Evaluation of VLER-Indiana Health Information Exchange Demonstration Project (VLER-IHIE)
Three out of four Veterans receive a portion of their care from non-VA providers. On April 9, 2009, President Barack Obama directed the Department of Veterans Affairs and the Department of Defense to create the Virtual Lifetime Electronic Record (VLER). On August 2010, Secretary of Veterans Affairs Eric K. Shinseki visited Indianapolis, and after visiting with leaders from the VA Health Services Research & Development (HSR&D) Center of Excellence and the Regenstrief Institute, he made the following public comments regarding the latest partnership between the two institutions: "This new technology allows safer, more secure, and private access to electronic health information which, in turn, enhances our ability to continue providing Veterans with the quality care that they have earned."
This new technology refers to the VLER HEALTH program that the Indianapolis VA is now implementing in partnership with the Regenstrief Institute and Indiana Health Information Exchange (IHIE). This VA-IHIE demonstration project is intended to create the capacity for VA institutions to exchange health information with community partners.
Investigators from the VA HSR&D Center on Implementing Evidence-Based Practice are active collaborators in building and implementing this program. The VA-IHIE program provides the bi-directional exchange of health information between VA and non-VA providers. Based on our pilot study of linked VA-IHIE data, investigators are conducting an evaluation of the impact of the VA-IHIE demonstration project upon health care quality and cost of Veterans by taking advantage of the initiation of the implementation as a natural experiment.
|Diabetes Mellitus Asthma Cardiovascular Diseases Heart Failure Osteoporosis||Other: Active Health Information Exchange Other: Non-Active Health Information exchange|
|Study Design:||Observational Model: Cohort
Time Perspective: Retrospective
|Official Title:||Evaluation of VLER_Indiana Health Information Exchange Demonstration Project|
- Understanding Utilization of Healthcare Procedures by Veterans According to Source of Data [ Time Frame: 2 years ]Determining rates of usage of healthcare by veterans by source of data. This will clue us into any differences in utilization patterns between groups.
- Effect of Health Information Exchange on Cost [ Time Frame: 2 Years ]Before after analysis of the presence of health information exchange on costs within the VA healthcare system; Measure is cost, unadjusted, in dollars for the year post enrollment in the health information exchange
- Health Care Quality: Ambulatory Care Performance Measures [ Time Frame: 3 years ]This study will measure the impact of HIE upon health care quality the underuse of ambulatory care services. Measurements of underuse before and after implementation will detect improvements in the quality of care. To measure underuse, the study employs a measurement set that is sensitive to the potential effects and feasible for electronic data capture. 15 measures have been chosen, falling in the areas of prevention, diabetes, asthma, cardiovascular disease, congestive heart failure, mental health and osteoporosis.
- Health Care Quality: Care Sensitive Admissions [ Time Frame: 3 years ]This study will use the Agency for Healthcare Research and Quality's (AHRQ) Prevention Quality Indicators (PQI) to calculate the outcome measure. The PQIs are a set of measures used with hospital inpatient data to identify ambulatory care sensitive conditions. The PQIs consist of 14 conditions. The study will adopt 12 that are commonly used for adult patients: angina, asthma, bacterial pneumonia, chronic obstructive pulmonary disease, congestive heart failure, dehydration, diabetes long-term complications, diabetes short-term complications, diabetes uncontrolled, hypertension, lower-limb amputation among diabetes patients, and urinary infection.
|Study Start Date:||December 2012|
|Study Completion Date:||January 2016|
|Primary Completion Date:||June 2015 (Final data collection date for primary outcome measure)|
Patients in this arm will represent Veterans seen at the Indianapolis VA Medical Center (VAMC) for whom information exchange has not been activated.
Other: Non-Active Health Information exchange
Patients not selecting to share data
Enrolled in Exchange
Patients in this arm will represent Veterans seen at the Indianapolis VAMC for whom information exchange has been activated by the patient choosing to "opt-in."
Other: Active Health Information Exchange
Patients selected to share data between the VA & external healthcare agencies.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01446705
|United States, Indiana|
|Richard L. Roudebush VA Medical Center, Indianapolis, IN|
|Indianapolis, Indiana, United States, 46202-2884|
|Principal Investigator:||David A Haggstrom, MD||Richard L. Roudebush VA Medical Center, Indianapolis, IN|