Nation-wide Pilot Specialty Care Program for US Veterans

Rationale / Objectives

  • Inadequate or disparities of healthcare, rising treatment costs, systemic inefficiencies, and unequal or slow diffusion of best practices are some of the main barriers for veterans in rural areas to access healthcare [1]. Moreover, veterans need to travel to receive care from a specialist, whose services may be distant, with added issues of mobility accessibility and added costs. Additionally, increase in the aging population, often with chronic diseases, create burden for primary care providers [3].

Project/Program Description & Major Achievements

  • The U.S. Department of Veterans Affairs (VA) initiated a virtual model of medical education aimed to allow veterans to receive care within their areas without having to travel in lengthy trips to see specialists. In 2015, there were 3,600 consults were placed and used as case presentation to educate outpatients clinics.

Lessons Learned

  • They learned that the project must demonstrate a positive return on investment in order to be sustainable. To achieve that, he project's evaluation team will interview primary care providers about the specialty side of their patients' care to get providers' perspectives. Moreover, they can potentially include geo-coding to identify the number of miles saved as a result of patients' ability to receive care near their home rather than driving to see specialists in distant cities.

People / Organizations Involved

Further Description

The U.S. Department of Veterans Affairs (VA) initiated a virtual model of medical education to deliver health care that is based on Agency of Healthcare Research and Quality’s (AHRQ) "Project Extension for Community Healthcare Outcomes" (Project ECHO). The VA created and implemented the nationwide program to provide specialized care at local VA offices across the country. VA physicians and other care providers were being trained in specialty care areas via telehealth technology. SCAN-ECHO enabled specialty care teams in areas such as diabetes, pain management, and Hepatitis C to use video conferencing equipment to connect with Veterans’ local primary care providers (PCPs) and Patient Aligned Care Teams.  During a scheduled SCAN-ECHO clinic, the PCP presented a patient’s case and the specialty care team recommended a treatment plan.  In addition to case presentations, formal clinical education was also provided.  The program aimed to allow veterans to receive care within their  areas without having to travell in lengthy trips to see specialists. [2][5]

Major Achievements

Care delivery has been evaluated by the Specialty Care Evaluation Center, a VA Health Services Research and Development (HSR & D)-funded center working to support a quantitative and qualitative evaluation of this program.




Participated community based outpation clinics 6000 participants in 2015, which doubled over the past years VA Patient Care Service – in the spotlight [6]
Number of consults placed and used 3,600 consults