Dissemination and Implementation of a Telehealth-Enabled Program for Providing Infectious Disease Expertise in Rural...

Area of Science:

• Telemedicine
• Infectious Diseases
• Antimicrobial Stewardship

Background:

• Telehealth enhances antibiotic use and antimicrobial stewardship in underserved facilities.
• Infectious diseases (ID) expertise is often limited in rural healthcare settings.
• The Department of Veterans Affairs (VA) implemented a videoconference antimicrobial stewardship team (VAST) to bridge this gap.

Purpose of the Study:

• To describe the implementation and impact of the VAST program.
• To assess the effectiveness of telehealth in disseminating ID and antimicrobial stewardship expertise to rural VA medical centers (VAMCs).

Main Methods:

• VASTs were implemented at 10 rural VAMCs from September 2021 to February 2024.
• Regular videoconference meetings connected rural VAMCs with off-site ID experts for clinical case discussions and prescribing recommendations.
• Data were collected via the VA Corporate Data Warehouse, healthcare professional surveys, and interviews.

Main Results:

• VASTs facilitated 624 clinical encounters for 531 patients, with common infections including respiratory, skin, and genitourinary.
• >90% of surveyed professionals perceived VASTs as improving veteran care quality and timeliness of recommendations.
• All interviewed professionals found VASTs met a critical need and facilitated collaboration.

Conclusions:

• Telehealth programs like VAST are effective in delivering specialized ID and antimicrobial stewardship expertise to rural VAMCs.
• This model demonstrates a successful strategy for augmenting antimicrobial stewardship in other healthcare systems.
• The VAST program highlights the potential of virtual collaboration to overcome geographical barriers in healthcare.