Dixon Brian E, Haggstrom David A, Weiner Michael
Center for Health Information and Communication, Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service CIN 13-416, Richard L. Roudebush VA Medical Center Richard M. Fairbanks School of Public Health Indiana University Center for Biomedical Informatics, Regenstrief Institute
Center for Health Information and Communication, Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service CIN 13-416, Richard L. Roudebush VA Medical Center School of Medicine, Indiana University Center for Health Services Research, Regenstrief Institute.
J Am Med Inform Assoc. 2015 Jul;22(4):917-20. doi: 10.1093/jamia/ocv019. Epub 2015 Mar 31.
Recent investigations into appointment scheduling within facilities operated by the US Department of Veterans Affairs (VA) illuminate systemic challenges in meeting its goal of providing timely access to care for all Veterans. In the wake of these investigations, new policies have been enacted to expand access to care at VA facilities as well as non-VA facilities if the VA is unable to provide access within a reasonable timeframe or a Veteran lives more than 40 miles from a VA medical facility. These policies are similar to broader health reform efforts that seek to expand access to care for other vulnerable populations. In this perspective, we discuss the informatics implications of expanded access within the VA and its wider applicability across the US health system. Health systems will require robust health information exchange, to maintain coordination while access to care is expanded. Existing informatics research can guide short-term implementation; furthermore, new research is needed to generate evidence about how best to achieve the long-term aim of expanded access to care.
近期对美国退伍军人事务部(VA)运营的医疗机构预约安排的调查揭示了在实现为所有退伍军人提供及时医疗服务这一目标过程中存在的系统性挑战。在这些调查之后,新政策已经颁布,以扩大在VA医疗机构以及非VA医疗机构的医疗服务可及性,前提是VA无法在合理时间内提供服务,或者退伍军人居住在距离VA医疗设施超过40英里的地方。这些政策类似于更广泛的医疗改革努力,旨在扩大其他弱势群体的医疗服务可及性。从这个角度出发,我们讨论了VA内部扩大医疗服务可及性的信息学影响及其在美国医疗系统中的更广泛适用性。医疗系统将需要强大的健康信息交换,以便在扩大医疗服务可及性的同时保持协调。现有的信息学研究可以指导短期实施;此外,还需要新的研究来提供证据,说明如何最好地实现扩大医疗服务可及性的长期目标。