Evaluation of the Veterans Health Administration's Specialty Care Transformational Initiatives to Promote Patient-Centered Delivery of Specialty Care: A Mixed-Methods Approach

• Published in: Telemedicine journal and e-health Vol. 23; no. 7; p. 577
• Main Authors: Williams, Katherine M, Kirsh, Susan, Aron, David, Au, David, Helfrich, Christian, Lambert-Kerzner, Anne, Lowery, Julie, Battaglia, Catherine, Graham, Glenn D, Doukas, Michael, Jain, Rajiv, Ho, P Michael
• Format: Journal Article
• Language: English
• Published: United States 01.07.2017
• Subjects: Adult; Aged; Aged, 80 and over; Delivery of Health Care - organization & administration; Female; Hospitals, Veterans - organization & administration; Humans; Male; Middle Aged; Patient-Centered Care - organization & administration; Telemedicine - organization & administration; United States; United States Department of Veterans Affairs; Veterans; evaluation; telemedicine; healthcare delivery; specialty care; patient centered care
• ISSN: 1556-3669
• DOI: 10.1089/tmj.2016.0166

Veteran's Affairs Office of Specialty Care (OSC) launched four national initiatives (Electronic-Consults [e-Consults], Specialty Care Access Networks-Extension for Community Healthcare Outcomes [SCAN-ECHO], Mini-Residencies, and Specialty Care Neighborhood) to improve specialty care delivery and funded a center to evaluate the initiatives. The evaluation, guided by two implementation frameworks, provides formative (administrator/provider interviews and surveys) and summative data (quantitative data on patterns of use) about the initiatives to OSC. Evaluation of initiative implementation is assessed through CFIR (Consolidated Framework for Implementation Research)-grounded qualitative interviews to identify barriers/facilitators. Depending on high or low implementation, factors such as receiving workload credit, protected time, existing workflow/systems compatibility, leadership engagement, and access to information/resources were considered implementation barriers or facilitators. Findings were shared with OSC and used to further refine implementation at additional sites. Evaluation of other initiatives is ongoing. The mixed-methods approach has provided timely information to OSC about initiative effect and impacted OSC policies on implementation at additional sites.