Specialty Care Access Network-Extension of Community Healthcare Outcomes Model Program for Liver Disease Improves Specialty Care Access

Authors

Lisa M. Glass, VA Ann Arbor Healthcare System, Internal Medicine, Gastroenterology 111D, 2215 Fuller Road, Ann Arbor, MI, 48105, USA; Department of Internal Medicine, Division of Gastroenterology and Hepatology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
Akbar K. Waljee, VA Ann Arbor Healthcare System, Internal Medicine, Gastroenterology 111D, 2215 Fuller Road, Ann Arbor, MI, 48105, USA; VA Center for Clinical Management Research, VA Ann Arbor Health Care System, Ann Arbor, MI, USA; Department of Statistics, University of Michigan, Ann Arbor, MI, USA
Heather McCurdy, VA Ann Arbor Healthcare System, Internal Medicine, Gastroenterology 111D, 2215 Fuller Road, Ann Arbor, MI, 48105, USA
Grace L. Su, VA Ann Arbor Healthcare System, Internal Medicine, Gastroenterology 111D, 2215 Fuller Road, Ann Arbor, MI, 48105, USA; Department of Internal Medicine, Division of Gastroenterology and Hepatology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
Anne Sales, VA Center for Clinical Management Research, VA Ann Arbor Health Care System, Ann Arbor, MI, USA; Department of Learning Health Sciences, Medical School, University of Michigan, Ann Arbor, MI, USA

Document Type

Article

Publication Date

12-1-2017

Abstract

BACKGROUND AND AIMS: To improve subspecialty access, VA Ann Arbor Healthcare System (VAAAHS) implemented the first Specialty Care Access Network (SCAN)-Extension of Community Healthcare Outcomes (ECHO) in chronic liver disease. SCAN-ECHO Liver links primary care providers (PCPs) to hepatologists via secure video-teleconferencing. We aim to describe characteristics of participants (PCPs) and patients (clinical question and diagnosis) in SCAN-ECHO Liver.

METHODS: This is a prospective study of the VAAAHS SCAN-ECHO Liver (June 10, 2011-March 31, 2015). This evaluation was carried out as a non-research activity under the guidance furnished by VHA Handbook 1058.05. It was approved through the Medicine Service at VAAAHS as noted in the attestation document which serves as documentation of approved non-research, quality improvement activities in VHA.

RESULTS: In total, 106 PCPs from 23 sites participated. A total of 155 SCAN-ECHO sessions discussed 519 new and 49 return patients. 29.4% of Liver Clinic requests were completed in SCAN-ECHO Liver. SCAN-ECHO Liver consults were completed an average of 10 days sooner than in conventional clinic. Potential travel saving was 250 miles round-trip (median 255 (IQR 142-316) per patient.

CONCLUSION: SCAN-ECHO Liver provided specialty care with increased efficiency and convenience for chronic liver disease patients. One of three of Liver Clinic consults was diverted to SCAN-ECHO Liver, reducing consult completion time by 20%.

Recommended Citation

Glass LM, Waljee AK, McCurdy H, Su GL, Sales A. Specialty Care Access Network-Extension of Community Healthcare Outcomes Model Program for Liver Disease Improves Specialty Care Access. Dig Dis Sci. 2017 Dec;62(12):3344-3349. doi: 10.1007/s10620-017-4789-2. Epub 2017 Oct 17. PMID: 29043594.