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Health Services Research & Development

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2005 HSR&D National Meeting Abstract


3085 — Informatics in the Implementation of Research

Author List:
Takahashi N
Austin C
Acken J
Vivell S
Sherman S

Objectives:
Informatics is important in patient care coordination and delivery of quality care. To facilitate patient care coordination in the pilot Smoking Cessation Telephone Counseling Program, data management tools and clinical reports were developed through VISTA (VHA’s clinical computer system). This project demonstrates that informatics can improve care and assimilate interventions into current clinical practice, resulting in implemented research.

Methods:
Trained smoking cessation counselors provided proactive telephone counseling over an 8-week period. Initially, Excel spreadsheets were used to record data from each telephone interview, which was then manually entered into a progress note. As patient referrals increased, the “pencil and paper” record keeping caused problems in data management and care coordination. Cross-coverage could not be provided among counselors and clinical reports could not be readily accessed. There was limited ability to provide clinical feedback to providers. A file was created in VISTA to capture the data, augmented by a Delphi graphical user interface to allow counselors to enter data as they conducted their telephone interviews. A Smoking Cessation progress note template was created to automatically upload summary of the interviews into VISTA, allowing provider feedback. Reports were available to track clinical outcomes and for cross-coverage among counselors.

Results:
VISTA’s capability to produce reports and provide data management helped to efficiently coordinate care for 672 patients. VISTA’s clinical reports maintained continuity of care through its ability to provide clinicians up-to-date information on patient outcomes. VISTA streamlined care coordination through the availability of cross-coverage reports; and its data management tool decreased the need for database management by 50%, allowing for more patient counseling. The improved care structure resulted in high satisfaction among providers and patients as reflected in the continuous referrals made to the program each month (183 referrals) during the 10 month intervention period.

Implications:
The Smoking Cessation Telephone Counseling Program has now become the standard of care at GLA. VISTA’s ability to increase efficiency, improve care, and assimilate into the current clinical structure helped to facilitate implementation. Therefore, informatics ability to augment the structure of care is crucial in the implementation of research into clinical practice.

Impacts:


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