Lessons Learned: Implementation & Sustainment of a Geriatric Care Model Within a Changing Healthcare Landscape

TL;DR

This paper discusses the challenges and lessons learned in implementing and sustaining a geriatric telemedicine program in rural VA healthcare settings.

Contribution

The paper provides insights into sustaining geriatric care models amid healthcare changes and offers lessons for value-based payment systems.

Findings

GRECC Connect reduced healthcare barriers for rural Veterans through telemedicine.

Sustaining the program faced challenges like rural staff turnover and technology limitations.

The program maintained gains in educating clinicians and caring for older Veterans despite healthcare changes.

Abstract

Americans in rural communities tend to be older and in poorer health than their urban counterparts. Telemedicine programs like GRECC Connect, within the VA healthcare system, have proven to reduce healthcare barriers such as limited availability of specialists in rural areas, cost, and travel time for frail older patients. During the initiation of this program, telehealth was widely supported within VA. Even with this support, implementation and dissemination was a challenge with rural staff turnover and limitations of technology and Wi-Fi access as examples. GRECC Connect has become a mature program which has been focusing in recent years on maintaining the positive gains GRECC Connect has made in educating rural primary care clinicians and caring for older medically complex rural Veterans despite the changing landscape of healthcare inside and outside of VA. We will discuss lessons learned in our efforts to sustain GRECC Connect clinical efforts and how these may inform implementation and sustainment of Geriatric models in context of a Value based payment system.