Community Care
OIT partnered with VHA to help make VA’s Community Care program a success. Community Care is nationwide program that utilizes partnerships with the private sector, academia, and government entities to provide eligible Veterans access to care. OIT worked closed with VHA to identify operational efficiencies and innovative scalable technology solutions including:
- Secure email technology that provides a safe, fast, and efficient mechanism for VA staff to share Veterans’ protected health information with community providers.
- A safe health information sharing system that allows community providers to securely view Veteran health information.
- A referral documentation tool that automatically converts Veterans’ paper medical records into a PDF format that can then be directly uploaded to a Community Care provider’s system.
- In FY16, Veterans scheduled 25.5 million community care appointments—an 18 percent increase from FY15.
- In FY16, VA processed nearly 18.9 million claims via all programs — a 13 percent increase since FY15.
- At the end of FY17, VA eHealth Exchange had a total of 121 Community Care partners, including 992 hospitals and 29,864 ambulatory sites.
- At the end of FY17, VA Direct Messaging had a total of 454 Community Care providers (hospital or health center), exceeding the FY17 goal of 200.
- In FY15, the Choice Program network contracted approximately 200,000 providers and facilities. In FY17, the Choice Program network contracted more than 400,000 providers and facilities.
Community Care IT Projects
Highlights of our 2017 Community Care Program IT projects.
GetWellNetwork
GetWellNetwork is a platform that enables Veterans to manage their care and access resources. In 2017, OIT worked with VHA to enhance GetWellNetwork capabilities by integrating functionality with VA’s electronic health record, VistA.
Now, important Veteran patient data—such as health education, goals, and preferences—can be accessed using GetWellNetwork and VistA.
Before this effort, a company like GetWellNetwork could collect Veteran health data, but could not analyze it in a meaningful way. Collaboration between OIT and VHA created a way to accurately and securely integrate Veteran- generated information from GetWellNetwork into VA’s own VistA system.
Nine VA medical centers currently use GetWellNetwork, but by the end of FY18, GetWellNetwork will expand to support 32 VA medical centers. Additional facilities are considering GetWellNetwork, potentially expanding its use to emergency rooms, community living centers, and other areas within VA medical centers.
VirtruPro
OIT partnered with VHA to identify a solution to an issue that had been plaguing health and benefits providers for years: sharing Veteran data securely with outside providers and private sector partners. Together, they identified Virtru Pro, an email application that allows encrypted communication between VA and community providers through an internet- based (cloud) service without the need for non-VA recipients to acquire additional software licenses.
Virtru Pro deployed in May 2017 to VHA’s Homeless Program Office (HPO) and Office of Community Care (OCC) with approximately 5,000 initial VA staff licenses and plans to deploy an additional 10,000 licenses.
Before Virtru Pro, OCC and HPO faced obstacles to electronically share critical Veteran information quickly and safely with community providers. They were unable to share Veteran protected health information (PHI) and personally identifiable information (PII) through email while remaining compliant with federal privacy law.
With Virtru Pro, users can securely send information to VA community partners and providers and move away from an inherently insecure and inefficient fax-based method of communication.
Referral Documentation (REFDOC)
Clinicians noted challenges with sharing documents across systems in the community and VA that led to delayed medical service to Veterans. In an extension to the work OIT and VHA did to help providers share data securely among different systems, the REFDOC project implemented a web application that allows VA staff to quickly pull individual Veteran patient information from VistA and the Corporate Data Warehouse into a PDF file to share with community providers for care coordination.
OIT deployed REFDOC at 122 sites nationwide. When combined with Virtru Pro, VA staff eliminated the time- consuming tasks of scanning, faxing, and mailing patient records to community providers, increasing the timeliness of Veteran access to services. So far, REFDOC has:
- 1,335 active users who have created over 818,837 packages since inception
- Avoided costs of approximately $8.3 million
- Improved timeliness of medical record transfers to third parties by reducing the average processing time by 10 minutes per package
Recovery Engagement and Coordination for Health—Veterans Enhanced Treatment (REACH VET)
In April 2017, OIT and VHA launched REACH VET, a program that uses a new predictive model to analyze existing data from Veterans’ health records to identify those at risk for adverse outcomes like suicide.
Recognizing the potential of REACH VET to enhance the White House VA Hotline and Veteran Crisis Line functionality, VHA and OIT partnered to provide White House VA Hotline agents, Veterans Crisis Line staff, and VA primary care and mental health providers access to REACH VET via their computers.
By engaging at-risk Veterans early, REACH VET reduces the frequency of adverse outcomes and allows VA to provide preemptive care and support for Veterans, in some cases before a Veteran even has suicidal thoughts. With the help of REACH VET and the VA Hotline, VHA and OIT are taking further steps to support and improve the quality of care for our nation’s Veterans.
“One veteran suicide is one too many. This cutting-edge program is saving lives by identifying at-risk Veterans and connecting them with the specialized care and support they need.”
Secretary Shulkin
Access to Care
In April 2017, VA launched the Access to Care website, a cloud-based, customer-facing website that enables Veterans to view wait times at VA facilities, compare care ratings, and review national data on access. The website represents VA’s commitment to being transparent and accountable in a way that Veterans can easily access and understand. Ultimately, the website gives Veterans the power to make a more informed decision about their VA health care.
The Access and Quality tool provides Veterans and their dependents with information they need to make manage their health care interactions. Available information includes:
- New and established patient wait times.
- Satisfactions scores for access to primary and specialty care.
- Timeliness of urgent appointments.
- Information about the quality of health care delivered at every medical center compared to local, private sector hospitals.
This project continues to be a flagship of the Secretary’s demonstration of VA’s commitment to improving timeliness of care, changing the culture within the agency, being transparent with the Veteran community, and empowering Veterans to make informed decisions about their health care. Not only does this tool process complex data, but it makes the data transparent to Veterans and the public. We will continue to improve transparency via the Access to Care site as we receive feedback from Veterans, employees, Veterans Service Organizations, and Congress.
Incorporating this feedback will ensure that the Veteran Access and Quality Tool is a Veteran-driven and Veteran-designed point of access for the level of care our Veterans deserve.
OIT’s Business Intelligence Service Line (BISL) accepted the challenge of launching the new Access to Care site within 30 days and assembled a talented team that worked around the clock to break new ground and launch a Veteran-facing, cloud-based application. Pre-launch activities included briefings to Veterans Service Organizations, the Senate Veterans Affairs Committee, the House Veterans Affairs Committee, and numerous news outlets, including USA Today and CBS’s “60 Minutes”. Since its launch on April 12, 2017, OIT made approximately 750 modifications and additions to the site, including six major releases—many at the request of the Secretary, reflecting his own personal involvement in the project and OIT’s commitment to delivering on VA’s promise to be more transparent.
VA’s work was recognized government- and industry-wide; the application was named a finalist in the 2017 Government Computer News Digital IT Awards.
Joint Legacy Viewer (JLV) and Community Viewer (CV)
VA and DoD share more medical information than any two health care organizations in the country, and that’s due in part to a VA’s Joint Legacy Viewer (JLV) tool. OIT and VHA worked with DoD over the past 18 months to develop and deploy the JLV to all clinicians in every VA facility to provide an intuitive display of DoD and VA health care data on a single screen.
We also worked with VHA to build on JLV’s success and in 2017, OIT worked with VHA to build on JLV’s success and expand capabilities so VA providers could share health data with community health care providers not currently engaged in health information exchange with VA in a secure, electronic manner. Both JLV and CV are read-only, web-based applications that support benefits delivery and clinical decisions that are essential to providing coordinated, secure, and streamlined health care and benefit adjudication to Veterans. Together, they improve access to safe, high-quality care for Veterans through an integrated view of health records from all sources.
- As of Nov. 2017, VA reports 89,623 JLV DoD and 332,586 VA users
- Between May 2013 and Oct. 2017, almost eight million medical records were viewed through JLV
- CV was nationally released in Nov. 2017 with 94 active providers
