Improving Communication Between VHA and Non-VHA Providers: Implications for Veteran-Centered Dual Care

Objectives: The aims of this project were to examine current practices of communication between VHA and non-VHA providers, from the perspective of VHA and non-VHA health care providers and to obtain feedback regarding the use of technology tools (the Blue Button feature in MyHealtheVet, telephone and secure messaging) in improving communication between VHA and non-VHA providers in dual care for Veterans. Methods: An online survey of a national sample of VHA physicians and mid-level providers and a mailed survey of non-VHA physicians practicing in Nebraska were conducted. Key informant interviews were conducted with VHA and Non-VHA physicians regarding the feasibility, effectiveness and efficiency of three selected communication tools: the Blue Button feature in MHV; telephone and secure messaging. A total of 130 VHA clinicians and 672 non-VHA physicians responded to the surveys. Results: Less than 12 % of VHA clinicians reported that they always or most of the time communicate with Non-VHA providers regarding dual care Veterans. Only 20% of VHA physicians responded that they always or most of the time receive useful medical information about their dual care patients from the Non-VHA providers. Only 13% of the non-VHA physicians responded that they always or most of the time receive useful medical information about their Veteran patients from the VHA. The Blue Button feature can lead to a more informed empowered patient, but had the perceived disadvantage of putting the Veteran at the center of the information exchange. Secure messaging was considered efficient for non-urgent communication. Telephones were considered the most direct and quick form of communication. Implications: Although the implementation of Patient Aligned Care Teams has improved patient to provider communication within the VHA through the increased use of secure emails and messaging, the current practices for communication between VHA and non-VHA providers need to be improved to provide high quality Veteran-centered care to our nation\u27s Veterans. Impacts: Improving communication between VA and non-VA health care providers has the potential to improve the quality and safety of care provided to dual care Veterans