A Model for Rapid Transition to Virtual Care, VA Connecticut Primary Care Response to COVID-19
- PDF / 568,355 Bytes
- 4 Pages / 595.276 x 790.866 pts Page_size
- 57 Downloads / 182 Views
VA Connecticut Health Care System, West Haven, CT, USA; 2Yale University School of Medicine, New Haven, CT, USA; 3Primary Care Service Line, VA New England Health Care System, Bedford, MA, USA; 4Clinical Contact Center, VA New England Health Care System, Bedford, MA, USA.
INTRODUCTION: Traditionally, health care delivery in the USA has been structured around in-person visits. The COVID-19 pandemic has forced a shift to virtual care models in order to reduce patient exposure to high-risk environments and to preserve valuable health care resources. This report describes one large primary care system’s model for rapid transition to virtual care (RTVC). SETTING AND PARTICIPANTS: A RTVC model was implemented at the VA Connecticut Health Care System (VACHS), which delivers care to over 58,000 veterans. PROGRAM DESCRIPTION: The RTVC model included immediate virtual care conversion, telework expansion, implementation of virtual respiratory urgent care clinics, and development of standardized note templates. PROGRAM EVALUATION: Outcomes include the rates of primary encounter types, staff teleworking, and utilization of virtual respiratory urgent care clinics. In under 2 weeks, most encounters were transitioned from in-person to virtual care, enabling telework for over half of the medical staff. The majority of virtual visits were telephone encounters, though rates of video visits increased nearly 18-fold. DISCUSSION: The RTVC model demonstrates expeditious and sustained transition to virtual care during the COVID-19 pandemic. Our experiences help inform institutions still reliant on traditional in-person visits, and future pandemic response. KEY WORDS: virtual care; COVID-19; prevention; pandemic; primary care. J Gen Intern Med DOI: 10.1007/s11606-020-06041-4 © Society of General Internal Medicine (This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply) 2020
INTRODUCTION
The COVID-19 pandemic presents fundamental challenges to health care delivery, with an impetus to shift to virtual care in the outpatient setting in order to reduce patient and health care worker exposure to high-risk environments and to preserve valuable health care resources. Received April 17, 2020 Accepted July 3, 2020
Despite mechanisms for reimbursing telemedicine and recent increasing trends in telemedicine visits, care in the USA has been predominantly structured around inperson visits.1 Data from 2018 show telehealth utilization rates of 0.95% (9.5 visits per 1000 beneficiaries) in the Medicare program2 and 1.13% (11.3 users per 1000 enrollees) in an all-payer database.3 Veterans Affairs (VA) data (averaged from October 2019 through February 2020) show that 4.2% and 0.68% of all appointments were telephone visits and video visits, respectively.4 The in-person model has shortcomings: optimal care can often be delivered without requiring patients to be physically present in clinic. This includes preventive care, chronic disease follow-up, and goals of care discussions. In addition, in
Data Loading...
