The purpose of this study is 1) to learn how VA patients can help share their health
information between their VA providers and providers outside the VA and 2) if sharing this
information is useful to providers and improves care received.
Recent studies estimate that 43 to 75% of Veterans also receive care from non-VA providers
(dual use). Dual use is a concern because splitting care between two or more health systems
and multiple providers may result in poor coordination of services and a loss of continuity
-ultimately putting the patient at increased risk for poor outcomes. Addressing dual use in
Veterans is an issue of care coordination. One component of care coordination is information
sharing, which often relies on the patient to share information between systems/providers.
Veterans registered in My HealtheVet with premium account status have access to download and
print a VA health summary (VA CCD). This health summary can be shared with non-VA providers
to inform them about recent VA care. This pilot randomized controlled trial will compare
usual care to an intervention which aims to improve care coordination for dual use Veterans
by educating them about the use of information technology to share health information and
informing their providers about the extent and nature of care from other health care
Methods: Dual use Veterans with at least one chronic health condition and both an upcoming
VA and non-VA appointments within the study time frame will be eligible to participate.
Veterans will be randomized to the intervention or usual care. Veterans in the intervention
group will be trained on use of My HealtheVet and their community patient portal (if
applicable) to access summary health information to share with providers. In addition,
he/she will create a document that lists all members of their health care team. All
participants will be asked to take a provider evaluation packet each provider visit (VA and
non-VA). After the visit, a phone call will be scheduled with the Veteran to ask about the
appointment and medical records from the appointment will be obtained. Outcomes: The main
outcomes will be related to patient perceived continuity of care, provider relational
coordination survey, medication concordance, and medical laboratory test duplication. Pre
and post scores on the patient activation measures will also be explored.
- Receives health care from VA and non-VA provider
- Diagnosed with a chronic health condition
- Prescribed 5 or more medications
- Upcoming VA and non-VA appointments within the study time frame
- Registered or willing to become registered with My HealtheVet
- Access to a computer with internet, phone, and a printer.
- English speaking
VA or Non-VA Providers: provide care to a stuy participant
- Previously shared health data with a provider via their My HealtheVet or local
provider patient portal
- No scheduled VA or non-VA appointments
Carolyn L Turvey, PhD MS
Iowa City VA Health Care System, Iowa City, IA