Journal article
Growth of Electronic Consultations in the Veterans Health Administration
The American journal of managed care, Vol.27(1), pp.12-19
01/01/2021
DOI: 10.37765/ajmc.2021.88572
PMID: 33471457
Abstract
OBJECTIVES: To evaluate the growth and variation of electronic consultation, or e-consult, use in the Veterans Health Administration (VHA) across regions and specialties.
STUDY DESIGN: Observational cohort study using administrative data of all veterans who received an e-consult for 41 specialties across 1269 VHA medical centers and associated clinical sites from January 1, 2012, through December 31, 2018.
METHODS: Assessments included (1) the number and characteristics of all e-consults, (2) growth of e-consult use, (3) e-consults as a proportion of all consults by region and by specific specialty, (4) need for an in-person visit with the same specialty within 12 months after an e-consult, and (5) potential miles of driving saved for patients and mileage reimbursement costs avoided for VHA due to e-consult use.
RESULTS: Over the 7-year study period, VHA providers completed 3,117,998 e-consults (5.5% of all specialty consults). e-Consults increased by 309% for all specialties. By 2018, for 16 of 41 specialties, e-consults accounted for greater than 10% of all consults. Overall, 21.5% of e-consults resulted in an in-person visit with the same specialty within 12 months. On average, each e-consult resulted in approximately 84.3 (SD, 89.9; interquartile range, 25.1-115.0) miles in driving saved, equating to potential driving reimbursement savings of $46 million.
CONCLUSIONS: Use of e-consults in the VHA grew substantially between 2012 and 2018, with variability across specialties. In-person follow-up after an e-consult was low, suggesting that e-consults may substitute for in-person visits and reduce considerable patient travel burden.
Details
- Title: Subtitle
- Growth of Electronic Consultations in the Veterans Health Administration
- Creators
- David R. Saxon - University of Colorado Anschutz Medical CampusPeter J. Kaboli - Iowa City VA Healthcare Syst, Ctr ForAccess & Delivery Res & Evaluat, Iowa City, IA USABjarni Haraldsson - Iowa City VA Healthcare Syst, Ctr ForAccess & Delivery Res & Evaluat, Iowa City, IA USAChristopher Wilson - University of Puget SoundMichael Ohl - Iowa City VA Healthcare Syst, Ctr ForAccess & Delivery Res & Evaluat, Iowa City, IA USAMatthew R. Augustine - The Bronx Defenders
- Resource Type
- Journal article
- Publication Details
- The American journal of managed care, Vol.27(1), pp.12-19
- Publisher
- Managed Care & Healthcare Communications Llc
- DOI
- 10.37765/ajmc.2021.88572
- PMID
- 33471457
- ISSN
- 1088-0224
- eISSN
- 1936-2692
- Number of pages
- 8
- Grant note
- Department of Veterans Affairs (VA); US Department of Veterans Affairs VA Office of Rural Health VeteransHealth Administration; US Department of Veterans Affairs CIN 13-412 / Office of Research and Development, Health Services Research and Development Service through the Center for Access and Delivery Research and Evaluation
- Language
- English
- Date published
- 01/01/2021
- Academic Unit
- Psychiatry; Epidemiology; Internal Medicine
- Record Identifier
- 9984359801102771
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