Opening a window of opportunity through technology and coordination: a multisite case study.

Area of Science:

• Healthcare Management
• Public Health
• Gerontology

Background:

• The Veterans Integrated Service Network (VISN 8) implemented the Community Care Coordination Service (CCCS) in April 2000.
• The CCCS aimed to enhance care coordination for clinically complex veterans.
• Key objectives included increasing access to care and reducing hospitalizations and emergency room (ER) visits.

Purpose of the Study:

• To evaluate the impact of the CCCS program on healthcare utilization and clinical outcomes for veterans.
• To assess the effectiveness of a coordinated care approach across the continuum of care.
• To determine the influence of home telehealth technology in care coordination.

Main Methods:

• A case study analysis was conducted across three medical centers: Ft. Myers, Lake City, and Miami.
• Utilization data (inpatient admissions, ER encounters, bed days) were analyzed after 18 months.
• Clinical impact was assessed using the Medical Outcomes Study 36-item Short Form health survey for veterans (SF36V).

Main Results:

• Significant reductions in inpatient admissions were observed (Ft. Myers: 46%, Lake City: 68%, Miami: 13%).
• ER encounters decreased notably (Ft. Myers: 19%, Lake City: 70%, Miami: 15%).
• Quality of life scores improved, with increases in SF36V components at Lake City and Ft. Myers.

Conclusions:

• The CCCS program effectively reduced healthcare utilization and improved quality of life for veterans.
• A coordinated care model, enhanced by daily telehealth communication, facilitates early problem identification and intervention.
• The CCCS demonstrates a successful strategy for managing clinically complex veteran populations.