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FORUM - Translating research into quality health care for Veterans

SOTA Conference: Improving Access to VA Care

The "Improving Access to VA Care" State of the Art (SOTA) conference was held in Arlington, Va., from September 21 to September 22, 2010. Access to care is one of VA's priority transformational initiatives, making this SOTA particularly timely. While access to care is a consideration for all Veterans, it is particularly important given the needs of Veterans returning from the conflicts in Iraq and Afghanistan, many of whom are returning to rural areas and/or returning with severe injuries that will require longterm care. Both Under Secretary for Health, Dr. Robert Petzel and Principal Deputy Under Secretary for Health, Robert Jesse, M.D., Ph.D., spoke at the SOTA, providing an overview of VHA's priorities and challenges regarding access and the importance of improving access to VA health care for Veterans. With the advent of health care reform, one particular challenge for VA will be to successfully compete with the many non-VA health care options that will become available to Veterans.

The 70 invited attendees, including VA and non-VA clinicians, researchers, and policymakers with special expertise in access to health care, worked to identify what we know and what we need to know to improve access to health care for Veterans. SOTA participants discussed resources, relationships, policies, and infrastructure related to accessing quality health care.

Conference participants were divided into work groups focusing on the following topics:

  • Defining access and constructs;
  • Identifying access issues for special populations;
  • Impact of access on utilization, quality, outcomes, and satisfaction;
  • Impact of policy and organization of care on access; and
  • Adoption and implementation of information technology.

Each of the groups worked to develop recommendations for policy strategies to assist VA and the larger health care community to improve access to care. They also developed research questions to target strategies that will improve access for Veterans, which will be refined for several SOTA products. The research agenda and policy recommendations will be reviewed and synthesized for presentation to VA leadership as appropriate. Also, a supplement to the Journal of General Internal Medicine is planned for publication in the summer of 2011. Papers are due to the journal for peer review by December 1. In addition, the SOTA planners will discuss and plan for other possible SOTA products which might include an RFA, a white paper(s) for leadership, and one or more cyber seminars to inform the research community about access research priorities.