Vet Connect: A Quality Improvement Program to Provide Telehealth Subspecialty Care for Veterans Residing in VA-Contracted Community Nursing Homes

Hale, Anne; Haverhals, Leah M.; Manheim, Chelsea; Levy, Cari

doi:10.3390/geriatrics3030057

Cited by 14 publications

(33 citation statements)

References 21 publications

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“…The mean age of reported participants was 78.6 years. Three studies were conducted in an exclusive male veterans population [ 14 , 16 , 19 ]. The median study time for the interventions was 12 months (range 5–48 months.…”

Section: Resultsmentioning

confidence: 99%

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Virtual geriatric clinics and the COVID-19 catalyst: a rapid review

et al. 2020

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Background During the current COVID-19 health crisis virtual geriatric clinics have become increasingly utilised to complete outpatient consultations, although concerns exist about feasibility of such virtual consultations for older people. The aim of this rapid review is to describe the satisfaction, clinic productivity, clinical benefit, satisfaction and costs associated with the virtual geriatric clinic model of care. Methods A rapid review of PubMed, MEDLINE and CINAHL databases was conducted up to April 2020. Two independent reviewers extracted the information. Four subdomains were focused on: satisfaction with the virtual geriatric clinic, clinic productivity, clinical benefit to patients, costs and any challenges associated with the virtual clinic process. Results Nine studies with 975 patients met our inclusion criteria. All were observational studies. Seven studies reported patients were satisfied with the virtual geriatric clinic model of care. Productivity outcomes included reports of cost-effectiveness, savings on transport, and improved waiting list metrics. Clinical benefits included successful polypharmacy reviews, and reductions in acute hospitalisation rates. Varying challenges were reported for both clinicians and patients in eight of the nine studies. Hearing impairments and difficulty with technology added to anxieties experienced by patients. Physicians missed the added value of a thorough physical examination and had concerns about confidentiality. Conclusion Virtual geriatric clinics demonstrate evidence of productivity, benefit to patients, cost effectiveness and patient satisfaction with the treatment provided. In the current suboptimal pandemic climate, virtual geriatric clinics may allow Geriatricians to continue to provide an outpatient service, despite the encountered inherent challenges.

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Section: Resultsmentioning

confidence: 99%

“…Seven studies reported on patient or physician satisfaction ( Table 3 ) [ 12 , 13 , 15–17 , 19 , 20 ]. All studies reported that patients were satisfied with the virtual clinic model of care.…”

Section: Resultsmentioning

confidence: 99%

Virtual geriatric clinics and the COVID-19 catalyst: a rapid review

et al. 2020

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“…VA has also implemented and tested providing telehealth palliative care services. 85,86 Passage of the Veterans E-Health and Telemedicine Support Act of 2017, allowing VA providers to practice telemedicine across state lines, will allow for even further expansion of VA telehealth services for reproductive cancer care. 87 VA recently commissioned and published an evidence map on telehealth services designed for women, with a section dedicated to using telehealth for high-risk breast cancer assessment.…”

Section: Palliative and Supportive Carementioning

confidence: 99%

Coordinating Care for Reproductive Health Malignancies in the Veterans' Health Administration: Promising Practices, Ongoing Challenges, and Future Research

2019

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In cancer care, communication and coordination across the cancer continuum is paramount for delivering effective, high-quality, patient-centered care. However, achieving optimally coordinated cancer care is inherently challenging, especially in the case of Veterans Administration (VA) care for women's reproductive health cancers. Given the relatively small number of women Veterans requiring care for reproductive malignancies, VA often must rely on community providers to deliver this care, necessitating coordination across two or more health care systems. Recently, VA has invested heavily in improving care for women Veterans through several initiatives and efforts. This article reviews VA's successes, challenges, and future opportunities in research and innovation in the context of care coordination across the cancer continuum (i.e., prevention and screening, diagnosis and treatment, survivorship care, palliative and supportive care) for women Veterans with reproductive health malignancies. We describe how coordination of VA care for reproductive health malignancies currently reflects a mix of successes that demonstrate use of strong evidenced-based practices and challenges, with solutions yet to be fully developed and implemented. We conclude that there are a multitude of opportunities for future research, interventions, and potential avenues for implementing innovative approaches to coordinate VA reproductive cancer care across the cancer continuum.

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“…Specialties with evidence demonstrating telehealth effectiveness include oncology, diabetology (including diabetes education services), cardiology, nephrology, psychiatry and addiction services, primary care, geriatrics, and women’s health. 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 For instance, DeNicola et al’s systematic review 17 of telehealth interventions in women’s services found improvements in rates of perinatal smoking cessation, breastfeeding and scheduling of office visits, and obstetric outcomes. For the common chronic disease state of obesity, Huang et al’s systematic review 18 found telemedicine visits to be an effective intervention in reducing body weight for patients with or without hypertension and diabetes.…”

Section: Introductionmentioning

confidence: 99%

“…For the common chronic disease state of obesity, Huang et al’s systematic review 18 found telemedicine visits to be an effective intervention in reducing body weight for patients with or without hypertension and diabetes. From a combined geriatric and financial perspective, Hale et al 16 demonstrated cost savings by delivering subspecialty care to nursing home residents through telehealth in the Veteran’s Health Administration system.…”

Section: Introductionmentioning

confidence: 99%