The Mission of the Richmond Institute for Veterans Research (RIVR) is to conduct cutting-edge research and support educational activities, working to find novel treatments for illnesses and supporting the Richmond VAMC in becoming the nationally renowned Center for Veterans Research.
By working toward this mission, we will improve the lives of ALL who have served our nation.
The Richmond Institute for Veterans Research, formerly known as McGuire Research Institute, Inc., is a 501(c)(3) not-for-profit organization, created to fund research and education at the Richmond VA Medical Center (VAMC). Established by the Veteran Affairs Central Office in 1989, RIVR has been the organization at the forefront of scientific discovery at the Richmond VAMC for 33 years.
This remarkable public-private partnership of RIVR and the Richmond VAMC provides the financial framework to empower all VA investigators and staff to carry out state-of-the-art pre-clinical and clinical research. Contributions to RIVR, a 501(c)(3) organization, provide the necessary funding to learn about diseases and their mechanisms and develop innovative diagnostic tools and therapies for the important work of the medical team serving the Veteran population.
Every day we strive to ensure the Richmond VAMC retains a national reputation as the premier resource for exceptional veteran patient care and groundbreaking research.
WHAT WE DO
We currently support over 100 Veteran Affairs research projects as well as the educational endeavors of our Principal Investigators. Our principal investigators focus their efforts on carrying out studies to develop and verify knowledge relating to the causes, diagnosis, treatment, and prevention of disease.
CURRENT AREAS OF RESEARCH
Traumatic Brain Injury (TBI)
Post-traumatic Stress (PTSD)
Depression and Suicide
Pain Management / substance abuse
Spinal Cord Injury & rehabilitation
Cancer / Radiation Oncology
Diabetic Kidney Disease
Chronic Kidney Disease
Hepatitis C & Non-alcoholic Steatohepatitis (NASH)
Infectious Disease / COVID-19
Parkinson's Disease / Dementia / Multiple Sclerosis.
Cholesterol & Lipids
MAJOR AREAS OF RESEARCH & INNOVATION
PAIN CONTROL / SUBSTANCE ABUSE
To combat the opioid epidemic, our investigators are testing new treatments including special nerve and spinal cord stimulators, mobile applications using artificial intelligence and deploy virtual reality tools to prevent, improve and/or eliminate opioid dependence for their low back and other chronic pain.
Our mental health researchers conduct innovative research projects aimed at understanding cognitive and psychosocial consequences of traumas like spinal cord injury, traumatic brain injury, PTSD, or chronic pain. These projects are designed to impact cognitive ability and mood / health behavior in illnesses frequently affecting Veterans such as substance use disorder (SUD), post-traumatic stress disorder (PTSD) and suicide as well as predict which Veterans are at high risk for poor outcomes.
Interventional studies are exploring new cognitive therapies and alternative approaches such as yoga, biofeedback, or telehealth to treat PTSD and/or SUD, including delivery of psychoeducation by virtual reality.
In addition, our VA participates recruiting Veterans for VA Mid-Atlantic MIRECC Center, dedicated to developing novel clinical, educational, and research resources to address post- deployment and TBI mental illness and related problems.
TRAUMATIC BRAIN INJURY (TBI)
Our investigators lead The Long-Term Impact of Military-relevant Brain Injury Consortium & Chronic Effects of Neurotrauma Consortium (LIMBIC-CENC), currently in its second decade of research activities with 11 ongoing studies to understand the short-and long-term recovery and health status outcomes of combat-exposed service members and Veterans, using Big Data analyses on a 2.5 million participant curated VINCI dataset and a longitudinal group of more than 2,700 highly characterized service members and Veterans with combat exposures, including TBI, PTSD and pain related issues. [www.LIMBIC-CENC.ORG].
REHABILITATION (Spinal cord injury, TBI, Amputation, Assistive Technology, PTSD, Pain, Addictions)
Together with clinical rehabilitation engineers and the Advanced Manufacturing hub at the Richmond VAMC for 3D printing, our investigators are developing tools and assistive technologies that improve quality of life and daily living of Veterans with a wide range of disabilities. We also are part of the federal TBI model systems program (21 linked Veteran and civilian academic centers with a 35-year longitudinal cohort), the federal spinal cord injury (SCI) Model Systems program (14 linked academic centers with a 40-year longitudinal cohort), an Osseous-Integration Amputation program, SCI exoskeleton and electrical stimulation programs, a prospective, longitudinal PTSD group, and psychological assessments of pain and addictions research programming. [www.PMR.VCU.EDU/Research/]
BRAIN / NEUROLOGIC DISORDERS
Our investigators are working on developing new therapies / devices and surgical techniques to treat different brain disorders such as epilepsy, Parkinson’s, multiple sclerosis, and dementia. Moreover, our researchers are incorporating portable CT scanning while improving new surgical techniques to improve Deep Brain stimulation surgery.
Our Cancer Program is a referral center serving over 800 newly diagnosed cancer patients annually with over 6000+ cancer survivors including those exposed to cardiotoxic anti-cancer therapy. Our cancer researchers continue to investigate mechanisms, but most importantly develop novel cures for many cancers affecting our Veterans. The Richmond VA Cancer Center actively participates in multicenter clinical trials to study therapies in cancer and metastasis to improve the lives of many Veterans with cancer.
ENDOCRINOLOGY / OSTEOPOROSIS
Our investigators have and continue to study changes in bone loss (osteoporosis) in Veterans with and without combat related injuries. Supported by NASA, our investigators are developing novel magnetic resonance imaging (MRI) techniques to assess bone loss in patients with spinal cord injury (SCI). This is of special interest to NASA since bone loss in SCI patients can serve as a model of space flight induced bone loss in astronauts during future extended missions to MARS.
As is a referral center for arrhythmias, cardiac devices and heart transplantation, the Richmond VAMC actively participates in multicenter clinical trials to find new drug and device therapies to prevent and better treat Veterans with coronary heart disease, heart failure and arrhythmias.
Our investigators continue to study the consequences of irregular heart rhythms. These studies are key to understanding the mechanisms of heart injury as well as identifying patients at risk of cardiac problems and finding alternative therapies to improve quality of life and survival.
COVID-19 AND INFECTIOUS DISEASE
Our investigators have and continue to participate in multicenter trials of COVID-19 to find new treatments to improve survival and post-COVID syndrome. Together with the LIMIBIC-CENC group, researchers are working to establish biomarkers and neuroimaging to evaluate the long-term impact of COVID-19 infections in a cohort of well-characterized, U.S. combat Veterans with well-delineated COVID-19 exposures and infections and combat-related injuries.
GASTRO-INTESTIONAL & LIVER DISEASE
Our ongoing basic and clinical researchers continue to study illnesses frequently affecting Veterans such as non-alcoholic steatohepatitis (NASH), fatty liver disease (NAFLD), cirrhosis and inflammatory bowel disease. Our investigators have established a metabolic clinic to address the most efficient way to clinically diagnose and treat NAFLD, uncovered the likely cause that can lead to new treatment pathways, while continuing to investigate novel treatments for inflammatory bowel disease with one of the largest clinical trial centers in the state of Virginia. Together with industry partners, we are developing digital therapeutics, devices and improve AI for early diagnosis of cancer.
One of our local investigators leads The North American Consortium for Study of End-stage Liver Disease 17 centers North American (NACSELD) and CLEARED worldwide (98 centers worldwide) consortia for Cirrhosis that continues to identify disparities, risk factors and treatment outcomes. This represents leading edged research by national and internationally known investigators.
WOMEN'S HEALTH RESEARCH
Our VA clinical researchers are directly participating with The Women’s Health Practice Based VA Research Network. Investigators are participating in a multisite trial evaluating a personalized individual risk-based approach to breast cancer screening to achieve better acceptance and prevention in the Veteran women. The Richmond VAMC is one of the few centers studying the rollout of newly implemented primary HPV testing as cervical cancer screening. Our investigators are also assessing the differences in access to minimally invasive surgery for a gender-neutral vs. gender-specific operations through national database work and actively enrolling in studies to better understand the veteran-perceived relationship of Military Sexual Trauma and Pelvic Floor disorders to improve screening, diagnosis, and treatment for these conditions.
THE VA INFORMATICS NETWORK AND COMPUTING INFRASTRUCTURE (VINCI)
Together with VINCI, providing access and tools of one of the largest long-term integrated national clinical civilian and Veteran datasets, our investigators attempt to improve the healthcare of Veteran by identifying populations at risk, disease trends, improve and identify the best treatment strategies, as well as implementation of new diagnostic tools and treatments for many diseases affecting Veterans.
NATURAL LANGUAGE PROCESSING / ARTIFICAL INTELLIGENCE
Collaborating with industry leaders to develop healthcare solutions for providers and patients alike by setting the focus on the patient instead of the computer and allowing for high end speech recognition with the help of AI to create a structured medical note, prepare the document and visit for coding and even automate billing.
MILLION VETERAN PROGRAM (MVP)
Our investigators are actively enrolling Veterans in MVP, a national research program that will help us learn how genes, lifestyle and military exposure affect heath and illness in Veterans, such as cancer, opioid dependence, depression, Parkinson’s, dementia, cardiac sudden death, heart failure, liver and many others.
The Richmond Institute for Veterans Research is on a mission to better the lives of veterans—today and for generations to come. Every day we strive to empower all our VA investigators and staff to achieve groundbreaking research, to discover mechanisms of disease, and to revolutionize new diagnostic tools and therapies.
Below are our defined objectives and strategies for reaching our goals, which can only be achieved with your help. Our goals are ambitious as the world of medical research is uncertain.
IMPROVING THE LIVES OF VIRGINIA'S VETERANS
At RIVR, our foremost priority is a commitment to improving the lives of Virginia’s Veterans and their loved ones through research, innovation, and education. Serving those who have served our country is paramount in our actions and work.
We strive to develop and deliver compassionate and personalized treatments for each individual and enhance the medical experience for all Veteran patients.
The Richmond VAMC provides a unique and specialized care for many Veterans across the country and the region, including:
TBI / Spinal Cord Injury / brain disorders and Rehabilitation.
Mental Health and pain management.
Cancer diagnosis and treatment including radiation oncology.
Cardiovascular therapies include arrhythmias (atrial fibrillation, ventricular arrhythmias), heart failure, coronary artery disease and cardiac devices.
The Richmond VAMC is the only center in the East coast (from Maine to Florida and Puerto Rico) performing Heart Transplantation for Veterans.
Gastrointestinal and Liver disease.
ALLOWING FOR CUTTING-EDGE DISCOVERIES
The research being done by the RIVR doctors and staff elevates the Richmond VAMC to a nationally renowned Veterans Research & Innovation hub.
RIVR empowers all VA investigators and staff at the Richmond VAMC to carry out groundbreaking research, to discover mechanisms of disease, and to develop novel diagnostic tools and therapies. We recruit the brightest leaders in each research area, and we are committed to advancing medical knowledge and new treatments while growing the infrastructure required to make this work possible.
A key catalyst is the IDEAS (Innovation, Development, Education, Advanced Implementation and Solution) Center at the Richmond VAMC. This is one of 3 national IDEAS centers in the VA System. Its mission is to employ advanced and diverse clinical experts, discover and design novel approaches, and implement customized solutions which create an agile environment to lead the VHA in revolutionizing healthcare for Veterans. The Vision of the IDEAS Center is to (1) become the leading facility in innovative healthcare programs, practices, and solutions for the VISN and the VHA to develop, strategize, and disseminate new models and discoveries to best serve the Veteran and (2) create a self-sustainable environment which will foster employees to be inspired and feel free to experiment and innovate, to receive support and mentorship.
Similarly, through national programs like the Million Veteran Program (MVP), one of the largest research programs in the world studying genes and health, the VA can analyze trends in genes, lifestyle, military experiences, and exposures to improve care for veterans.
Invention of EyeRight - medical device goggles that follows eye movement and aids the diagnosis of different neurological disorders (Patent submitted by VA). This invention received the Impact Award – Federal Laboratory Consortium, July 2022.
Develop a novel pill bottle cap to deactivating unused opioids to avoid inappropriate distribution.
Developed a new surgical technique that made Deep Brain stimulation surgery easier for the patient using a frameless technique.
Research in extra beats (PVCs) have led to recognize for the very first-time deleterious effects of PVCs as they can result in cardiomyopathy. This research has impacted how we treat Veterans with PVCs nowadays.
Fecal microbiota transplant to treat Alcohol use disorder and hepatic encephalopathy in Veterans with liver cirrhosis.
Discover mechanism(s) that link diabetes and the development of non-alcoholic steatohepatitis.
ELEVATING MEDICAL EDUCATION
At RIVR, we are passionate about training future healthcare leaders. We strive to recruit talented health professional trainees (HPTs) including students, fellows, researchers, physicians, nurses, and coordinators to deliver compassionate patient care and pioneering research. Our employees continue their education and professional development, ensuring RIVR is on the frontlines of new ideas and innovations.
The Richmond VAMC participates in at least 40 different medical training programs from anesthesiology to vascular surgery with our affiliate, Virginia Commonwealth University Health System (VCUHS). Nearly 600 VCUHS trainees and 200 medical students rotate through these specialties at Richmond VAMC every year.
Also, there are almost as many associated health education (AHE) disciplines at Richmond VAMC, training 300 plus AHE HPTs—from multiple affiliated training programs such as assistive technology to speech and language pathology, from nursing to psychology—in certificate programs, undergraduate and graduate internships, residencies, and postdoctoral fellowships.
Richmond VAMC also hosts its own VA-based, fully accredited terminal residency and fellowship programs, including chaplaincy, dentistry, pharmacy, podiatry, prosthetics and orthotics, and psychology residencies, with more disciplines to be added in the coming year. Finally, many students participate as research assistants during the summer months.
Finally, the Simulation laboratory (IDEAS Center for Innovation) has developed ties with the national simulation and learning program (SLICE) as well as VCU to expand the boundaries of traditional medical simulation and venture in the pre-deployment testing of technology and applications using 5G secure technology. The Richmond VAMC has established pathways to improve outcomes for Veterans through standardized high-fidelity simulation-based education and training of the VA facility health care professionals and trainees by promoting best practices and supporting organized interactions and collaboration among facilities and healthcare providers. Several research initiatives in healthcare simulation and outcome evaluations are currently underway and national societies like the Anesthesia Patient Safety Foundation are reaching out to us for further disseminating our achievements.
OUR PATIENTS SAY...
"Effects of Electrical Stimulation and Vitamin D Supplementation of Bone
I really enjoyed participating in the program. I have benefited from the exercise and training a great deal I had muscle atrophy in my legs and torso area from my injury 27 years ago but I can feel more muscle mass in my calves,thighs, and buttocks, also me being a T1 C8 paraplegic, my stomach muscles don't work making it bigger and since I started the study my stomach and waist size has gotten smaller I lost 3 and a 1/2 pounds I feel that overall I'm healthier at the present than at the start of the study. I hope that my participation in the study will help someone else as well. "
"Participating in the research last conducted I hope helped the team learn and find avenues to help people who need blood thinners. I hope my being a part helped to find a better solution."