NCT01446705

Brief Summary

Three out of four Veterans receive a portion of their care from non-VA providers. On April 9, 2009, President Barack Obama directed the Department of Veterans Affairs and the Department of Defense to create the Virtual Lifetime Electronic Record (VLER). On August 2010, Secretary of Veterans Affairs Eric K. Shinseki visited Indianapolis, and after visiting with leaders from the VA Health Services Research \& Development (HSR\&D) Center of Excellence and the Regenstrief Institute, he made the following public comments regarding the latest partnership between the two institutions: "This new technology allows safer, more secure, and private access to electronic health information which, in turn, enhances our ability to continue providing Veterans with the quality care that they have earned." This new technology refers to the VLER HEALTH program that the Indianapolis VA is now implementing in partnership with the Regenstrief Institute and Indiana Health Information Exchange (IHIE). This VA-IHIE demonstration project is intended to create the capacity for VA institutions to exchange health information with community partners. Investigators from the VA HSR\&D Center on Implementing Evidence-Based Practice are active collaborators in building and implementing this program. The VA-IHIE program provides the bi-directional exchange of health information between VA and non-VA providers. Based on our pilot study of linked VA-IHIE data, investigators are conducting an evaluation of the impact of the VA-IHIE demonstration project upon health care quality and cost of Veterans by taking advantage of the initiation of the implementation as a natural experiment.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
57,073

participants targeted

Target at P75+ for all trials

Timeline
Completed

Started Dec 2012

Typical duration for all trials

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

April 27, 2011

Completed
5 months until next milestone

First Posted

Study publicly available on registry

October 5, 2011

Completed
1.2 years until next milestone

Study Start

First participant enrolled

December 1, 2012

Completed
2.5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 1, 2015

Completed
7 months until next milestone

Study Completion

Last participant's last visit for all outcomes

January 1, 2016

Completed
28 days until next milestone

Results Posted

Study results publicly available

January 29, 2016

Completed
Last Updated

May 16, 2019

Status Verified

May 1, 2019

Enrollment Period

2.5 years

First QC Date

April 27, 2011

Results QC Date

July 31, 2015

Last Update Submit

May 14, 2019

Conditions

Diabetes MellitusAsthmaCardiovascular DiseasesHeart FailureOsteoporosis

Outcome Measures

Primary Outcomes (3)

  • Understanding Utilization of Healthcare Procedures by Veterans According to Source of Data

    Determining rates of usage of healthcare by veterans by source of data. This will clue us into any differences in utilization patterns between groups.

    2 years

  • Effect of Health Information Exchange on Cost

    Before after analysis of the presence of health information exchange on costs within the VA healthcare system; Measure is cost, unadjusted, in dollars for the year post enrollment in the health information exchange

    2 Years

  • Health Care Quality: Affect of HIE on LDL Levels of Participants.

    This study will measure the impact of HIE upon health care quality the underuse of ambulatory care services for diabetics. Measurements of underuse before and after implementation will detect improvements in the quality of care. To measure underuse, the study employs a measurement set that is sensitive to the potential effects and feasible for electronic data capture. In this specific instance, we expect the LDL levels to reflect lower numbers among diabetics due to greater health management via information sharing.

    3 years

Secondary Outcomes (1)

  • Health Care Quality: Care Sensitive Admissions

    3 years

Study Arms (2)

No Exchange

Patients in this arm will represent Veterans seen at the Indianapolis VA Medical Center (VAMC) for whom information exchange has not been activated.

Other: Non-Active Health Information exchange

Enrolled in Exchange

Patients in this arm will represent Veterans seen at the Indianapolis VAMC for whom information exchange has been activated by the patient choosing to "opt-in."

Other: Active Health Information Exchange

Interventions

Active Health Information ExchangeOTHER

Patients selected to share data between the VA \& external healthcare agencies.

Enrolled in Exchange
Non-Active Health Information exchangeOTHER

Patients not selecting to share data

No Exchange

Eligibility Criteria

Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)
Sampling MethodNon-Probability Sample
Study Population

Veteran's receiving care at the Indianapolis VAMC

You may qualify if:

  • Veteran's receiving care at the Indianapolis VAMC at least one year prior and one year post VA-IHIE enrollment
  • Veteran's receiving care from a facility other than the Indianapolis VAMC one year prior and one year post VA-IHIE enrollment

You may not qualify if:

  • None

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Richard L. Roudebush VA Medical Center, Indianapolis, IN

Indianapolis, Indiana, 46202-2884, United States

Location

Related Publications (9)

  • Dixon BE, Haggstrom DA, Weiner M. Implications for informatics given expanding access to care for Veterans and other populations. J Am Med Inform Assoc. 2015 Jul;22(4):917-20. doi: 10.1093/jamia/ocv019. Epub 2015 Mar 31.

    PMID: 25833394RESULT

  • Kho AN, Cashy JP, Jackson KL, Pah AR, Goel S, Boehnke J, Humphries JE, Kominers SD, Hota BN, Sims SA, Malin BA, French DD, Walunas TL, Meltzer DO, Kaleba EO, Jones RC, Galanter WL. Design and implementation of a privacy preserving electronic health record linkage tool in Chicago. J Am Med Inform Assoc. 2015 Sep;22(5):1072-80. doi: 10.1093/jamia/ocv038. Epub 2015 Jun 23.

    PMID: 26104741RESULT

  • French DD, Margo CE, Campbell RR. Enhancing postmarketing surveillance: continuing challenges. Br J Clin Pharmacol. 2015 Oct;80(4):615-7. doi: 10.1111/bcp.12658. Epub 2015 Jun 1. No abstract available.

    PMID: 25869078RESULT

  • Byrne C, Hunolt E, Bouhaddou O, Pan E, Botts NE, Mercincavage L, Olinger L, Banty K, Bennett J, Weiner M, Haggstrom DA, Cromwell T. Performance evaluation framework for the Virtual Lifetime Electronic Record (VLER) health information exchange pilot program. AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium. 2013 Nov 16; 1(1):162.

    RESULT

  • Dixon BE, Miller T, Overhage JM. Barriers to achieving the last mile in health information exchange: A survey of small hospitals and physician practices. Jounal of Healthcare Information Management. 2013 Oct 3; 27(4):53-58.

    RESULT

  • French DD, Dixon BE, Perkins SM, Myers LJ, Weiner M, Zillich AJ, Haggstrom DA. Short-Term Medical Costs of a VHA Health Information Exchange: A CHEERS-Compliant Article. Medicine (Baltimore). 2016 Jan;95(2):e2481. doi: 10.1097/MD.0000000000002481.

    PMID: 26765453RESULT

  • Dixon BE, Ofner S, Perkins SM, Myers LJ, Rosenman MB, Zillich AJ, French DD, Weiner M, Haggstrom DA. Which veterans enroll in a VA health information exchange program? J Am Med Inform Assoc. 2017 Jan;24(1):96-105. doi: 10.1093/jamia/ocw058. Epub 2016 Jun 6.

    PMID: 27274014RESULT

  • Dixon BE, Barboza K, Jensen AE, Bennett KJ, Sherman SE, Schwartz MD. Measuring Practicing Clinicians' Information Literacy. An Exploratory Analysis in the Context of Panel Management. Appl Clin Inform. 2017 Feb 15;8(1):149-161. doi: 10.4338/ACI-2016-06-RA-0083.

    PMID: 28197620RESULT

  • Nguyen KA, Haggstrom DA, Ofner S, Perkins SM, French DD, Myers LJ, Rosenman M, Weiner M, Dixon BE, Zillich AJ. Medication Use among Veterans across Health Care Systems. Appl Clin Inform. 2017 Mar 8;8(1):235-249. doi: 10.4338/ACI-2016-10-RA-0184.

    PMID: 28271121RESULT

MeSH Terms

Conditions

Diabetes MellitusAsthmaCardiovascular DiseasesHeart FailureOsteoporosis

Condition Hierarchy (Ancestors)

Glucose Metabolism DisordersMetabolic DiseasesNutritional and Metabolic DiseasesEndocrine System DiseasesBronchial DiseasesRespiratory Tract DiseasesLung Diseases, ObstructiveLung DiseasesRespiratory HypersensitivityHypersensitivity, ImmediateHypersensitivityImmune System DiseasesHeart DiseasesBone Diseases, MetabolicBone DiseasesMusculoskeletal Diseases

Results Point of Contact

Title
Dr. David A. Haggstrom
Organization
Center for Health Information and Communication, Roudebush VA Medical Center
dahaggst@iu.edu
317-988-2067

Study Officials

  • David A Haggstrom, MD

    Richard L. Roudebush VA Medical Center, Indianapolis, IN

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
Yes

Study Design

Study Type
observational
Observational Model
COHORT
Time Perspective
RETROSPECTIVE
Sponsor Type
FED
Responsible Party
SPONSOR

Study Record Dates

First Submitted

April 27, 2011

First Posted

October 5, 2011

Study Start

December 1, 2012

Primary Completion

June 1, 2015

Study Completion

January 1, 2016

Last Updated

May 16, 2019

Results First Posted

January 29, 2016

Record last verified: 2019-05

Data Sharing

IPD Sharing
Will not share

Locations

US(1)