Allison A Lewinski1,2,3, Caitlin Sullivan4, Kelli D Allen4,5, Matthew J Crowley4,6, Jennifer M Gierisch4,7,8, Karen M Goldstein4,8, Kaileigh Gray4, Susan N Hastings4,7,9,10, George L Jackson4,7,8, Felicia McCant4, Abigail Shapiro4, Matthew Tucker4, Carolyn Turvey11,12,13, Leah L Zullig4,7, Hayden B Bosworth4,14,7,8,10,15,16. 1. Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC, USA. allison.lewinski@duke.edu. 2. School of Nursing, Duke University, Durham, NC, USA. allison.lewinski@duke.edu. 3. HSR&D COIN (558/152), Durham Veterans Affairs Health Care System, 508 Fulton Street, Durham, NC, 27705, USA. allison.lewinski@duke.edu. 4. Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC, USA. 5. Department of Medicine & Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 6. Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Duke University School of Medicine, Durham, NC, USA. 7. Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA. 8. Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC, USA. 9. Division of Geriatrics, Department of Medicine, Duke University School of Medicine, Durham, NC, USA. 10. Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC, USA. 11. Comprehensive Access and Delivery Research and Evaluation Center, Iowa City Veterans Affairs Health Care System, Iowa City, IA, USA. 12. Iowa City Veterans Rural Health Resource Center, Iowa City, IA, USA. 13. Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA, USA. 14. School of Nursing, Duke University, Durham, NC, USA. 15. Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA. 16. Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Abstract
BACKGROUND: Virtual care is critical to Veterans Health Administration (VHA) efforts to expand veterans' access to care. Health care policies such as the Veterans Access, Choice, and Accountability (CHOICE) Act and the Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act impact how the VHA provides care. Research on ways to refine virtual care delivery models to meet the needs of veterans, clinicians, and VHA stakeholders is needed. OBJECTIVE: Given the importance of virtual approaches for increasing access to high-quality VHA care, in December 2019, we convened a Think Tank, Accelerating Implementation of Virtual Care in VHA Practice, to consider challenges to virtual care research and practice across the VHA, discuss novel approaches to using and evaluating virtual care, assess perspectives on virtual care, and develop priorities to enhance virtual care in the VHA. METHODS: We used a participatory approach to develop potential priorities for virtual care research and activities at the VHA. We refined these priorities through force-ranked prioritization and group discussion, and developed solutions for selected priorities. RESULTS: Think Tank attendees (n = 18) consisted of VHA stakeholders, including operations partners (e.g., Office of Rural Health, Office of Nursing Services, Health Services Research and Development), clinicians (e.g., physicians, nurses, psychologists, physician assistants), and health services researchers. We identified an initial list of fifteen potential priorities and narrowed these down to four. The four priorities were (1) scaling evidence-based practices, (2) centralizing virtual care, (3) creating high-value care within the VHA with virtual care, and (4) identifying appropriate patients for virtual care. CONCLUSION: Our Think Tank took an important step in setting a partnered research agenda to optimize the use of virtual care within the VHA. We brought together research and operations stakeholders and identified possibilities, partnerships, and potential solutions for virtual care.
BACKGROUND: Virtual care is critical to Veterans Health Administration (VHA) efforts to expand veterans' access to care. Health care policies such as the Veterans Access, Choice, and Accountability (CHOICE) Act and the Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act impact how the VHA provides care. Research on ways to refine virtual care delivery models to meet the needs of veterans, clinicians, and VHA stakeholders is needed. OBJECTIVE: Given the importance of virtual approaches for increasing access to high-quality VHA care, in December 2019, we convened a Think Tank, Accelerating Implementation of Virtual Care in VHA Practice, to consider challenges to virtual care research and practice across the VHA, discuss novel approaches to using and evaluating virtual care, assess perspectives on virtual care, and develop priorities to enhance virtual care in the VHA. METHODS: We used a participatory approach to develop potential priorities for virtual care research and activities at the VHA. We refined these priorities through force-ranked prioritization and group discussion, and developed solutions for selected priorities. RESULTS: Think Tank attendees (n = 18) consisted of VHA stakeholders, including operations partners (e.g., Office of Rural Health, Office of Nursing Services, Health Services Research and Development), clinicians (e.g., physicians, nurses, psychologists, physician assistants), and health services researchers. We identified an initial list of fifteen potential priorities and narrowed these down to four. The four priorities were (1) scaling evidence-based practices, (2) centralizing virtual care, (3) creating high-value care within the VHA with virtual care, and (4) identifying appropriate patients for virtual care. CONCLUSION: Our Think Tank took an important step in setting a partnered research agenda to optimize the use of virtual care within the VHA. We brought together research and operations stakeholders and identified possibilities, partnerships, and potential solutions for virtual care.
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Authors: Allison A Lewinski; Conor Walsh; Sharron Rushton; Diana Soliman; Scott M Carlson; Matthew W Luedke; David J Halpern; Matthew J Crowley; Ryan J Shaw; Jason A Sharpe; Anastasia-Stefania Alexopoulos; Amir Alishahi Tabriz; Jessica R Dietch; Diya M Uthappa; Soohyun Hwang; Katharine A Ball Ricks; Sarah Cantrell; Andrzej S Kosinski; Belinda Ear; Adelaide M Gordon; Jennifer M Gierisch; John W Williams; Karen M Goldstein Journal: J Med Internet Res Date: 2022-08-26 Impact factor: 7.076