A Model for Rapid Transition to Virtual Care, VA Connecticut Primary Care Response to COVID-19

J Gen Intern Med. 2020 Oct;35(10):3073-3076. doi: 10.1007/s11606-020-06041-4. Epub 2020 Jul 23.

Abstract

Introduction: Traditionally, health care delivery in the USA has been structured around in-person visits. The COVID-19 pandemic has forced a shift to virtual care models in order to reduce patient exposure to high-risk environments and to preserve valuable health care resources. This report describes one large primary care system's model for rapid transition to virtual care (RTVC).

Setting and participants: A RTVC model was implemented at the VA Connecticut Health Care System (VACHS), which delivers care to over 58,000 veterans.

Program description: The RTVC model included immediate virtual care conversion, telework expansion, implementation of virtual respiratory urgent care clinics, and development of standardized note templates.

Program evaluation: Outcomes include the rates of primary encounter types, staff teleworking, and utilization of virtual respiratory urgent care clinics. In under 2 weeks, most encounters were transitioned from in-person to virtual care, enabling telework for over half of the medical staff. The majority of virtual visits were telephone encounters, though rates of video visits increased nearly 18-fold.

Discussion: The RTVC model demonstrates expeditious and sustained transition to virtual care during the COVID-19 pandemic. Our experiences help inform institutions still reliant on traditional in-person visits, and future pandemic response.

Keywords: COVID-19; pandemic; prevention; primary care; virtual care.

MeSH terms

  • Betacoronavirus
  • COVID-19
  • Connecticut / epidemiology
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / therapy*
  • Humans
  • Pandemics
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / therapy*
  • Primary Health Care / organization & administration*
  • Program Evaluation
  • SARS-CoV-2
  • Telemedicine / organization & administration*
  • Telemedicine / statistics & numerical data
  • United States / epidemiology
  • United States Department of Veterans Affairs
  • Veterans / statistics & numerical data