Advancing Evidence-Based Care For Diabetes: Lessons From The Veterans Health Administration

Kupersmith, Joel; Francis, Joseph; Kerr, Eve A.; Krein, Sarah L.; Pogach, Leonard; Kolodner, Robert M.; Perlin, Jonathan B.

doi:10.1377/hlthaff.26.2.w156

Cited by 90 publications

(63 citation statements)

References 25 publications

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“…Because VistA was deployed comcomitant with implementing multiple other systemic changes, it is not possible to apportion how much of the system's improvement was due to the different change strategies. There is likely significant synergism among the EHR, performance measurement, increased accountability, aligned financial incentives, and an environent focused on quality improvement, accountability, and population health (3,117,149,274).…”

Section: Improved Information Managementmentioning

confidence: 99%

Extreme Makeover: Transformation of the Veterans Health Care System

Kizer¹,

Dudley

2009

Annu. Rev. Public Health

152

130

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The veterans health care system administered by the U.S. Department of Veterans Affairs (VA) was established after World War I to provide health care for veterans who suffered from conditions related to their military service. It has grown to be the nation's largest integrated health care system.As the system grew, a number of factors contributed to its becoming increasingly dysfunctional. By the mid-1990s, VA health care was widely criticized for providing fragmented and disjointed care of unpredictable and irregular quality, which was expensive, difficult to access, and insensitive to individual needs.Between 1995 and 1999, the VA health care system was reengineered, focusing especially on management accountability, care coordination, quality improvement, resource allocation, and information management. Numerous systemic changes were implemented, producing dramatically improved quality, service, and operational efficiency. VA health care is now considered among the best in America, and the VA transformation is viewed as a model for health care reform.

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Section: Improved Information Managementmentioning

confidence: 99%

Extreme Makeover: Transformation of the Veterans Health Care System

Kizer¹,

Dudley

2009

Annu. Rev. Public Health

152

130

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“…VHA has been a leader in the use of performance measures and clinical reminders to foster evidence-based healthcare [22]. As part of its recent implementation of its new nationwide program for managing obesity called MOVE!…”

Section: Technical or Policy Changes To Improve Data  Completeness Amentioning

confidence: 99%

VHA Corporate Data Warehouse height and weight data: Opportunities and challenges for health services research

Noël¹,

Copeland²,

Perrin³

et al. 2010

JRRD

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Abstract-Within the Veterans Health Administration (VHA), anthropometric measurements entered into the electronic medical record are stored in local information systems, the national Corporate Data Warehouse (CDW), and in some regional data warehouses. This article describes efforts to examine the quality of weight and height data within the CDW and to compare CDW data with data from warehouses maintained by several of VHA's regional groupings of healthcare facilities (Veterans Integrated Service Networks [VISNs]). We found significantly fewer recorded heights than weights in both the CDW and VISN data sources. In spite of occasional anomalies, the concordance in the number and value of records in the CDW and the VISN warehouses was generally 97% to 99% or greater. Implausible variation in same-day and same-year heights and weights was noted, suggesting measurement or data-entry errors. Our work suggests that the CDW, over time and through validation, has become a generally reliable source of anthropometric data. Researchers should assess the reliability of data contained within any source and apply strategies to minimize the impact of data errors appropriate to their study population.

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“…LCS is another in a long series of partnerships in the VHA that have been created to improve patient care. [25][26][27][28] The LCSDP is an example of a partnership that can be used by the VHA as a model to implement new clinical programs. Lessons learned from the VHA can serve as an example to other healthcare systems as they develop partnerships to implement new clinical programs.…”

Section: Resultsmentioning

confidence: 99%

Implementation of New Clinical Programs in the VHA Healthcare System: The Importance of Early Collaboration Between Clinical Leadership and Research

Kinsinger

Provenzale

et al. 2014

J GEN INTERN MED

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Collaboration between policy, research, and clinical partners is crucial to achieving proven quality care. The Veterans Health Administration has expended great efforts towards fostering such collaborations. Through this, we have learned that an ideal collaboration involves partnership from the very beginning of a new clinical program, so that the program is designed in a way that ensures quality, validity, and puts into place the infrastructure necessary for a reliable evaluation. This paper will give an example of one such project, the Lung Cancer Screening Demonstration Project (LCSDP). We will outline the ways that clinical, policy, and research partners collaborated in design, planning, and implementation in order to create a sustainable model that could be rigorously evaluated for efficacy and fidelity. We will describe the use of the Donabedian quality matrix to determine the necessary characteristics of a quality program and the importance of the linkage with engineering, information technology, and clinical paradigms to connect the development of an on-the-ground clinical program with the evaluation goal of a learning healthcare organization. While the LCSDP is the example given here, these partnerships and suggestions are salient to any healthcare organization seeking to implement new scientifically proven care in a useful and reliable way.

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Advancing Evidence-Based Care For Diabetes: Lessons From The Veterans Health Administration

Cited by 90 publications

References 25 publications

Extreme Makeover: Transformation of the Veterans Health Care System

Extreme Makeover: Transformation of the Veterans Health Care System

VHA Corporate Data Warehouse height and weight data: Opportunities and challenges for health services research

Implementation of New Clinical Programs in the VHA Healthcare System: The Importance of Early Collaboration Between Clinical Leadership and Research

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