victim Assistance, and Office of the White House Physician. He developed his special expertise in psychological trauma and military psychiatry while leading Navy Special Psychiatric Rapid Intervention Teams for more than 10 years, directing Mental Health Services aboard the hospital ship USNS Comfort during Desert Shield/Desert Storm, and treating service members and their families. He has lectured internationally on traumatic stress, developed curricula in trauma psychiatry, and trained personnel for specialized wartime assignments. His publications on psychological trauma include original research on the effects of exposure to the stresses of deployment during Desert Shield and Desert Storm. In 2002, Dr. Dinneen became director of health care planning and TRICARE operations at the Navy Bureau of Medicine. He implemented a standard business planning process for the Navy’s 38 medical treatment facilities and was responsible for the orderly transition to the new generation of TRICARE contracts. A diplomate of the American Board of Psychiatry and Neurology, Dr. Dinneen graduated from Harvard University (cum laude) and received both an M.D. and Ph.D. (in neurochemistry) from the Medical College of Virginia. PAUL M. HORN was named New York University (NYU) Distinguished Scientist in Residence and NYU Stern Executive in Residence in September of 2007. Prior to his taking on the position at NYU, he was senior vice president and executive director of research of IBM Corporation, where he directed IBM’s worldwide research program, which employed 3,200 technical workers at eight sites in five countries, and helped guide IBM’s overall technical strategy. During his 28 years at IBM, Dr. Horn championed the translation of technology-based research into marketplace opportunities. Trained as a solid-state physicist who has held management positions in science, semiconductors, and storage, he has successfully applied advances in all of these disciplines to solving real-world technology problems. Dr. Horn’s top priority as head of IBM’s Research Division was to stimulate innovation and innovative business models and quickly bring those innovations to the marketplace to sustain and grow IBM’s businesses and to create the new businesses of IBM’s future. Prior to joining IBM in 1979, Dr. Horn was a professor of physics in the James Franck Institute and the Physics Department at the University of Chicago. He is a fellow of the American
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Systems Engineering to Improve Traumatic Brain Injury Care in the Military Health System: Workshop Summary Physical Society and was an Alfred P. Sloan Research Fellow from 1974 to 1978. He is a member of NAE, a former associate editor of Physical Review Letters, and the author of more than 85 scientific and technical papers. He has received numerous awards, including the 1988 Bertram Eugene Warren Award from the American Crystallographic Association, the 2000 Distinguished Leadership Award from the New York Hall of Science, the 2002 Hutchison Medal from the University of Rochester, and the 2002 Pake Prize from the American Physical Society. In 2003, Dr. Horn was named one of the top computing business leaders in the United States by Scientific American magazine. He is also a member of numerous professional committees, including the GAO board of advisors, the Gallaudet University Advisory Board, and the board of trustees of the Committee for Economic Development. He is also a member of the boards of trustees of Clarkson University, New York Polytechnic, and the New York Hall of Science and a member of the UC Berkeley Industrial Advisory Board. Dr. Horn graduated from Clarkson College of Technology and received his doctoral degree in physics from the University of Rochester in 1973. COL (s) MICHAEL S. JAFFEE, M.D. (USAF) is national director, Defense and Veterans Brain Injury Center, Walter Reed Army Medical Center. Prior positions include director of the neurology program/OIC, neuropsychiatry, and principal investigator, Department of Defense and Department of Veterans Affairs Brain Injury Center, Wilford Hall Medical Center (WHMC), Lackland AFB, Texas; consultant on aerospace neurology, USAF School of Aerospace Medicine, Brooks City-Base, Texas; assistant clinical professor of neurology and psychiatry, University of Texas Health Science Center; and assistant professor of neurology/WHMC neurology clerkship coordinator, Uniformed Services University of the Health Sciences. Among the honors awarded him are the U.S. Surgeon General’s Certificate of Appreciation (2003) for outstanding presentation at the national annual meeting of the Association of Military Surgeons of the United States and being chosen for the DOD/VA Clinical Guidelines Development Panel for Use of Narcotics in Chronic Pain (one of only four physicians selected from the Department of Defense to sit on the panel). He is a member of the American Psychiatric Association, American Academy of Neurology, Academy of Psychosomatic Medicine, and American Neuropsychiatric Association. Dr. Jaffee received his B.A./B.S. in economics in 1988 from
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Systems Engineering to Improve Traumatic Brain Injury Care in the Military Health System: Workshop Summary the University of Pennsylvania, his M.D. in 1992 from the University of Virginia School of Medicine, and completed his residency in psychiatry and neurology in 1998 at WHMC, Lackland AFB-San Antonio. CAPT WILLIAM P. NASH was commissioned in the U.S. Navy Medical Corps in 1978 after earning his M.D. from the University of Illinois College of Medicine in Chicago. His postgraduate training included an internship in surgery from 1978 to 1979 and a residency in psychiatry from 1982 to 1985, both at Naval Medical Center, San Diego. In addition to a tour as a naval flight surgeon, Dr. Nash served at Camp Pendleton, Portsmouth, Bremerton, and San Diego in several clinical, teaching, and leadership positions, including head of two Navy SPRINT (Special Psychiatric Rapid Intervention) teams and director of two Navy residency programs in psychiatry. He also served for five years as director of clinical services aboard the hospital ship USNS MERCY (T-AH 19) and six years as the Navy psychiatry specialty leader. In July 2001, Dr. Nash transferred to Marine Corps Base, Camp Pendleton, California, and, in January 2004, he joined the 1st Marine Division as part of the new Operational Stress Control and Readiness Program, which embeds mental health professionals directly with ground combat units. He deployed to Iraq with the ground combat element of I Marine Expeditionary Force (MEF) from August 2004 through March 2005, where he served as division psychiatrist and I MEF combat stress coordinator. Captain Nash was awarded a Bronze Star for the forward combat/operational stress management support and training he offered during that deployment. In October 2005, he was transferred to Headquarters, Marine Corps, to become the first combat/operational stress control coordinator for the Marine Corps, under the direction of the deputy commandant for manpower and reserve affairs. Along with Dr. Charles Figley, Dr. Nash co-edited, Combat Stress Injury: Theory, Research, and Management (Routledge, 2007). ALEXANDER K. OMMAYA is chief officer, Translational Research, VA, where he facilitates collaborative projects with external groups in translational research, including pharmacovigilance and pharmacogenomics; develops translational research priorities and new administrative approaches for support; develops an integrated communication strategy and implementation plan for the Office of Research and Development; and is the representative to the VA Technology Assessment
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Systems Engineering to Improve Traumatic Brain Injury Care in the Military Health System: Workshop Summary Advisory Group. Previously, he was director of the Forum on Drug Discovery, Development, and Translation at the National Academies (2005–2006), where he established a multi-stakeholder group of leaders in the pharmaceutical and health insurance industries, government agencies that sponsor and regulate research and drug approval, and representatives of foundations, associations, and consumer advocacy groups. As director of the forum, he gathered support from 24 public and private entities and attracted key leaders; planned and implemented activities, such as research projects, workshops, and publications; and identified, developed, and implemented new collaborative projects, including the creation of template clinical trial agreements, the use of adaptive clinical trial designs, and drug development training. From May 2001 to December 2004, Dr. Ommaya was director of the IOM Clinical Research Roundtable. Before his work at the National Academies, he was manager of Blue Cross and Blue Shield of Florida; senior advisor, Agency for Health Care Policy and Research, U.S. Department of Health and Human Services; senior analyst, Henry M. Jackson Foundation, Walter Reed Army Medical Center; health policy fellow, U.S. Senate, Office of Senator George Mitchell; and senior biologist, Laboratory of Neuropsychology, National Institute of Mental Health. Among the awards he has received are the IOM Performance Award (2004); Blue Cross and Blue Shield Association Best Practices in Care and Primary Management (2000); and the AHCPR Administrator’s Award for Group Achievements (1998). Dr. Ommaya received his Sc.D. in health policy and management from the Johns Hopkins University School of Public Health and his M.A. in biopsychology from Mount Holyoke College. He is a member of the VA Technology Assessment Advisory Group and a reviewer for the Journal of the American Medical Association and Health Affairs. DAVID TRENT ORMAN is currently a civilian employee of the Department of the Army, where he heads the Post-Traumatic Stress Disorder-Traumatic Brain Injury/Behavioral Health (PTSD-TBI/BH) Integration Office. His role in the HQ U.S. Army Medical Command is to provide program integration/oversight in the behavioral health (BH) domains that impact soldiers suffering from PTSD/TBI and related BH syndromes. Dr. Orman brings 30 years of active-duty military and civilian administrative, educational, and research experience to his current position. Prior roles include eight years as the Army Surgeon General’s
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Systems Engineering to Improve Traumatic Brain Injury Care in the Military Health System: Workshop Summary psychiatry consultant, program director for psychiatric education at Tripler Army Medical Center, and associate program director for Texas A&M School of Medicine/Scott & White’s psychiatry residency. He also was chief of psychiatry at Brook Army Medical Center and Darnall Army Community Hospital and division psychiatrist for the 1st Cavalry Division. He received his medical school education through the Uniformed Services University of the Health Sciences and completed his psychiatry residency at Walter Reed Army Medical Center, where he was chief resident in 1985. He is coauthor of numerous publications in the medical literature. Raised in the U.S. Air Force, Dr. Orman moved frequently with his retired E-9 father and DAFC mother. COL RONALD POROPATICH is assigned to the U.S. Army Medical Research and Materiel Command (USAMRMC) at Fort Detrick, Maryland, where he is deputy director of the Telemedicine and Advanced Technology Research Center and the USAMRMC military liaison to the Department of Homeland Security. COL Poropatich is also the medical informatics consultant for the U.S. Army Surgeon General, where he works on implementation of information management/information technology solutions throughout the Army Medical Department. He is a former president and board member of the American Telemedicine Association and a practicing pulmonary/critical-care physician at Walter Reed Army Medical Center in Washington, D.C. He is also an associate editor of Telemedicine and e-Health Journal. WILLIAM B. ROUSE is executive director of the Tennenbaum Institute and a professor in the College of Computing and School of Industrial and Systems Engineering at Georgia Institute of Technology. Dr. Rouse has written hundreds of articles and book chapters and is the author of many books; among the most recent are People and Organizations: Explorations of Human-Centered Design (Wiley, 2007), Essential Challenges of Strategic Management (Wiley, 2001), and the award-winning Don’t Jump to Solutions (Jossey-Bass, 1998). He is editor of Enterprise Transformation: Understanding and Enabling Fundamental Change (Wiley, 2006), co-editor of Organizational Simulation: From Modeling & Simulation to Games & Entertainment (Wiley, 2005), co-editor of the best-selling Handbook of Systems Engineering and Management (Wiley, 1999), and editor of the eight-volume series Human/Technology Interaction in Complex Systems (Elsevier). Among his many advisory roles, he has served as
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Systems Engineering to Improve Traumatic Brain Injury Care in the Military Health System: Workshop Summary chair of the National Research Council Committee on Human Factors, is a member of the U.S. Air Force Scientific Advisory Board, and a member of the DOD Senior Advisory Group on Modeling and Simulation. Dr. Rouse is a member of NAE, as well as a fellow of four professional societies—Institute of Electrical and Electronics Engineers, International Council on Systems Engineering, Institute for Operations Research and Management Science, and Human Factors and Ergonomics Society. NINA A. SAYER is an investigator with the VA Health Services Research and Development Center for Excellence at the Minneapolis VAMC and the Center for Chronic Disease Outcomes Research and research director for the Polytrauma and Blast-Related Injuries Quality Enhancement Research Initiative (PT/BRI QUERI). In the latter capacity, she is responsible for directing the PT/BRI QUERI national research portfolio and implementing the results to improve outcomes for individuals who sustain polytrauma and blast-related injuries during their service in the Global War on Terror. From 1998 to 2002 she was co-director of training in psychology at the Minneapolis VAMC, where she was responsible for the American Psychological Association Ph.D. Psychology Internship Training Program. Her research on post-deployment health has included VA-funded studies of disability compensation, unmet needs for mental health services, community reintegration, and polytrauma. She is a member of the faculty at the University of Minnesota.