Open forum infectious diseases · 2025
Dissemination and Implementation of a Telehealth-Enabled Program for Providing Infectious Disease Expertise in Rural Settings.
Клиническое исследованиеСтатьяНазвание и аннотация: Перевод в очереди
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Jump Robin L P, Bej Taissa A, Vivo Amanda, Wilson Brigid M, Kowal Corinne, Song Sunah, Abdelrahim Sara, Wilson Geneva, Milner Amelia, Nguyen Alexandria, Rodriguez Keri L, Beyer Nicole, Michaels Zachary, Amundson Carla, Bajema Kristina L, Beck Abigail, Burnham Jason P, Crnich Christopher J, Drekonja Dimitri M, Epstein Lauren, Ewers Tola, Livorsi Daniel J, Narayan Muthu, Perez Federico, Pfeiffer Christopher D, Sabzwari Rabeeya W, Salti Ahmed M, Tate Danielle, Walkner Tammy, Webster Andrew S, Evans Charlesnika T
Аннотация
BACKGROUND: Telehealth can facilitate improving antibiotic use and related antimicrobial stewardship activities in facilities underserved by infectious diseases (IDs) expertise. We describe implementation of the Department of Veterans Affairs (VA) videoconference antimicrobial stewardship team (VAST) to connect multidisciplinary teams from rural VA medical centers (VAMCs) with geographically distant ID experts.
METHODS: We implemented VASTs at 10 rural VAMCs from September 2021 to February 2024. VASTs consisted of regular meetings between rural VAMCs and an off-site ID expert who met by videoconference to discuss clinical cases, emphasizing recommendations for antibiotic prescribing. The VA Corporate Data Warehouse was used to collect information on patient medical encounter information. Interviews with healthcare professionals and surveys assessed perceptions of and experiences with VASTs.
RESULTS: VASTs completed 624 clinical encounters on 531 unique patients. Half (53%) of the encounters required >20 minutes. The most frequently discussed infections were respiratory tract (35%), skin and soft tissue (19%), and genitourinary (17%). Of the 73 (53% of 138 contacted) professionals who responded to the survey, >90% perceived VASTs as improving the quality of veteran care and agreed that recommendations were timely. All 24 interviewees identified VASTs as meeting an important need at the rural site and that the virtual system facilitated collaboration.
CONCLUSIONS: These findings indicate successful implementation of a telehealth program to disseminate ID and antimicrobial stewardship expertise to rural VAMCs. This is a strong model augmenting antimicrobial stewardship in other healthcare systems.
METHODS: We implemented VASTs at 10 rural VAMCs from September 2021 to February 2024. VASTs consisted of regular meetings between rural VAMCs and an off-site ID expert who met by videoconference to discuss clinical cases, emphasizing recommendations for antibiotic prescribing. The VA Corporate Data Warehouse was used to collect information on patient medical encounter information. Interviews with healthcare professionals and surveys assessed perceptions of and experiences with VASTs.
RESULTS: VASTs completed 624 clinical encounters on 531 unique patients. Half (53%) of the encounters required >20 minutes. The most frequently discussed infections were respiratory tract (35%), skin and soft tissue (19%), and genitourinary (17%). Of the 73 (53% of 138 contacted) professionals who responded to the survey, >90% perceived VASTs as improving the quality of veteran care and agreed that recommendations were timely. All 24 interviewees identified VASTs as meeting an important need at the rural site and that the virtual system facilitated collaboration.
CONCLUSIONS: These findings indicate successful implementation of a telehealth program to disseminate ID and antimicrobial stewardship expertise to rural VAMCs. This is a strong model augmenting antimicrobial stewardship in other healthcare systems.