A Telehealth Collaboration Between a Regional Veterans Affairs Primary Care System and a School of Pharmacy: Key Outcomes from 2024
Main Article Content
Abstract
Background: The Veterans Health Administration is the largest integrated healthcare system in the United States, delivering services to more than 9.1 million Veterans across 1,380 facilities. We describe a partnership with a regional Veterans Affairs (VA) healthcare system and a health professional school.
Methods: The VA Northern California Health Care System, in collaboration with the University of the Pacific, Thomas J. Long School of Pharmacy, implemented a remote population health management course for pharmacy students. The course combined didactic and experiential learning, utilizing remote access to VA electronic health records and clinical dashboards to conduct telehealth activities focused on diabetes, cancer screenings, and opioid safety. A time and motion analysis evaluated the time the students saved the healthcare system. Pre- and post-course assessments evaluated students’ knowledge and confidence in performing telehealth activities.
Results: In 2024, 126 students participated in the course, collectively saving 377.5 hours of healthcare system labor. Analysis of pre- and post-course assessments revealed statistically significant improvements in students' knowledge and confidence related to course activities and population health initiatives.
Conclusions: These findings demonstrate the effectiveness of a scalable telehealth course model in enhancing student learning while supporting population health management efforts within a healthcare system.
Article Details
How to Cite
CARR-LOPEZ, Sian M. et al.
A Telehealth Collaboration Between a Regional Veterans Affairs Primary Care System and a School of Pharmacy: Key Outcomes from 2024.
Medical Research Archives, [S.l.], v. 13, n. 5, may 2025.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/6493>. Date accessed: 21 june 2025.
doi: https://doi.org/10.18103/mra.v13i5.6493.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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21. Yuan Y, Price M, Schmidt DF, Ward M, Nebeker J, Pizer S. Integrated health record viewers and reduction in duplicate medical imaging: Retrospective observational analysis. JMIR Med Inform. 2022;10(5): e32168. doi: 10.2196/32168
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24. Krebs EE, Lorenz KA, Bair MJ, et al. Development and initial validation of the PEG, a three-item scale assessing pain intensity and interference. J Gen Intern Med. 2009;24(6):733-738. doi:10.1007/s11606-009-0981-1
25. Carr-Lopez SM, Strohecker LA, Miyahara RK, et al. Impact of a Veterans Affairs primary care collaboration to provide remote team-based care and telehealth introductory pharmacy practice experiences. J Am Coll Clin Pharm. 2021;4(9):1109–1116. https://doi.org/10.1002/jac5.1474
26. Pylypchuk Y, Barker W. Use of Telemedicine among office-based physicians, 2021. In: ASTP Health IT Data Brief. Washington (DC): Office of the Assistant Secretary for Technology Policy; March 2023.1-16.
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29. Saigí-Rubió F, Borges do Nascimento IJ, Robles Net al. The current status of telemedicine technology use across the World Health Organization European Region: An Overview of systematic reviews. J Med Internet Res. 2022;24(10), e40877. doi.org/10. 2196/40877
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36. Carmichael JM, Meier J, Robinson A, Taylor J, Higgins DT, Patel S. Leveraging electronic medical record data for population health management in the Veterans Health Administration: Successes and lessons learned. Am J Health Syst Pharm. 2017;74(18):1447-1459. doi:10.2146/ajhp161048
37. Mariño RJ, Capurro D, Merolli M. Pilot implementation of a telehealth course for health professions students. BMC Med Educ. 2024;24(1):963. Published 2024 Sep 4. doi:10.1186/s12909-024-05931-z
38. Alami H, Shaw SE, Fortin JP, Savoldelli M, Fleet R, Têtu B. The 'wrong pocket' problem as a barrier to the integration of telehealth in health organisations and systems. Digit Health. 2023;9:20552076231169835. Published 2023 Apr 16. doi:10.1177/20552076231169835
2. Rosland AM, Nelson K, Sun H, et al. The patient-centered medical home in the Veterans Health Administration. Am J Manag Care. 2013;19(7):e263-e272.
3. Rodriguez HP, Giannitrapani KF, Stockdale S, Hamilton AB, Yano EM, Rubenstein LV. Teamlet structure and early experiences of medical home implementation for Veterans. J Gen Intern Med. 2014;29 Suppl 2(Suppl 2):S623-S631. doi:10.1007/s11606-013-2680-1
4. VA Telehealth Services celebrates 20 years - VA News. news.va.gov. Published May 1, 2023. Accessed April 7, 2025. https://news.va.gov/118570/va-telehealth-services-celebrates-20-years/
5. Heyworth L, Shah N, Galpin K. 20 years of telehealth in the Veterans Health Administration: Taking stock of our past and charting our future. J Gen Intern Med. 2024;39(Suppl 1):5-8. doi:10.1007/s11606-024-08617-w
6. US Department of Veterans Affairs Veterans Health Administration Office of Academic Affiliations. Health professions trainee satisfaction survey: AY 2023-2024. Accessed April 7, 2025. https://www.va.gov/OAA/docs/OAA_Stat_Sheet_AY23-24.pdf
7. Harada ND, Falco K, Bowman M, Byrne JM. Telehealth and virtual supervision practices for health professions education in the Department of Veterans Affairs. BMC Med Educ. 2025;25(1):314. doi:10.1186/s12909-025-06698-7
8. Ourth H, Groppi J, Morreale AP, Quicci-Roberts K. Clinical pharmacist prescribing activities in the Veterans Health Administration. Am J Health Syst Pharm. 2016;73(18):1406-1415. doi:10.2146/ajhp150778
9. Hammond RW, Schwartz AH, Campbell MJ et al. Collaborative drug therapy management by pharmacists—2003. Pharmacotherapy. 2003; 23(9):1210-1225. doi:10.1592/phco.23.10.1210.32752
10. McFarland MS, Buck ML, Crannage E, et al. Assessing the impact of comprehensive medication management on achievement of the quadruple aim. Am J Med. 2021;134(4):456-461. doi:10.1016/j.amjmed.2020.12.008
11. Perez A, Doloresco F, Hoffman JM, et al. ACCP: economic evaluations of clinical pharmacy services: 2001-2005. Pharmacotherapy. 2009;29(1):128. doi:10.1592/phco.29.1.128.
12. Talon B, Perez A, Yan C, et al. Economic evaluations of clinical pharmacy services in the United States: 2011-2017. J Am Coll Clin Pharm. 2019;3:793–806. https://doi.org/10.1002/jac5.1199
13. US Department of Veterans Affairs Pharmacy Benefits Management Services, Clinical Pharmacy Practice Office. Optimizing the Clinical Pharmacist Practitioner (CPP) to Improve Access and Quality Care. Accessed April 7, 2025. https://www.pbm.va.gov/PBM/CPPO/Documents/ExternalFactSheet_OptimizingtheCPPToImproveAccess_508.pdf
14. Kerns RD, Otis J, Rosenberg R, Reid MC. Veterans' reports of pain and associations with ratings of health, health-risk behaviors, affective distress, and use of the healthcare system. J Rehabil Res Dev. 2003;40(5):371-379. doi:10.1682/jrrd.2003.09.0371
15. Gellad WF, Good CB, Shulkin DJ. Addressing the opioid epidemic in the United States: lessons from the Department of Veterans Affairs. JAMA Intern Med. 2017;177(5):611-612. doi:10.1001/jamainternmed.2017.0147
16. Gallagher RM. Advancing the pain agenda in the Veteran population. Anesthesiol Clin. 2016;34(2):357-378. doi:10.1016/j.anclin.2016.01.003
17. Dowell D, Ragan KR, Jones CM, Baldwin GT, Chou R. CDC clinical practice guideline for prescribing opioids for pain - United States, 2022. MMWR Recomm Rep. 2022;71(3):1-95. doi:10.15585/mmwr.rr7103a1
18. US Department of Veterans Affairs and Department of Defense. Clinical Practice Guideline for the Use of Opioids in the Management of Chronic Pain. May 2022. Accessed April 7, 2025. https://www.healthquality.va.gov/guidelines/Pain/cot/VADODOpioidsCPG.pdf
19. US Department of Veterans Affairs. About Us - Women Veterans Health Care. Accessed April 7, 2025. https://www.womenshealth.va.gov/WOMENSHEALTH/about-us.asp
20. Legler A, Price M, Parikh M, et al. Effect on VA patient satisfaction of provider's use of an integrated viewer of multiple electronic health records. J Gen Intern Med. 2019;34(1):132-136. doi:10.1007/s11606-018-4708-z
21. Yuan Y, Price M, Schmidt DF, Ward M, Nebeker J, Pizer S. Integrated health record viewers and reduction in duplicate medical imaging: Retrospective observational analysis. JMIR Med Inform. 2022;10(5): e32168. doi: 10.2196/32168
22. The Association of American Medical Colleges. New and emerging areas in medicine series. Telehealth competencies across the learning continuum. March 2021. Accessed April 7, 2025. https://store.aamc.org/downloadable/download/sample/sample_id/412/
23. American Association of Colleges of Pharmacy. AACP Curriculum Outcomes and Entrustable Professional Activities (COEPA) 2022. Accessed April 7, 2025. https://www.aacp.org/sites/default/files/2022-11/coepa-document-final.pdf
24. Krebs EE, Lorenz KA, Bair MJ, et al. Development and initial validation of the PEG, a three-item scale assessing pain intensity and interference. J Gen Intern Med. 2009;24(6):733-738. doi:10.1007/s11606-009-0981-1
25. Carr-Lopez SM, Strohecker LA, Miyahara RK, et al. Impact of a Veterans Affairs primary care collaboration to provide remote team-based care and telehealth introductory pharmacy practice experiences. J Am Coll Clin Pharm. 2021;4(9):1109–1116. https://doi.org/10.1002/jac5.1474
26. Pylypchuk Y, Barker W. Use of Telemedicine among office-based physicians, 2021. In: ASTP Health IT Data Brief. Washington (DC): Office of the Assistant Secretary for Technology Policy; March 2023.1-16.
27. Ndwabe H, Basu A, Mohammed J. Post pandemic analysis on comprehensive utilization of telehealth and telemedicine. Clin eHealth. 2024;7:5-14. doi:10.1016/j.ceh.2023.12.002
28. Gullslett MK, Ronchi E, Lundberg L, et al. Telehealth development in the WHO European Region: Results from a quantitative survey and insights from Norway. Int J Med Inform. 2024;191:105558. doi: 10.1016/j.ijmedinf.2024.105558
29. Saigí-Rubió F, Borges do Nascimento IJ, Robles Net al. The current status of telemedicine technology use across the World Health Organization European Region: An Overview of systematic reviews. J Med Internet Res. 2022;24(10), e40877. doi.org/10. 2196/40877
30. World Health Organization. The ongoing journey to commitment and transformation. Digital health in the WHO European Region 2023. 2023. Accessed April 7,2025. https://cdn.who.int/media/docs/librariesprovider2/data-and-evidence/english-ddh-260823_7amcet.pdf?sfvrsn=4c674522_2&download=true
31. U.S. Food and Drug Administration. What is digital health? September 22, 2022. Accessed April 7, 2025. https://www.fda.gov/medical-devices/digital-health-center-excellence/what-digital-health
32. World Health Organization. Regional digital health action plan for the WHO European Region 2023-2030. 2022. Accessed April 7, 2025. https://iris.who.int/bitstream/handle/10665/360950/72wd05e-DigitalHealth-220529.pdf?sequence=2
33. World Federation for Medical Education. Basic Medical Education: WFME Global Standards for Quality Improvement. 2015. Accessed April 7, 2025. https://wfme.org/wp-content/uploads/2015/01/BME_2015_v2.pdf
34. World Federation for Medical Education. Basic Medical Education: WFME Global Standards for Quality Improvement. 2020. Accessed April 7, 2025. https://wfme.org/wp-content/uploads/2020/12/WFME-BME-Standards-2020.pdf
35. American Osteopathic Association. Commission on Osteopathic College Accreditation. Accreditation of Colleges of Osteopathic Medicine: COM Continuing Standards. 2023. Accessed April 7, 2025. https://osteopathic.org/index.php?aam-media=/wp-content/uploads/COCA-2023-COM-Continuing-Standards.pdf
36. Carmichael JM, Meier J, Robinson A, Taylor J, Higgins DT, Patel S. Leveraging electronic medical record data for population health management in the Veterans Health Administration: Successes and lessons learned. Am J Health Syst Pharm. 2017;74(18):1447-1459. doi:10.2146/ajhp161048
37. Mariño RJ, Capurro D, Merolli M. Pilot implementation of a telehealth course for health professions students. BMC Med Educ. 2024;24(1):963. Published 2024 Sep 4. doi:10.1186/s12909-024-05931-z
38. Alami H, Shaw SE, Fortin JP, Savoldelli M, Fleet R, Têtu B. The 'wrong pocket' problem as a barrier to the integration of telehealth in health organisations and systems. Digit Health. 2023;9:20552076231169835. Published 2023 Apr 16. doi:10.1177/20552076231169835