Implementing Geographic Information Systems (GIS) into VHA Home Based Primary Care

Jason D Lind; Jacqueline Fickel; Bridget A Cotner; Judith R Katzburg; Diane Cowper-Ripley; Marguerite Fleming; Michael K Ong; Alicia A Bergman; Sarah E Bradley; Sarah A Tubbesing

doi:10.1016/j.gerinurse.2019.10.010

Implementing Geographic Information Systems (GIS) into VHA Home Based Primary Care

Geriatr Nurs. 2020 May-Jun;41(3):282-289. doi: 10.1016/j.gerinurse.2019.10.010. Epub 2019 Nov 19.

Affiliations

¹ James A. Haley Veterans' Hospital and Clinics, Research and Development Service, 8900 Grand Oak Circle (151R), Tampa, FL 33637-1022, United States. Electronic address: [email protected].
² VA HSR&D Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States.
³ James A. Haley Veterans' Hospital and Clinics, Research and Development Service, 8900 Grand Oak Circle (151R), Tampa, FL 33637-1022, United States.
⁴ North Florida/South Georgia Veterans Health System, Center of Innovation, Gainesville, FL, United States; VA Office of Rural Health, GeoSpatial Outcomes Division, Gainesville, FL, United States.
⁵ VA Office of Reporting, Analytics, Performance, Improvement, and Deployment, Center for Innovation and Analytics, Washington, D.C., United States.
⁶ University of California at Los Angeles, David Geffen School of Medicine, Los Angeles, CA, United States; Division of Hospital Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States.
⁷ Home Based Primary Care Program, VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States; University of California at Los Angeles, David Geffen School of Medicine, Los Angeles, CA, United States.

PMID: 31757414
DOI: 10.1016/j.gerinurse.2019.10.010

Abstract

The Veteran's Health Administration (VHA) Home Based Primary Care (HBPC) program provides comprehensive in-home primary care services to elderly Veterans with complex chronic medical conditions. Nurses have prominent roles in HBPC including as program leaders, primary care providers and nurses who make home visits. Delivery of primary care services to patients in their homes can be challenging due to travel distances, difficult terrain, traffic, and adverse weather. Mapmaking with geographic information systems (GIS) can support optimization of resource utilization, travel efficiency, program capacity, and management during normal operations, and patient safety during disasters. This paper reports on the feasibility, acceptability and outcomes of an initiative to implement GIS mapmaking in VHA HBPC programs. A mixed method evaluation assessed extent of adoption and identified facilitators and barriers to uptake. Results indicate that GIS mapping in VHA HBPC is feasible and can increase effectiveness and efficiency of VHA HBPC nurses.

Keywords: Geographic information systems; Home based primary care; Nursing; Primary health care; Veterans.

Publication types

Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Aged
Chronic Disease / therapy
Feasibility Studies
Female
Geographic Information Systems*
Health Personnel / organization & administration*
Health Personnel / trends
Home Care Services / organization & administration*
Humans
Interviews as Topic
Primary Health Care / organization & administration*
Program Evaluation
Quality Improvement*
United States
United States Department of Veterans Affairs
Veterans / psychology