Presented at the 2012 AAPM Annual Meeting « Back

VA SCAN-ECHO Initiative

Gerald W. Grass, MD, gerald.grass@va.gov, VA Connecticut Healthcare System/Yale University, Guilford, Connecticut

Background: VA SCAN-ECHO is an initiative to bring specialty care pain medicine consultation access to the desktop of every primary care provider in a broad area. It is designed to assist VA Medical Centers in providing specialty pain medicine care services with the highest quality possible to the greatest number of Veterans at the most reasonable cost utilizing innovative new technology and services. VA SCAN's mission is to increase pain medicine quality through sharing of "best practices" and evidence-based practice guidelines, and thereby improve both provider and Veteran satisfaction in a cost effective and financially responsible manner. Process: Region 1 VA SCAN is establishing telemedicine programs in 33 VA Medical Centers and 157 community based outpatient centers in 11 states. Participation in this initiative promotes the development of "subject matter expertise" and clinical competency of primary care providers through "case-based" learning and formal CME accredited didactic sessions to successfully co-manage difficult to treat chronic pain patients and build a cohesive "knowledge network" of collaborating providers. Lessons Learned: Barriers to the successful implementation project have included; infrastructure resource utilization, primary care time allocation, technology gaps, policy & procedure, legal & regulatory issues, strategic plan development and marketing strategy. Outcome: Preliminary outcome and performance measure include: reduce access time to specialty pain care consultation, improve quality of care, improve patient outcomes, increase veteran and provider satisfaction, and evidence of reduction in costs associated with fee-basis referrals, beneficiary travel expenses, unnecessary diagnostic testing, and inappropriate pharmacy benefits expenditures.

Funding: This is a T21 (Healthcare Transformation into the 21st Century) initiative, sponsored by the Office of Specialty Care and the Office of Specialty Care Transformation under the leadership the Secretary of the VA Eric Shinseki (1.2 million dollars).