BACKGROUND/RATIONALE:
In spite of VA's long history of high quality care, veterans consistently rate the VA lower on convenience and accessibility. This is particularly a problem for rural veterans who comprise nearly 40% VHA enrollees. Remote patient encounters over the telephone or internet have the potential to improve quality and access to healthcare, but are not routinely delivered as a part of planned and comprehensive primary care.

OBJECTIVE(S):
For this four year career development award, I had three specific aims. Specific Aim 1: Evaluate stakeholder perspectives on integrating remote patient encounters in primary care. Specific Aim 2: Develop and pilot test structured telephone visits in primary care. Specific Aim 3: Evaluate the effectiveness of structured telephone visits in primary care

METHODS:
For the first specific aim used qualitative methods and focus groups to obtain input from the three key stakeholder groups: primary care providers, nurses and staff, and patients. For the second aim we will conduct a pilot intervention study with comparison to concurrent controls. Data was independently coded by 2 investigators for the important themes from these discussions using Atlas.ti.

FINDINGS/RESULTS:
Not yet available.

IMPACT:
The VA has committed to remote patient encounters as a means to improve the quality and access of care and as a principle of the Patient Aligned Care Teams. Understanding the perspectives of all stakeholders involved is an important step in designing and implementing new models of remote patient encounters. While not all patients will be appropriate for structured remote patient encounters, developing this method of delivering care will create more flexibility for patients to interact with the health care system and may contribute to a more patient-centered experience.

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External Links for this Project

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PUBLICATIONS:

None at this time.

DRA: Health Systems Science
DRE: Prevention, Treatment - Efficacy/Effectiveness Clinical Trial
Keywords: Complex care, Primary care, Telemedicine
MeSH Terms: none