Study: VHA missing opportunities to reach some patients

The Veterans Health Administration is missing opportunities to utilize its EHR to reach patients with specific medical conditions that require intensive treatment and self-management, according to a study published in the Journal of Medical Internet Research.

Researchers, led by Stephanie Leah Shimada, PhD, of the Center for Healthcare Organization and Implementation Research in Bedford, Mass., conducted a cross-sectional analysis of veterans with at least one inpatient admission or two outpatient visits from April 2010 to March 2012.

The study compared adoption (registration, authentication, opt-in to use secure messaging) and use (prescription refill and secure messaging) of its EHR system, My HealtheVet, in April 2012 across 18 specific clinical conditions. Utilizing multivariate logistic regression models adjusting for sociodemographics, comorbidities and clustering of patients within facilities, the study calculated predicted probabilities of adoption.

Among about 6 million veterans, 18.64 percent had registered for My HealtheVet, 11.06 percent refilled prescriptions, and 1.91 percent used secure messaging with their clinical providers. “Results … suggest that patients with HIV, hyperlipidemia and spinal cord injury had the highest predicted probabilities of adoption, whereas those with schizophrenia or schizoaffective disorder, alcohol or drug abuse and stroke had the lowest,” wrote Shimada et al.

Registration rates varied as well, ranging from 29.19 percent of patients with traumatic brain injury to 14.18 percent of those with schizophrenia or schizoaffective disorder.

“Some of the variation in actual reach can be explained by facility-level differences in My HealtheVet adoption and by differences in patients’ sociodemographic characteristics (eg, age, race, income) by diagnosis," according to the authors.

Access the study.