Chronic Illness Clinical Trial
Official title:
Dual Health Systems Users: Strategies to Implement Optimal Care Coordination
The purpose of this study is 1) to learn how VA patients can help share their health information between their VA providers and providers outside the VA and 2) if sharing this information is useful to providers and improves care received.
Recent studies estimate that 43 to 75% of Veterans also receive care from non-VA providers
(dual use). Dual use is a concern because splitting care between two or more health systems
and multiple providers may result in poor coordination of services and a loss of continuity
-ultimately putting the patient at increased risk for poor outcomes. Addressing dual use in
Veterans is an issue of care coordination. One component of care coordination is information
sharing, which often relies on the patient to share information between systems/providers.
Veterans registered in My HealtheVet with premium account status have access to download and
print a VA health summary (VA CCD). This health summary can be shared with non-VA providers
to inform them about recent VA care. This pilot randomized controlled trial will compare
usual care to an intervention which aims to improve care coordination for dual use Veterans
by educating them about the use of information technology to share health information and
informing their providers about the extent and nature of care from other health care systems.
Methods: Dual use Veterans with at least one chronic health condition and both an upcoming VA
and non-VA appointments within the study time frame will be eligible to participate. Veterans
will be randomized to the intervention or usual care. Veterans in the intervention group will
be trained on use of My HealtheVet and their community patient portal (if applicable) to
access summary health information to share with providers. In addition, he/she will create a
document that lists all members of their health care team. All participants will be asked to
take a provider evaluation packet each provider visit (VA and non-VA). After the visit, a
phone call will be scheduled with the Veteran to ask about the appointment and medical
records from the appointment will be obtained. Outcomes: The main outcomes will be related to
patient perceived continuity of care, provider relational coordination survey, medication
concordance, and medical laboratory test duplication. Pre and post scores on the patient
activation measures will also be explored.
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