Transforming Veterans’ Care in Rural Practices Using Health IT
A 65-year-old veteran living in a rural community presents at his local Critical Access Hospital (CAH) with symptoms of pneumonia. After evaluating the patient, the physician discharges him with a prescription for antibiotics. What the physician doesn’t know is that his US Department of Veterans Affairs (VA) providers had prescribed warfarin (a blood thinner) to help prevent harmful blood clots that may cause a stroke. Yet certain antibiotics, when combined with warfarin, can lead to an adverse drug reaction that could include bleeding or interfere with the protection the anticoagulant (blood thinner) provides, which could lead to a stroke.
Following the lead of the White House Rural Council, we in the US Department of Health and Human Services (HHS) and the VA are working with our public and private partners to ensure rural providers and the communities they serve have health IT tools to help them avoid scenarios like this one.
Nearly 70% of veterans get health care services at both VA and non-VA clinics and hospitals. The percentage is higher among those veterans who live in rural and frontier areas of the country. In a recent evaluation of the VA Blue Button program conducted by Dr. Carolyn Turvey of the Iowa VA medical center, 52.5% of participants reported they carry information from one provider to another; about 13% indicated their providers use phone, mail or fax; 15% indicated that they do not know how their providers communicate between one another, and 15% reported their providers do not communicate at all. Currently there is no systematic and streamlined way for VA and non-VA health providers to exchange the patients’ health information to coordinate or co-manage care. One solution is to empower patients to initiate electronic transfer of their health information between their health care providers. That’s where our joint work comes in.