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Defining Core Issues in Utilizing Information Technology to Improve Access: Evaluation and Research Agenda

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Abstract

The Department of Veterans Affairs (VA) has been at the vanguard of information technology (IT) and use of comprehensive electronic health records. Despite the widespread use of health IT in the VA, there are still a variety of key questions that need to be answered in order to maximize the utility of IT to improve patient access to quality services. This paper summarizes the potential of IT to enhance healthcare access, key gaps in current evidence linking IT and access, and methodologic challenges for related research. We also highlight four key issues to be addressed when implementing and evaluating the impact of IT interventions on improving access to quality care: 1) Understanding broader needs/perceptions of the Veteran population and their caregivers regarding use of IT to access healthcare services and related information. 2) Understanding individual provider/clinician needs/perceptions regarding use of IT for patient access to healthcare. 3) System/Organizational issues within the VA and other organizations related to the use of IT to improve access. 4) IT integration and information flow with non-VA entities. While the VA is used as an example, the issues are salient for healthcare systems that are beginning to take advantage of IT solutions.

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Acknowledgements

This paper summarizes deliberations of the Adoption and Implementation of IT Workgroup at the VA Health Services Research & Development (HSR&D) State of the Art Conference on Improving Access to VA Care held September 21–22 2010 in Arlington, VA. In addition to the authors, the following individuals were part of the workgroup: Leigh Anderson, MD; David Atkins, MD, MPH; Nancy Maher, Ph.D.; Kevin Vigilante, MD, MPH; and Kenneth R. Wingart, Ph.D. The last author was supported by a VA HSR&D Career Scientist Award (08–027).

Conflict of Interest

With the exception of Drs. Alverson, Poropatich, and Ralston, all authors are employees of the Department of Veterans Affairs. No author received compensation for preparation of this manuscript apart from his or her employment.

Disclaimer

The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government.

Author information

Authors and Affiliations

  1. Health Services Research & Development (HSR&D) Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA

    George L. Jackson PhD, MHA & Hayden B. Bosworth PhD

  2. Division of General Internal Medicine, Duke University Medical Center, Durham, NC, USA

    George L. Jackson PhD, MHA & Hayden B. Bosworth PhD

  3. HSR&D Center for Clinical Management Research, Ann Arbor Veterans Affairs Medical Center, Ann Arbor, MI, USA

    Sarah L. Krein PhD, RN

  4. Division of General Medicine, University of Michigan Medical School, Ann Arbor, MI, USA

    Sarah L. Krein PhD, RN

  5. Center for Telehealth and Cybermedicine Research, University of New Mexico Health Sciences Center, Albuquerque, NM, USA

    Dale C. Alverson MD

  6. Office of Care Coordination Services, Veterans Health Administration, Washington, DC, USA

    Adam W. Darkins MD, MPH

  7. Office of Patient Care Services, Veterans Health Administration, Washington, DC, USA

    William Gunnar MD, JD

  8. Office of Graduate Medical Education and Geriatric Research, Education & Clinical Center, Veteran Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA

    Nancy D. Harada PhD, PT

  9. David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA

    Nancy D. Harada PhD, PT

  10. HSR&D Northwest Center for Outcomes Research in Older Adults, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA

    Christian D. Helfrich PhD, MPH

  11. Department of Health Services, University of Washington School of Public Health, Seattle, WA, USA

    Christian D. Helfrich PhD, MPH & James D. Ralston MD, MPH

  12. HSR&D Center for Health Quality, Outcomes and Economic Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, USA

    Thomas K. Houston MD, MPH

  13. Department of Qualitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA

    Thomas K. Houston MD, MPH

  14. Veterans Rural Health Resource Center, Central Region, Iowa City, IA, USA

    Thomas F. Klobucar PhD

  15. Veterans and Consumers Health Informatics Office, Office of Health Information, Veterans Health Administration, Washington, DC, USA

    Kim M. Nazi PhD

  16. Telemedicine and Advanced Technology Research Center, Fort Detrick, MD, USA

    Ronald K. Poropatich MD

  17. Group Health Research Institute, Group Health Cooperative of Puget Sound, Seattle, WA, USA

    James D. Ralston MD, MPH

Authors
  1. George L. Jackson PhD, MHA
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  2. Sarah L. Krein PhD, RN
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  3. Dale C. Alverson MD
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  4. Adam W. Darkins MD, MPH
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  5. William Gunnar MD, JD
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  6. Nancy D. Harada PhD, PT
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  7. Christian D. Helfrich PhD, MPH
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  8. Thomas K. Houston MD, MPH
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  9. Thomas F. Klobucar PhD
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  10. Kim M. Nazi PhD
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  11. Ronald K. Poropatich MD
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  12. James D. Ralston MD, MPH
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  13. Hayden B. Bosworth PhD
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Corresponding author

Correspondence to George L. Jackson PhD, MHA.

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Jackson, G.L., Krein, S.L., Alverson, D.C. et al. Defining Core Issues in Utilizing Information Technology to Improve Access: Evaluation and Research Agenda. J GEN INTERN MED 26 (Suppl 2), 623 (2011). https://doi.org/10.1007/s11606-011-1789-3

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  • DOI: https://doi.org/10.1007/s11606-011-1789-3

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