WEBVTT 00:00:05.230 --> 00:00:09.029 All across America and around the world, this 00:00:09.029 --> 00:00:15.150 is Veterans Radio. This is Veterans Radio. Good 00:00:15.150 --> 00:00:18.609 day. I'm Jim Fausone. I'm the Officer of the 00:00:18.609 --> 00:00:20.710 Deck today here on Veterans Radio, and thanks 00:00:20.710 --> 00:00:23.460 for joining us. We've got some interesting stories 00:00:23.460 --> 00:00:25.640 for you. We always want to remind you, you can 00:00:25.640 --> 00:00:28.739 find more about Veterans Radio at its Facebook 00:00:28.739 --> 00:00:32.420 site or at the web, veteransradio .org, where 00:00:32.420 --> 00:00:35.259 we're on the web 24 -7. You can find a lot of 00:00:35.259 --> 00:00:38.299 our podcasts there as well. We post new ones 00:00:38.299 --> 00:00:42.479 every Tuesday, so you can get a new story, a 00:00:42.479 --> 00:00:45.219 new interview, something you didn't know before 00:00:45.219 --> 00:00:49.460 by going to veteransradio .org. 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It provides water 00:01:38.760 --> 00:01:42.019 damage remediation, flood water removal, fire 00:01:42.019 --> 00:01:45.859 and smoke damage remediation, mold removal, biohazard 00:01:45.859 --> 00:01:50.920 cleanup. It also has a focus on veteran franchisees. 00:01:51.239 --> 00:01:54.379 You can learn more about them by going to PuroClean 00:01:54.379 --> 00:01:58.599 .com. We want to give you a little advance notice. 00:01:58.599 --> 00:02:02.560 We're going to have a Veterans Radio event on 00:02:02.560 --> 00:02:07.739 Sunday, September 28, 2025. Radio on the River. 00:02:08.199 --> 00:02:10.879 We're doing a new location on Freedom River in 00:02:10.879 --> 00:02:14.379 Livingston County, Michigan. We want you to save 00:02:14.379 --> 00:02:16.340 the date. We're going to have veteran storytelling 00:02:16.340 --> 00:02:18.740 and guest speakers. We'll have raffle items, 00:02:19.259 --> 00:02:23.580 great local musicians and food. Also, uniquely, 00:02:23.699 --> 00:02:25.879 there's going to be an opportunity to fly in 00:02:25.879 --> 00:02:29.099 a UH -1 Huey from the Michigan Flight Museum 00:02:29.099 --> 00:02:32.240 and maybe you can also win a free ride that way. 00:02:33.180 --> 00:02:36.620 But plan on supporting Veterans Radio either 00:02:36.620 --> 00:02:40.159 by buying tickets or sponsoring Radio on the 00:02:40.159 --> 00:02:45.319 River. Contact us at Dale at VeteransRadio .org 00:02:45.319 --> 00:02:48.800 or Jim at VeteransRadio .org to get more information 00:02:48.800 --> 00:02:51.719 but we'd love to have you come out and we'd certainly 00:02:51.719 --> 00:02:54.599 love to have you sponsor. We just want to remind 00:02:54.599 --> 00:02:59.099 you that Veterans Radio podcasts are available 00:02:59.099 --> 00:03:02.580 on all your favorite streaming platforms including 00:03:02.580 --> 00:03:09.360 RSS .com, Apple Podcasts, Spotify, YouTube Podcasts, 00:03:09.419 --> 00:03:12.759 iHeartRadio, and Reeves Across America radio. 00:03:13.280 --> 00:03:16.099 So wherever you are, you can find us, whether 00:03:16.099 --> 00:03:19.199 it's on your mobile phone or your computer or 00:03:19.199 --> 00:03:22.960 your laptop, your tablet, but listen in to Veterans 00:03:22.960 --> 00:03:25.759 Radio podcast. We post something new every week 00:03:25.759 --> 00:03:29.139 and you're going to find it informative. We want 00:03:29.139 --> 00:03:32.960 to welcome to Veterans Radio today from the National 00:03:32.960 --> 00:03:35.560 Association of Veterans Research and Education 00:03:35.560 --> 00:03:40.599 Foundation, its CEO, Rashi Romanov. Rashi, welcome 00:03:40.599 --> 00:03:43.439 to Veterans Radio. Thank you so much. I'm excited 00:03:43.439 --> 00:03:45.819 to be here. Well, this is a great opportunity 00:03:45.819 --> 00:03:49.340 to talk about a hidden gem, if you will, inside 00:03:49.340 --> 00:03:52.379 the VA. But let me set this up a little bit. 00:03:53.000 --> 00:03:55.419 You hold a bachelor's degree in biology and public 00:03:55.419 --> 00:03:58.039 policy and a master's degree in health care policy 00:03:58.039 --> 00:04:01.060 and management. You've been a Fulbright scholar, 00:04:01.939 --> 00:04:04.800 a presidential management fellow. You've worked 00:04:04.800 --> 00:04:09.460 for the VA. You've been a Director of Operations 00:04:09.460 --> 00:04:11.800 for the VA Center for Strategic Partnerships 00:04:11.800 --> 00:04:14.960 in the Office of the Secretary. When you left 00:04:14.960 --> 00:04:17.420 there in 2017, you went to work for American 00:04:17.420 --> 00:04:21.579 Health Insurance Plans. You were the Executive 00:04:21.579 --> 00:04:24.139 Vice President of the Elizabeth Dole Foundation, 00:04:24.319 --> 00:04:26.379 which so many veterans know what good work they 00:04:26.379 --> 00:04:31.129 do. You've had a career focused on health care 00:04:31.129 --> 00:04:34.069 and veterans affairs, so this is sort of being 00:04:34.069 --> 00:04:39.490 CEO of Navref is sort of the perfect job, but 00:04:39.490 --> 00:04:42.129 I suspect nobody knows what Navref is, so let's 00:04:42.129 --> 00:04:48.120 start there. I would agree. absolutely, you know, 00:04:48.259 --> 00:04:51.540 it's in so many ways, it's a perfect job. And 00:04:51.540 --> 00:04:55.079 I love what we do. So, NAVREP is what I often 00:04:55.079 --> 00:04:58.360 say is one of the best kept secrets of the VA. 00:04:59.120 --> 00:05:02.939 We are a membership association and we represent 00:05:03.339 --> 00:05:07.300 the congressionally authorized nonprofit infrastructure 00:05:07.300 --> 00:05:11.519 that the VA uses to advance veterans research. 00:05:12.560 --> 00:05:14.540 So essentially the easiest way to explain it 00:05:14.540 --> 00:05:17.660 is anytime you hear of an NIH trial happening 00:05:17.660 --> 00:05:21.040 at the VA, of a Pfizer or Merck trial happening 00:05:21.040 --> 00:05:24.259 at the VA, chances are all of that funding and 00:05:24.259 --> 00:05:27.089 all of that work is being coordinated. by one 00:05:27.089 --> 00:05:31.170 of these VA affiliated nonprofits. It's an infrastructure 00:05:31.170 --> 00:05:34.269 that's been around for more than 30 years. It 00:05:34.269 --> 00:05:37.050 was, you know, Congress and VA came together 00:05:37.050 --> 00:05:40.829 and in the late 80s really innovated this whole 00:05:40.829 --> 00:05:44.310 design of how the VA could work more effectively 00:05:44.310 --> 00:05:47.649 with the private sector because essentially if 00:05:47.649 --> 00:05:50.149 tomorrow one of these pharmaceutical companies 00:05:50.149 --> 00:05:53.189 creates a cure for cancer, we want to make sure 00:05:53.189 --> 00:05:55.470 that veterans can be first in line to access 00:05:55.470 --> 00:05:59.100 that. without these nonprofits and this infrastructure, 00:05:59.180 --> 00:06:02.000 there would really not be a way for veterans 00:06:02.000 --> 00:06:04.060 to be able to access these lifesaving drugs. 00:06:04.740 --> 00:06:08.120 So we love representing this space. I think this 00:06:08.120 --> 00:06:11.180 public private partnership space and ways to 00:06:11.180 --> 00:06:15.379 connect, cutting edge, emerging healthcare innovations, 00:06:16.459 --> 00:06:18.839 therapeutics, new drugs, being able to connect 00:06:18.839 --> 00:06:21.139 all that to the VA and the federal government 00:06:21.139 --> 00:06:23.459 is a really, really exciting place, especially 00:06:23.459 --> 00:06:27.540 right now. NAVREF sort of sits right in between 00:06:27.540 --> 00:06:31.040 that ecosystem and tries to make all this easier. 00:06:31.959 --> 00:06:34.240 Well, it is important right now in particular 00:06:34.240 --> 00:06:38.980 because VA just celebrated its 100 years of medical 00:06:38.980 --> 00:06:42.480 research that's really focused on veteran -related 00:06:42.480 --> 00:06:46.160 issues. That's kind of a milestone not many people 00:06:46.160 --> 00:06:49.939 can point to, is it? Absolutely. And it's not 00:06:49.939 --> 00:06:52.060 uncommon. Sometimes when we talk to people, there's 00:06:52.060 --> 00:06:53.879 a little bit of, wait, VA does research? And 00:06:53.879 --> 00:06:57.040 you're like, yes. Not only does it do research, 00:06:57.160 --> 00:07:00.339 but it has this rich tradition and rich history 00:07:00.339 --> 00:07:03.959 of doing research that's not only benefited veterans, 00:07:04.139 --> 00:07:06.660 but has really advanced American public health 00:07:06.660 --> 00:07:10.060 for all Americans and all citizens of the world. 00:07:10.750 --> 00:07:12.569 The VA research program, as you rightly noted, 00:07:12.649 --> 00:07:16.149 it turned 100 years old. My joke that I often 00:07:16.149 --> 00:07:19.170 say is it doesn't look a year past 97, but it 00:07:19.170 --> 00:07:21.829 turned 100 years old this year. And so we spent 00:07:21.829 --> 00:07:24.430 a lot of time really raising and celebrating 00:07:24.430 --> 00:07:27.649 all of the amazing achievements that the VA has 00:07:27.649 --> 00:07:30.550 celebrated in this last century. So things like 00:07:30.550 --> 00:07:33.389 the pacemaker, the nicotine patch, they did the 00:07:33.389 --> 00:07:37.569 first successful liver transplant. So many examples 00:07:37.569 --> 00:07:39.870 of how the VA has really been on the precipice 00:07:39.870 --> 00:07:43.000 and cutting edge of research and new drugs and 00:07:43.000 --> 00:07:45.779 new therapeutics. But you know, more recently, 00:07:45.819 --> 00:07:47.759 these aren't all just things from like the 60s 00:07:47.759 --> 00:07:50.699 and 70s. More recently, you know, things like 00:07:50.699 --> 00:07:52.839 psychedelics research, which is in the news a 00:07:52.839 --> 00:07:55.959 lot. VA is pioneering the work that's happening 00:07:55.959 --> 00:07:59.000 there. Recently, there was a really great news 00:07:59.000 --> 00:08:02.699 article about VA researchers actually doing the 00:08:02.699 --> 00:08:05.720 early work to isolate GLP -1s that are used in 00:08:05.720 --> 00:08:08.500 things like Ozempic and Wigovia. So when you 00:08:08.500 --> 00:08:11.439 think about, you know, know, all of the achievements 00:08:11.439 --> 00:08:13.360 that the VA has done over the last hundred years, 00:08:13.459 --> 00:08:16.379 and then you start to contextualize that in terms 00:08:16.379 --> 00:08:19.000 of what the next hundred years could look like, 00:08:19.379 --> 00:08:21.980 especially when you think of how much data the 00:08:21.980 --> 00:08:24.759 VA has and the future of healthcare is really 00:08:24.759 --> 00:08:27.920 going to be around how we're using data effectively 00:08:27.920 --> 00:08:31.709 to empower. local physicians and local decision 00:08:31.709 --> 00:08:34.850 making and really be able to better predict disease. 00:08:35.129 --> 00:08:37.110 And I cannot think of a system that is better 00:08:37.110 --> 00:08:39.389 poised to lead on this than the VA, which is 00:08:39.389 --> 00:08:42.049 the largest integrated healthcare system. It's 00:08:42.049 --> 00:08:45.009 that piece of it in particular is particularly 00:08:45.009 --> 00:08:49.549 fascinating in that you have this huge population 00:08:49.549 --> 00:08:52.529 that the VA has got data on. Now it's mostly 00:08:52.529 --> 00:08:57.960 men, but that's changing over time. But the million 00:08:57.960 --> 00:09:02.860 veteran push, hey, we want all this data so we 00:09:02.860 --> 00:09:07.279 can ultimately more personalized treatment by 00:09:07.279 --> 00:09:10.759 segmenting it more clearly than just male, female, 00:09:11.700 --> 00:09:16.340 old, young. I mean, it really has a unique data 00:09:16.340 --> 00:09:19.840 set as computers get better, AI gets better, 00:09:20.559 --> 00:09:23.100 researchers get better. It's got to be a treasure 00:09:23.100 --> 00:09:26.700 trove for researchers. Absolutely. You know, 00:09:26.960 --> 00:09:30.320 it's over 9 million enrollees in the VA healthcare 00:09:30.320 --> 00:09:33.759 system. You mentioned the Million Veteran Program, 00:09:33.840 --> 00:09:37.320 which is the world's largest and most diverse 00:09:37.320 --> 00:09:40.179 genetic biobank, again, in the entire world. 00:09:41.159 --> 00:09:43.019 And to say nothing of the fact that, you know, 00:09:43.159 --> 00:09:45.080 one thing that I think makes the VA so unique 00:09:45.470 --> 00:09:49.250 the ability to do longitudinal studies at the 00:09:49.250 --> 00:09:52.549 VA. Now, wait, wait, explain what longitudinal 00:09:52.549 --> 00:09:55.850 studies for those of us who did not get a Fulbright 00:09:55.850 --> 00:09:58.830 scholarship. Well, longitudinal studies is essentially 00:09:58.830 --> 00:10:03.370 just these long -term multi -year, multi -generational 00:10:03.370 --> 00:10:06.549 even in some instances studies. When we think 00:10:06.549 --> 00:10:09.149 about things like traumatic brain injury or a 00:10:09.149 --> 00:10:12.950 toxic exposure or cancer or Alzheimer's, dementia, 00:10:13.470 --> 00:10:17.779 things that progress and change over time. You 00:10:17.779 --> 00:10:21.139 know, the VA holds on to patients for years, 00:10:21.399 --> 00:10:24.679 if not decades. Now people's interactions and 00:10:24.679 --> 00:10:27.279 sort of level of engagement with the VA might 00:10:27.279 --> 00:10:29.039 change over time, right? When they're working, 00:10:29.279 --> 00:10:31.460 they might only go to the VA for certain kinds 00:10:31.460 --> 00:10:33.820 of appointments, and maybe they go to a civilian 00:10:33.820 --> 00:10:36.179 or their, you know, employer insurance provider 00:10:36.179 --> 00:10:39.460 for different things. But in a lot of instances, 00:10:39.580 --> 00:10:41.679 the VA is having engagement with their patients 00:10:41.679 --> 00:10:44.679 for years, if not decades. So the ability to 00:10:44.679 --> 00:10:48.240 be able to study, well, what does toxic exposures 00:10:48.240 --> 00:10:50.779 and the progression of this look like over a 00:10:50.779 --> 00:10:53.860 lifetime is really unparalleled. And traumatic 00:10:53.860 --> 00:10:57.039 brain injuries in the news all the time, and 00:10:57.039 --> 00:11:01.539 it changes over time. If you have a TBI in your 00:11:01.539 --> 00:11:04.360 20s or 30s, how that manifests and changes in 00:11:04.360 --> 00:11:07.399 your 40s, 50s, and 60s looks very, very different. 00:11:07.179 --> 00:11:10.039 And there's no other system in the country, if 00:11:10.039 --> 00:11:12.720 not the world, that's really able to monitor 00:11:12.720 --> 00:11:15.620 this progress and study disease progression like 00:11:15.620 --> 00:11:19.720 you can at the VA. And just to put some more 00:11:19.720 --> 00:11:22.980 context in this, I have an article in front of 00:11:22.980 --> 00:11:28.039 me from Task and Purpose. It says in physical 00:11:28.039 --> 00:11:33.370 year 2024, Congress appropriated 984 million 00:11:33.370 --> 00:11:38.529 to the VA for 102 research sites nationwide and 00:11:38.529 --> 00:11:44.549 nearly 7 ,300 active projects. Those numbers 00:11:44.549 --> 00:11:47.389 are astounding. Unless I read them here, I would 00:11:47.389 --> 00:11:49.190 never have somebody to ask me, how many do you 00:11:49.190 --> 00:11:53.830 think? Talk about the scope of all that and where 00:11:53.830 --> 00:11:57.169 NAVREV sits in on that. Yeah, so it's a great 00:11:57.169 --> 00:11:59.360 question. And what I would say is, You know, 00:11:59.500 --> 00:12:03.820 that $984 million that you cited, that actually 00:12:03.820 --> 00:12:06.860 doesn't even include extramural funding, which 00:12:06.860 --> 00:12:10.419 is what NAVREF really supports. So on top of 00:12:10.419 --> 00:12:14.419 that $984 million, our members facilitate annually 00:12:14.419 --> 00:12:18.710 upwards of $300 million a year. on clinical research. 00:12:19.129 --> 00:12:20.830 So the way that I say it just to make it easy 00:12:20.830 --> 00:12:23.029 is about one in every three dollars that the 00:12:23.029 --> 00:12:25.909 VA is spending on research is actually coming 00:12:25.909 --> 00:12:27.990 from an external partner, right? It's a place 00:12:27.990 --> 00:12:31.710 like the NIH. DOD is increasingly investing in 00:12:31.710 --> 00:12:34.309 the VA for research as it relates to service 00:12:34.309 --> 00:12:37.740 member health. the pharmaceutical industry, biotech 00:12:37.740 --> 00:12:40.240 sector is increasingly coming to us saying, hey, 00:12:40.379 --> 00:12:42.399 we really want to leverage data, we really want 00:12:42.399 --> 00:12:45.340 to work with you, state and local governments, 00:12:46.159 --> 00:12:48.500 philanthropy. So places like the prostate cancer 00:12:48.500 --> 00:12:52.139 foundation made a historic $50 million investment 00:12:52.139 --> 00:12:54.539 into VA research over the last few years. And 00:12:54.539 --> 00:12:57.240 so, you know, it's, you're right. I think it's 00:12:57.240 --> 00:12:59.259 when people often say like, so tell me what's 00:12:59.259 --> 00:13:02.039 going on in VA research. I say it's my most favorite 00:13:02.039 --> 00:13:04.600 and hardest question to get because it's It's 00:13:04.600 --> 00:13:07.059 almost easier to say what's not happening in 00:13:07.059 --> 00:13:10.399 VA research, right? There's just so many opportunities 00:13:10.399 --> 00:13:13.220 and fields of study. Now, what I will say, what 00:13:13.220 --> 00:13:16.080 the VA has done, I think, over the last five 00:13:16.080 --> 00:13:20.019 to 10 years is really making sure that they're 00:13:20.019 --> 00:13:23.750 focused in on those issues that are most impacting 00:13:23.750 --> 00:13:26.750 veteran populations. And so VA's Office of Research 00:13:26.750 --> 00:13:29.210 and Development has really taken on an enterprise 00:13:29.210 --> 00:13:31.590 optimization plan where they're really ensuring 00:13:31.590 --> 00:13:34.029 that those resources are going to the areas where 00:13:34.029 --> 00:13:36.309 we know veterans are really struggling, right? 00:13:36.309 --> 00:13:38.950 Areas like mental health, behavioral health, 00:13:39.149 --> 00:13:42.970 suicide prevention, traumatic brain injury, PTSD. 00:13:43.879 --> 00:13:48.700 cancer, aging, dementia. So it's really, really 00:13:48.700 --> 00:13:51.259 fascinating to be able to take a step back and 00:13:51.259 --> 00:13:53.139 look at what's possible. And then I think, you 00:13:53.139 --> 00:13:54.919 know, from the perspective of NAVRA, because 00:13:54.919 --> 00:13:57.559 we sort of sit in this bridge with the public 00:13:57.559 --> 00:14:00.779 and private sector, where does it make sense 00:14:00.779 --> 00:14:03.700 for the private sector to really leverage the 00:14:03.700 --> 00:14:06.620 VA for the testing of new drugs? So like cancer 00:14:06.620 --> 00:14:09.860 is perhaps the oncology program is perhaps the 00:14:09.860 --> 00:14:12.919 biggest area of interest right because we know 00:14:12.919 --> 00:14:15.399 that veterans have a higher incidence and prevalence 00:14:15.399 --> 00:14:18.799 of cancer um either as a result of their military 00:14:18.799 --> 00:14:21.980 service or as a result of other factors um so 00:14:21.980 --> 00:14:24.039 places you know it's a great place to come and 00:14:24.039 --> 00:14:26.240 study things like lung cancer prostate cancer 00:14:26.240 --> 00:14:28.899 we have such higher rates of that unfortunately 00:14:28.899 --> 00:14:31.779 within the veteran population and so oftentimes 00:14:31.779 --> 00:14:34.740 you have a lot of interest from the manufacturers 00:14:34.740 --> 00:14:36.940 and the drug developers of those cures and of 00:14:36.940 --> 00:14:39.320 those life -saving interventions to really want 00:14:39.320 --> 00:14:42.559 to come to the VA and figure out how can we design 00:14:42.559 --> 00:14:44.759 these interventions to really best serve the 00:14:44.759 --> 00:14:50.019 veteran community. For those of us in the veterans 00:14:50.019 --> 00:14:54.000 world and are familiar with terms like presumptive 00:14:54.000 --> 00:14:59.870 conditions, Parkinson's, ALS, And we've had the 00:14:59.870 --> 00:15:03.110 chance on Veterans Radio to talk to the leaders 00:15:03.110 --> 00:15:07.409 of the Parkinson's Foundation and the ALS Foundation 00:15:07.409 --> 00:15:13.110 about how they help veterans. But part of this 00:15:13.110 --> 00:15:16.730 is sort of, it's that swinging door between civilian 00:15:16.730 --> 00:15:24.100 population and veteran population. Do you see 00:15:24.100 --> 00:15:27.519 the push being pushing out from VA or pulling 00:15:27.519 --> 00:15:31.340 in from VA on those kind of issues? Yeah, and 00:15:31.340 --> 00:15:33.860 I think that tends to be one of the biggest questions 00:15:33.860 --> 00:15:37.720 right now, really, is it really comes down to 00:15:37.720 --> 00:15:40.279 where people are accessing their care and how 00:15:40.279 --> 00:15:42.259 they're able to connect back to some of these 00:15:42.259 --> 00:15:45.539 benefits that they really only get at the VA. 00:15:47.080 --> 00:15:49.100 I think it's, you know, one of the things that 00:15:49.100 --> 00:15:51.019 I think is really interesting about all of this 00:15:51.019 --> 00:15:54.799 is, you know, the bedrock of VA research is really 00:15:54.799 --> 00:15:57.960 rooted in partnerships. And that partnership 00:15:57.960 --> 00:16:01.539 is really between leading academic medical centers 00:16:01.539 --> 00:16:05.159 and the VA. You know, as is often quoted, the 00:16:05.159 --> 00:16:08.399 VA trains more than 70 % of the nation's doctors, 00:16:08.399 --> 00:16:12.250 right. And so the benefit of this system not 00:16:12.250 --> 00:16:14.330 only do you have veterans, I think, moving in 00:16:14.330 --> 00:16:16.210 and out of the system, we also have providers 00:16:16.210 --> 00:16:18.389 moving in and out of the system, right? Chances 00:16:18.389 --> 00:16:20.789 are if you're at the VA in Durham, you're doing 00:16:20.789 --> 00:16:23.090 some sort of appointment or seeing patients at 00:16:23.090 --> 00:16:26.669 Duke as well. And so it's allowed not only, so 00:16:26.669 --> 00:16:28.909 I think not only as patients are moving in and 00:16:28.909 --> 00:16:31.570 out of the system, you also have this movement 00:16:31.570 --> 00:16:33.850 of providers, which has allowed the VA to bring 00:16:33.850 --> 00:16:36.169 in the best and brightest of academic medicine 00:16:36.169 --> 00:16:39.169 to treat veterans. I think as veterans are seeking 00:16:39.169 --> 00:16:41.639 out care in the community, I'll be honest, I 00:16:41.639 --> 00:16:43.340 don't think that's going anywhere. I think when 00:16:43.340 --> 00:16:45.580 you sort of see what's happening with the budget 00:16:45.580 --> 00:16:48.139 and in the news, I think community care is an 00:16:48.139 --> 00:16:50.679 element that's gonna be here for a bit. So what 00:16:50.679 --> 00:16:53.279 I think we're really focused on is how are we 00:16:53.279 --> 00:16:55.419 working with those community care providers and 00:16:55.419 --> 00:16:58.159 those systems so that. when a veteran goes out 00:16:58.159 --> 00:17:00.320 into the community to seek care and maybe, you 00:17:00.320 --> 00:17:02.720 know, something happens on a lung cancer screening 00:17:02.720 --> 00:17:04.660 or something happens with the breast cancer screen, 00:17:04.799 --> 00:17:07.000 how are they connected back to the VA so that 00:17:07.000 --> 00:17:09.119 they can still be enrolled and connected with 00:17:09.119 --> 00:17:11.400 all these research opportunities that they're 00:17:11.400 --> 00:17:13.759 really only going to get at the VA? Yeah, there 00:17:13.759 --> 00:17:16.339 are some things VA does much better than the 00:17:16.339 --> 00:17:20.480 civilian population because it's its cohort of 00:17:20.480 --> 00:17:24.869 patients have a higher incident of that. thing, 00:17:25.569 --> 00:17:28.230 and therefore they are more experienced, more 00:17:28.230 --> 00:17:31.170 trained, more focused on recognizing it. We're 00:17:31.170 --> 00:17:34.990 talking to Rashi Romanov, CEO of National Association 00:17:34.990 --> 00:17:37.890 of Veterans Research and Education Foundation, 00:17:38.470 --> 00:17:42.410 better known as NAVREF, N -A -V -R -E -F. Put 00:17:42.410 --> 00:17:44.569 a dot org on that and you can find the website. 00:17:44.869 --> 00:17:49.769 How did a nice Pittsburgh girl like you end up 00:17:49.769 --> 00:17:54.480 so focused on a veteran healthcare and research 00:17:54.480 --> 00:17:58.019 issues? Yeah, great question. If you would have 00:17:58.019 --> 00:18:01.059 told me 20 years ago that this is what I'd be 00:18:01.059 --> 00:18:03.660 doing, actually, I don't know. I don't know that 00:18:03.660 --> 00:18:07.079 I would totally believe it. But I think going 00:18:07.079 --> 00:18:10.680 through grad school, going through all the formal 00:18:10.680 --> 00:18:13.819 training, I knew I wanted to do something around 00:18:13.819 --> 00:18:16.859 impacting healthcare. Honestly thought I might 00:18:16.859 --> 00:18:20.230 end up at a place doing more global health care, 00:18:20.509 --> 00:18:23.369 global women's health, things like that. And 00:18:23.369 --> 00:18:25.250 when I was a presidential management fellow, 00:18:25.410 --> 00:18:27.269 just going through a job fair, if you can believe 00:18:27.269 --> 00:18:30.369 it, in DC, met someone at the VA, and they said, 00:18:30.490 --> 00:18:32.369 hey, so what are you interested in? And I said, 00:18:32.410 --> 00:18:34.369 I really want to work in health care, but I want 00:18:34.369 --> 00:18:35.950 the work to make a difference. I want to be able 00:18:35.950 --> 00:18:37.789 to feel the impact. And they said, well, have 00:18:37.789 --> 00:18:39.250 you ever thought about working at the VA? And 00:18:39.250 --> 00:18:41.230 I'll be honest, like many Americans, I was like, 00:18:41.250 --> 00:18:43.089 I didn't really know that much about the VA. 00:18:43.519 --> 00:18:45.960 I did not come from a military family, so it 00:18:45.960 --> 00:18:48.079 was a bit of a black box to me, which I think 00:18:48.079 --> 00:18:50.420 is helpful now at this job when you think about 00:18:50.420 --> 00:18:53.460 explaining this to other partners. And so when 00:18:53.460 --> 00:18:55.880 I started to think about it, you know... largest 00:18:55.880 --> 00:18:58.220 integrated healthcare system in the world, the 00:18:58.220 --> 00:19:01.339 ability, and it's a national leader. If you figure 00:19:01.339 --> 00:19:04.220 something out in the VA, it is going to become 00:19:04.220 --> 00:19:07.759 a national if not global standard. And the ability 00:19:07.759 --> 00:19:10.279 to transform healthcare policy and the delivery 00:19:10.279 --> 00:19:13.180 of healthcare at that level for a population 00:19:13.180 --> 00:19:16.180 that has so earned the highest quality of healthcare. 00:19:16.299 --> 00:19:18.940 I can't think of another patient population in 00:19:18.940 --> 00:19:22.259 the country that deserves the highest quality 00:19:22.259 --> 00:19:24.299 of healthcare than our service members and veterans. 00:19:24.720 --> 00:19:26.960 It just sort of checked all the boxes, and I 00:19:26.960 --> 00:19:29.420 think the ability, and I think there's also, 00:19:29.440 --> 00:19:31.460 I'll just say this, I think particularly in this 00:19:31.460 --> 00:19:33.440 environment that we're living in in Washington, 00:19:34.819 --> 00:19:37.619 I often say this feels like the last bastion 00:19:37.619 --> 00:19:42.619 of an issue that has wide bipartisan support. 00:19:42.900 --> 00:19:44.799 One of the things I used to say at the VA, which 00:19:44.799 --> 00:19:46.859 still stands true about working in this space, 00:19:47.220 --> 00:19:49.579 I love that you don't really know the political 00:19:49.579 --> 00:19:51.619 affiliation of anyone you're working with in 00:19:51.619 --> 00:19:55.230 these circles because, everyone is so hyper focused 00:19:55.230 --> 00:19:57.609 on serving veterans and serving their families. 00:19:57.970 --> 00:20:00.950 And I can't think of a better North Star when 00:20:00.950 --> 00:20:04.470 you're going to work every day. And so it's really 00:20:04.470 --> 00:20:06.710 honestly reassuring to work in a space where 00:20:06.710 --> 00:20:08.609 not only you feel like you can have an impact, 00:20:08.670 --> 00:20:11.730 but there's such wide support around doing the 00:20:11.730 --> 00:20:14.509 right thing and wanting to get this right and 00:20:14.509 --> 00:20:16.490 knowing that getting it right is of critical 00:20:16.490 --> 00:20:18.970 importance that it makes partnership so much 00:20:18.970 --> 00:20:21.720 easier. Well, let's transition from there. It's 00:20:21.720 --> 00:20:24.740 a good jumping off point because Research is 00:20:24.740 --> 00:20:28.359 a long game and we've just talked about VA has 00:20:28.359 --> 00:20:31.920 been at it for a hundred years as Never have 00:20:31.920 --> 00:20:35.299 looks into the future for research. There are 00:20:35.299 --> 00:20:39.259 certainly economic concerns But talk about why 00:20:39.259 --> 00:20:41.720 this is so important in the in the long game 00:20:41.720 --> 00:20:45.920 aspect of it Absolutely. So I love that research 00:20:45.920 --> 00:20:47.859 is a long game. I think I'm probably going to 00:20:47.859 --> 00:20:50.660 steal it. It is a long game, and it's a team 00:20:50.660 --> 00:20:53.079 sport. That's our other line that we say. You 00:20:53.079 --> 00:20:57.140 need a lot of different entities supporting and 00:20:57.140 --> 00:21:00.119 rowing in the right direction for biomedical 00:21:00.119 --> 00:21:05.109 research to really be successful. When you talk 00:21:05.109 --> 00:21:06.950 about, I'll give you one example of something 00:21:06.950 --> 00:21:08.849 that shows that research is a long game at the 00:21:08.849 --> 00:21:12.890 VA. Back in the 80s, and the New York Times recently 00:21:12.890 --> 00:21:14.950 published on this, so I'll give credit to them. 00:21:16.009 --> 00:21:18.450 But back in the 80s, there was a VA researcher 00:21:18.450 --> 00:21:22.210 at the Bronx who was doing all this work on lizards 00:21:22.210 --> 00:21:24.349 and lizard venom, right? And it was this really 00:21:24.349 --> 00:21:26.349 interesting story of, okay, why are they doing 00:21:26.349 --> 00:21:28.150 lizard? And they were saying, essentially the 00:21:28.150 --> 00:21:30.029 premise being, you don't really see a lot of 00:21:30.029 --> 00:21:31.849 overweight lizards. I wonder what's going on 00:21:31.849 --> 00:21:34.490 here. I wonder what's happening in sort of their 00:21:34.490 --> 00:21:37.109 biology and in their systems to allow all this 00:21:37.109 --> 00:21:40.210 to happen. They did all this work. They got lizard 00:21:40.210 --> 00:21:43.150 venom. They isolated all these compounds. Fast 00:21:43.150 --> 00:21:46.730 forward, this VA researcher at the Bronx isolated 00:21:46.730 --> 00:21:51.250 the GLP -1 compound via lizard venom. Can I stop 00:21:51.250 --> 00:21:53.650 you there because it would be so easy to look 00:21:53.650 --> 00:21:56.630 at lizard research and call it fraud, waste, 00:21:56.670 --> 00:22:00.009 and abuse. Absolutely. Absolutely. You have to 00:22:00.009 --> 00:22:02.170 keep the long game in mind in research. It's 00:22:02.170 --> 00:22:05.630 a long game. And the reporting is really great. 00:22:05.750 --> 00:22:08.289 And it was interesting because there's a line 00:22:08.289 --> 00:22:11.210 in there. Now, I will say wearing my VA hat, 00:22:11.250 --> 00:22:13.369 there's a line in there where the researcher 00:22:13.369 --> 00:22:15.089 actually brought it to the VA and said, hey, 00:22:15.150 --> 00:22:17.069 I think there's something here. And there's one 00:22:17.069 --> 00:22:18.750 line in the article that said the VA was like, 00:22:18.750 --> 00:22:20.710 oh, I'm not sure that there's a benefit here 00:22:20.710 --> 00:22:24.130 to veterans. And then fast forward, the GLP -1 00:22:24.130 --> 00:22:28.160 is Ozempic, Wigoby, like all these. different 00:22:28.160 --> 00:22:31.059 medications around diabetes and weight loss, 00:22:31.079 --> 00:22:32.920 and is really transforming how we're thinking 00:22:32.920 --> 00:22:36.059 about chronic care management in the United States. 00:22:36.279 --> 00:22:38.900 And so an example of something that started as 00:22:38.900 --> 00:22:43.460 maybe an isolated project in the 90s, now 20, 00:22:43.460 --> 00:22:46.339 30 years later, having this huge impact in how 00:22:46.339 --> 00:22:48.880 we think about diabetes is fascinating. So it 00:22:48.880 --> 00:22:51.319 is a long game. One of the interesting things 00:22:51.319 --> 00:22:58.119 too about VA health care and VA research is the 00:22:58.119 --> 00:23:00.920 world of clinical trials. And I don't think the 00:23:00.920 --> 00:23:04.279 general public, most veterans understand kind 00:23:04.279 --> 00:23:07.180 of what clinical trials are about and why that's 00:23:07.180 --> 00:23:12.859 so important as a segment of VA managed care. 00:23:12.940 --> 00:23:17.440 Can you talk from NAVRAF standpoint about clinical 00:23:17.440 --> 00:23:20.440 trials and the value? Yeah, absolutely. And I 00:23:20.440 --> 00:23:21.700 think, you know, if there's one thing, I think 00:23:21.700 --> 00:23:25.130 the beginning of 2025 is really showed us, and 00:23:25.130 --> 00:23:27.470 this is, I think, beyond just the VA veteran 00:23:27.470 --> 00:23:30.329 space, is that I think the world of research 00:23:30.329 --> 00:23:32.509 has to do a better job of explaining what it 00:23:32.509 --> 00:23:35.130 is they do. I think there's a lot of things that 00:23:35.130 --> 00:23:37.309 people don't understand about how all of this 00:23:37.309 --> 00:23:41.029 is organized. And so I will say, for the purposes 00:23:41.029 --> 00:23:45.690 of clinical trials in the VA, access to clinical 00:23:45.690 --> 00:23:48.589 trials and clinical research is a fundamental 00:23:48.589 --> 00:23:52.569 component of high quality care. There has been 00:23:52.569 --> 00:23:54.970 research that's been published that says institutes 00:23:54.970 --> 00:23:58.029 and research centers that are doing research 00:23:58.029 --> 00:24:01.630 have higher quality of care output, right? A 00:24:01.630 --> 00:24:03.670 big part of it. So, you know, what I often say 00:24:03.670 --> 00:24:06.450 to civilian populations is if, God forbid, somebody 00:24:06.450 --> 00:24:08.890 gets really sick and they say, okay, where do 00:24:08.890 --> 00:24:10.609 you want to go? People might say, oh, I want 00:24:10.609 --> 00:24:12.529 to try to get to the Mayo Clinic. I want to try 00:24:12.529 --> 00:24:14.910 to get to the Cleveland Clinic. St. Jude's is 00:24:14.910 --> 00:24:16.750 a really good example in the pediatric space. 00:24:16.990 --> 00:24:18.829 When you dig into that and you say, well, why 00:24:18.829 --> 00:24:21.289 those places and it's usually oh well they have 00:24:21.289 --> 00:24:23.470 doctors there that will get me into some trial 00:24:23.470 --> 00:24:26.170 or some life -saving medication right and that 00:24:26.170 --> 00:24:28.250 is exactly how we should be thinking about the 00:24:28.250 --> 00:24:33.049 VA. So not only clinical trials are the opportunities 00:24:33.049 --> 00:24:35.549 for veterans and patients to be able to access 00:24:35.549 --> 00:24:39.450 new emerging treatments, new emerging therapeutics. 00:24:39.710 --> 00:24:41.710 Some of these new drugs, when you think about 00:24:41.710 --> 00:24:44.690 things like radiation oncology, may allow you 00:24:44.690 --> 00:24:47.529 to defer things like surgery or painful chemotherapy. 00:24:47.730 --> 00:24:49.529 There's newer therapies that are available that 00:24:49.529 --> 00:24:51.910 might suit the veteran and the patient and their 00:24:51.910 --> 00:24:55.329 family more adequately. Drugs that have a higher 00:24:55.329 --> 00:24:58.650 efficacy rate, higher likelihood of being successful. 00:24:58.829 --> 00:25:01.230 So there's a lot there in terms of the benefits 00:25:01.230 --> 00:25:03.730 to the patient. What I'll also say, and this 00:25:03.730 --> 00:25:06.730 is a bit more of a systems thinking, but research 00:25:06.730 --> 00:25:09.650 is also one of the most compelling things we 00:25:09.650 --> 00:25:12.900 have to offer. providers and young physicians 00:25:12.900 --> 00:25:16.400 that are looking for places to come. Oftentimes, 00:25:16.539 --> 00:25:18.640 when it comes to recruitment, being able to say, 00:25:18.819 --> 00:25:20.619 you know, not only can you come here and be, 00:25:20.619 --> 00:25:23.180 you know, a clinician and see patients or an 00:25:23.180 --> 00:25:25.519 oncologist, but you will also be able to access 00:25:25.519 --> 00:25:28.700 all of this data and do cutting edge research 00:25:28.700 --> 00:25:31.119 and publish papers and transform care. That's 00:25:31.119 --> 00:25:33.200 why a lot of physicians and clinician scientists 00:25:33.200 --> 00:25:35.140 get into this field, right? They want to find 00:25:35.140 --> 00:25:39.420 cures to these diseases. And so not addressing 00:25:39.420 --> 00:25:42.230 sort of the connection of all this stuff to, 00:25:42.309 --> 00:25:44.410 you know, research isn't a nice to have. It's 00:25:44.410 --> 00:25:46.630 a critical component of high quality care. But 00:25:46.630 --> 00:25:49.190 from a systems angle, without research, being 00:25:49.190 --> 00:25:52.869 able to recruit physicians and nurses and all 00:25:52.869 --> 00:25:55.269 these, it's going to become much, much more challenging 00:25:55.269 --> 00:26:00.269 for the VA. Well, and you, if a doctor or a scientist 00:26:00.269 --> 00:26:03.990 in that realm wants to have the opportunity to 00:26:04.460 --> 00:26:07.900 be challenged and use their scientific creativity 00:26:07.900 --> 00:26:12.119 to something useful. That's why it's a great 00:26:12.119 --> 00:26:15.880 recruiting tool. When we've talked to researchers 00:26:15.880 --> 00:26:18.799 and doctors at the VA, oftentimes they're saying, 00:26:18.980 --> 00:26:21.559 well, okay, let me give you the phone number 00:26:21.559 --> 00:26:24.700 or the email address where you can link up and 00:26:24.700 --> 00:26:28.470 see if you qualify for the clinical trial. One 00:26:28.470 --> 00:26:32.349 of the things VA Scope does, it's really a national 00:26:32.349 --> 00:26:35.829 scope, so we do these, and somebody from California 00:26:35.829 --> 00:26:38.349 can get in, or Maine, or Florida, or Alaska, 00:26:39.130 --> 00:26:42.529 which you may not get in a more localized healthcare 00:26:42.529 --> 00:26:44.950 practice. So I always found that kind of interesting 00:26:44.950 --> 00:26:48.049 that, hmm, there's a pretty big reach on this, 00:26:48.109 --> 00:26:50.549 isn't there? Absolutely. And you know, I often 00:26:50.549 --> 00:26:53.349 say VA made investments into things like telehealth 00:26:53.349 --> 00:26:57.049 back in the 90s when it was not the sexy thing 00:26:57.049 --> 00:26:59.109 to be thinking about. They invented things like 00:26:59.109 --> 00:27:01.250 the electronic medical record when it was not 00:27:01.250 --> 00:27:04.690 the trend hot item to think about. And so The 00:27:04.690 --> 00:27:08.109 result is that now, 20, 30 years later, there's 00:27:08.109 --> 00:27:11.890 such a robust technological infrastructure. So 00:27:11.890 --> 00:27:15.269 things like VA's tele -oncology programs here, 00:27:15.670 --> 00:27:18.009 they're sort of headquartered in Durham, but 00:27:18.009 --> 00:27:20.490 the physicians working on that are seeing patients 00:27:20.490 --> 00:27:24.200 all over the country via telehealth. In what 00:27:24.200 --> 00:27:26.980 other system is that possible for you to be able 00:27:26.980 --> 00:27:30.160 to get the best and brightest of, you know, cancer 00:27:30.160 --> 00:27:33.460 leadership and cancer expertise in a small town 00:27:33.460 --> 00:27:35.940 potentially in, you know, North Dakota via telehealth? 00:27:36.059 --> 00:27:39.119 It's just, it's amazing. Well, we really appreciate 00:27:39.119 --> 00:27:41.460 the time you've given us today, Rashi Romanoff, 00:27:41.539 --> 00:27:45.019 CEO of Navref. If people want to know more, and 00:27:45.019 --> 00:27:48.279 maybe we're going to get a couple of VA researchers 00:27:48.279 --> 00:27:52.180 say, yeah, maybe I should join up, or corporate 00:27:52.180 --> 00:27:54.799 partners, where do they go to get some more information? 00:27:55.380 --> 00:27:57.799 Absolutely. So we always direct everyone, come 00:27:57.799 --> 00:28:02.650 to our website. www .NAVREF .org, N -A -V -R 00:28:02.650 --> 00:28:06.990 -E -F. Reach out there, email our team if you 00:28:06.990 --> 00:28:09.369 want to get connected about ways to learn about 00:28:09.369 --> 00:28:12.430 how you can get involved in VA research. We have 00:28:12.430 --> 00:28:14.869 a number of resources available on our website 00:28:14.869 --> 00:28:18.789 around things for PIs and researchers who are 00:28:18.789 --> 00:28:20.710 trying to learn more about extramural research 00:28:20.710 --> 00:28:23.400 ways to get involved. Just reach out to us. If 00:28:23.400 --> 00:28:25.240 you're a veteran who's interested in learning 00:28:25.240 --> 00:28:28.259 more about research, also let us know. Things 00:28:28.259 --> 00:28:30.579 like the Million Veteran Program are always looking 00:28:30.579 --> 00:28:33.180 for people to get involved. And if you're really 00:28:33.180 --> 00:28:34.920 passionate about research or want to learn more, 00:28:35.059 --> 00:28:37.660 we're happy to connect you locally to some advocates 00:28:37.660 --> 00:28:39.740 that can really help get you connected into these 00:28:39.740 --> 00:28:43.039 trials. Well, NAVRF's doing very important work 00:28:43.039 --> 00:28:45.880 supporting the work that VA is doing in research, 00:28:45.980 --> 00:28:48.259 which is very important work. Sureshya, thank 00:28:48.259 --> 00:28:50.180 you for the time that you've given to Veterans 00:28:50.180 --> 00:28:52.500 Radio today. Thank you so much, Jim. It was great 00:28:52.500 --> 00:28:55.079 to be here. And I want to thank everybody for 00:28:55.079 --> 00:28:58.380 listening to Veterans Radio today. I am Jim Fossone. 00:28:58.980 --> 00:29:01.240 It's been a pleasure to be your host. I'm a Veterans 00:29:01.240 --> 00:29:03.960 disability lawyer at Legal Help for Veterans 00:29:03.960 --> 00:29:11.079 and you can reach us at 800 -693 -4800 or legalhelpforveterans 00:29:11.079 --> 00:29:14.289 .com on the web. You can follow Veterans Radio 00:29:14.289 --> 00:29:17.589 on Facebook and listen to its podcasts and internet 00:29:17.589 --> 00:29:22.069 radio shows by visiting us at veteransradio .org. 00:29:22.309 --> 00:29:25.710 That's veteransradio .org. We would again want 00:29:25.710 --> 00:29:28.690 to thank our national sponsors, the National 00:29:28.690 --> 00:29:32.630 Veterans Business Development Council, nvbdc 00:29:32.630 --> 00:29:37.710 .org. 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