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16.05.2019 | Perspective

Coordinating Care Across VA Providers and Settings: Policy and Research Recommendations from VA’s State of the Art Conference

verfasst von: Kristina M. Cordasco, MD, MPH, MSHS, Susan M. Frayne, MD, MPH, Devan Kansagara, MD, MCR, Donna M. Zulman, MD, MS, Steven M. Asch, MD, MPH, Robert E. Burke, MD, MS, Edward P. Post, MD, PhD, Stephan D. Fihn, MD, MPH, Thomas Klobucar, PhD, Laurence J. Meyer, Susan R. Kirsh, MD, MPH, David Atkins, MD, MPH

Erschienen in: Journal of General Internal Medicine | Sonderheft 1/2019

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Abstract

Delivering well-coordinated care is essential for optimizing clinical outcomes, enhancing patient care experiences, minimizing costs, and increasing provider satisfaction. The Veterans Health Administration (VA) has built a strong foundation for internally coordinating care. However, VA faces mounting internal care coordination challenges due to growth in the number of Veterans using VA care, high complexity in Veterans’ care needs, the breadth and depth of VA services, and increasing use of virtual care. VA’s Health Services Research and Development service with the Office of Research and Development held a conference assessing the state-of-the-art (SOTA) on care coordination. One workgroup within the SOTA focused on coordination between VA providers for high-need Veterans, including (1) Veterans with multiple chronic conditions; (2) Veterans with high-intensity, focused, specialty care needs; (3) Veterans experiencing care transitions; (4) Veterans with severe mental illness; (5) and Veterans with homelessness and/or substance use disorders. We report on this workgroup’s recommendations for policy and organizational initiatives and identify questions for further research. Recommendations from a separate workgroup on coordinating VA and non-VA care are contained in a companion paper. Leaders from research, clinical services, and VA policy will need to partner closely as they develop, implement, assess, and spread effective practices if VA is to fully realize its potential for delivering highly coordinated care to every Veteran.

Leung LB, Yoon J, Rubenstein LV, Post EP, Metzger ME, Wells KB, et al. Changing Patterns of Mental Health Care Use: The Role of Integrated Mental Health Services in Veteran Affairs Primary Care J Am Board Fam Med.. 2018: 31(1):38–48CrossRefPubMed

Nelson KM, Helfrich C, Sun H, Hebert PL, Liu CF, Dolan E, Taylor L, et al. Implementation of the Patient-centered Medical Home in the Veterans Health Administration: Associations with Patient Satisfaction, Quality of Care, Staff Burnout, and Hospital and Emergency Department Use. JAMA Intern Med. 2014;174(8):1350–8.CrossRefPubMed

VA National Center for Veterans Analysis and Statistics, available at: https://www.va.gov/vetdata/utilization.asp. Accessed December 7^th, 2018.

Agha Z, Lofgren RP, VanRuiswyk JV, et al..Are Patients at Veterans Affairs Medical Centers Sicker?: A Comparative Analysis of Health status and Medical Resource Use. Arch Intern Med.2000;160:3252–3257.CrossRefPubMed

Lehavot K, Hoerster KD, Nelson KM, Jakupcak M, Simpson TL. Health indicators for military, veteran, and civilian women. Am J Prev Med.2012;42(5):473–480.CrossRef

Hoerster KD, Lehavot K, Simpson T, McFall M, Reiber G, Nelson KM. Health and Health Behavior Differences: U.S. Military, Veteran, and Civilian Men. Am J Prev Med. 2012;43(5):483–489CrossRefPubMed

Vimalananda N, Dvorin K, Fincke BG, Tardiff N, Bokhour BG. Patient, Primary Care Provider, and Specialist Perspectives on Specialty Care Coordination in an Integrated Health Care System. J Ambul Care Manage.. 2018; 41(1):15–24.CrossRefPubMedPubMedCentral

Zuchowski JL, Rose DR, Hamilton AB, Stockdale SE, Meredith LS, Yano EM, et al. Challenges in Referral Communication Between VHA Primary Care and Specialty Care. J Gen Intern Med. 2015; 30(3):305–11.CrossRefPubMed

Bergeson SC and Dean JD. A Systems Approach to Patient-Centered Care. JAMA. 2006;296(23):2848–2851.CrossRefPubMed

10.

Kirsh SR, Ho PM, Aron DC. Providing Specialty Consultant Expertise to Primary Care: An Expanding Spectrum of Modalities. Mayo Clin Proc. 2014; 89(10):1416–1426.CrossRefPubMed

11.

Darkins A. The Growth of Teleheatlh Services in the Veterans Health Administration Between 1994 and 2014: A Study of the Diffusion of Innovation. Telemedicine and e-Health., 2014; 20(9): https://doi.org/10.1089/tmj.2014.0143

12.

Veterans E-Health and Telemedicine Support Act of 2017. https://www.congress.gov/115/bills/s925/BILLS-115s925es.xml. Accessed July 27^th, 2018

13.

VA Telehealth Services. https://www.telehealth.va.gov/. Accessed July 27^th, 2018

14.

Mattocks K, Cunningham K, Elwy AR, et al. Recommendations for the evaluation of cross-system care coordination from the VA state-of-the-art working group on VA/non-VA care. Journal of General Internal Medicine. 2019; https://doi.org/10.1007/s11606-019-04972

15.

McDonald K, Singer S, Gorin SS, et al. Incorporating theory into practice: Reconceptualizing exemplary care coordination initiatives from the US Veterans health delivery system. Journal of General Internal Medicine. 2019; https://doi.org/10.1007/s11606-019-04969-w

16.

Yoon J, Zulman D, Scott JY, Maciejewski ML. Costs Associated with Multimorbidity Among VA Patients. Med Care. 2014;52:S31-S36CrossRefPubMed

17.

Pemberton MR, Forman-Hoffman VL, Lipari RN, et al. Prevalence of Past Year Substance Use and Mental Illness by Veteran Status in a Nationally Representative Sample. SAMHSA Center for Behavioral Health Statistics and Quality, November 2016, available at: https://www.samhsa.gov/data/sites/default/files/NSDUH-DR-VeteranTrends-2016/NSDUH-DR-VeteranTrends-2016.htm. Accessed December 7^th, 2018

18.

Fargo J, Metraux S, Byrne T, et al. Prevalence and Risk of Homelessness Among US Veterans. Prev Chronic Dis. 2012; 9:E45PubMedPubMedCentral

19.

VA Office of Academic Affiliations. 2017 Statistics: Health Professions Trainees. https://www.va.gov/OAA/docs/OAA_Statistics_Short_2017.pdf. Accessed July 26^th, 2018.

20.

Hemming K, Haines TP, Chilton PJ, et al. The stepped wedge cluster randomized trial: rationale, design, analysis, and reporting. BMJ. 2015; 35

21.

Turner EL, Li F, Gallis JA, Prague M, Murray DM. Review of recent methodological developments in group-randomized trials: Part1—Design. Am J Public Health. 2017;107(6):907–15.CrossRefPubMedPubMedCentral

22.

Lipshitz JM, Benzer JK, Miller C, Easley SR, Leyson J, Post EP, et al. Understanding collaborative care implementation in the Department of Veterans Affairs: core functions and implementation challenges. BMC Health Serv Res. 2017;17(691):1–11.

23.

Peterson K, Anderson J, Bourne D, et al. Health care coordination theoretical frameworks: a systematic scoping review to increase their understanding and use in practice. J Gen Intern Med. 2019. https://doi.org/10.1007/s11606-019-04966-z.

24.

Gorin SS, Haggstrom D, Han PKJ, Fairfield KM, Krebs P, Clauser SB. Cancer Care Coordination: a Systematic Review and Meta-Analysis of Over 30 Years of Empirical Studies. Ann Behav Med., 2017; 51(4):532–546.CrossRefPubMed

25.

Fix GM, Asch SM, Saifu HN, Fletcher MD, Gifford AL, Bokhour BG. Delivering PACT-Principled Care: Are Specialty Care Patients Being Left Behind? J Gen Int Med. 2014; 29(S2):695–702.CrossRef

26.

Szymkowiak D, Montgomery AE, Johnson EE, Manning T, O’Toole TP. Persistent Super-Utilization of Acute Care Services Among Subgroups of Veterans Experiencing Homelessness. Med Care. 2017;55:893–900.CrossRefPubMed

27.

Wagner EH, Sandhu N, Coleman K, Phillips K, Sugarman JR. Improving Care Coordination in Primary Care. Med Care. 2014;52: S33-S38.CrossRefPubMed

28.

Hopman P, DeBruin SR, Forjaz MJ, Rodriguez-Blazquez C, Tonnara G, Lemmens LC, et al. Effectiveness of comprehensive care programs for patients with multiple chronic conditions or frailty: A systematic literature review. Heath Policy. 2016;120(7):818–832.CrossRef

29.

Kansagara D, Chiovaro JC, Kagen D, Jencks S, Rhyne K, O’Neil M, et al. So many options, where do we start? An Overview of the Care Transitions Literature. J Hosp Med. 2016;11(3):221–230.CrossRefPubMed

30.

National Quality Forum: Emergency Department Transitions of Care [Internet] – A Quality Measurement Framework Final Report. http://www.qualityforum.org/Publications/2017/08/Emergency_Department_Transitions_of_Care_-_A_Quality_Measurement_Framework_Final_Report.aspx. Accessed July 26^th, 2018

31.

Bull MJ, Hansen HE, Gross CR. Predictors of elder and family caregiver satisfaction with discharge planning. J Cardiovasc Nurs. 2000;14(3):76–87.CrossRefPubMed

32.

Clare J, Hofmeyer A. Discharge planning and continuity of care for aged people: indicators of satisfaction and implications for practice. Aust J Adv Nurs. 1998;16(1):7–13.PubMed

33.

Moore C, Wisnivesky J, Williams S, McGinn T. Medical errors related to discontinuity of care from an inpatient to an outpatient setting. J Gen Intern Med. 2003;18:646–651.CrossRefPubMedPubMedCentral

34.

Nunez S, Hexdall A, Aguirre-Jaime A. Unscheduled returns to the emergency department: an outcome of medical errors? Qual Saf Health Care. 2006;15(2):102–108.CrossRefPubMedPubMedCentral

35.

Kelly AM, Chirnside AM, Curry CH. An analysis of unscheduled return visits to an urban emergency department. N Z Med J. 1993;106(61):334–336.PubMed

36.

Pierce JM, Kellerman AL, Oster C. “Bounces”: an analysis of short-term return visits to a public hospital emergency department. Ann Emerg Med. 1990;19(7):752–757.CrossRefPubMed

37.

Stephens C, Sackett N, Pierce R, Schopfer D, Schmajuk G, Moy N, et al. Transitional care challenges of rehospitalized veterans: listening to patients and providers. Popul Health Manag. 2013;16(5):326–331.CrossRefPubMedPubMedCentral

38.

Hastings SN, Schmader KE, Sloane RJ, Weinberger M, Goldberg KC, Oddone EZ. Adverse Health Outcomes After Discharge from the Emergency Department – Incidence and Risk Factors in a Veteran Population. J Gen Intern Med. 2007; 22(11):1527–31.CrossRefPubMedPubMedCentral

39.

Trivedi RB, Post EP, Sun H, Pomerantz A, Saxon AJ, Piette JD,et al. Prevalence, Comorbidity, and Prognosis of Mental Health Among US Veterans. AJPH. 2015;105(12):2564–2569CrossRef

40.

Fox AB, Meyer EC, Vogt D. Attitudes About the VA Health-Care Setting, Mental Illness, and Mental Health Treatment and Their Relationship with VA Mental Health Service Use Among Female and Male OEF/OIF Veterans. Psychol Serv. 2015; 12(1):49CrossRefPubMed

41.

Bovin Mj, Miller Cj, Koenig CJ, Lipschitz JM, Zamora Ka, Wright PB, et al. Veterans’ experiences initiating VA-based mental health care. Psychol Serv.. 2018. Advance online publication. https://doi.org/10.1037/ser0000233

Titel: Coordinating Care Across VA Providers and Settings: Policy and Research Recommendations from VA’s State of the Art Conference
verfasst von: Kristina M. Cordasco, MD, MPH, MSHS
Susan M. Frayne, MD, MPH
Devan Kansagara, MD, MCR
Donna M. Zulman, MD, MS
Steven M. Asch, MD, MPH
Robert E. Burke, MD, MS
Edward P. Post, MD, PhD
Stephan D. Fihn, MD, MPH
Thomas Klobucar, PhD
Laurence J. Meyer
Susan R. Kirsh, MD, MPH
David Atkins, MD, MPH
Publikationsdatum: 16.05.2019
Verlag: Springer US
Erschienen in: Journal of General Internal Medicine / Ausgabe Sonderheft 1/2019
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI: https://doi.org/10.1007/s11606-019-04970-3

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