VA Ann Arbor Healthcare System
What Providers Are Saying
The VA Ann Arbor Health Care System (VAAAHS) has started a new program to increase access to specialty care for Veterans in rural and medically underserved areas. This program, called the Specialty Care Access Network-Extension for Community Healthcare Outcomes (SCAN-ECHO), has taken video teleconferencing to the next level of excellence in serving our Veterans.
Unlike typical video teleconferencing, which visually and audibly links one patient with one primary care provider in another location, SCAN-ECHO uses dedicated video teleconferencing to simultaneously link several primary care providers, many of whom are in different rural communities within our service area, to a specialist at the VA Ann Arbor Medical Center.
The conferences are provider-to-provider focusing on a variety of specialties including hepatology, cardiology, nephrology endocrinology, and irritable bowel disease (IBD). The sessions are one and a half hours in length with a 10-15 minute didactic session for CMEs and CEUs.
SCAN-ECHO uses teleconferencing units and a bridge that allows multiple providers to dial in at once. “Video teleconferencing between specialists and primary care providers allows for real time consultation and over a period of time, primary care providers and specialists develop a relationship," said the Chief of Gastroenterology and Hepatology Grace Su, MD, who applied T21 funding via the office of specialty care transformation, to start SCAN-ECHO at VAAAHS.
During a SCAN-ECHO session, primary care providers take turns presenting cases using a standardized format, other providers listen to the discussion, and the specialist and/or specialty care team recommends a treatment plan. A formal clinical education segment follows.
Dr. Su, who is also the VISN 11 Scan Echo Director, explained, “We see patients from all over the state of Michigan, and the amount of time the patient has to travel to see us limits our ability to take care of patients with chronic liver disease. Chronic liver disease requires more than one visit.”
Dr. Richard Moseley, Chief of Medicine for VAAAHS and also serves as one of the SCAN-ECHO Liver specialists, said “I think project SCAN-ECHO is the future of medicine in this country; we have a large patient population living in rural underserved areas.”
At VAAAHS, cases are presented to the facilitators Dr. Richard Moseley-Chief of Medicine, VAAAHS and Dr. Su (for SCAN-ECHO Liver), and other specialists by primary care providers about their patients SCAN-ECHO clinics are currently available for, liver disease, renal disease, heart disease, inflammatory bowel disease (IBD), and Endocrine and Metabolism diseases such as diabetes.
Heather MCCurdy, RN is the clinical coordinator for SCAN-ECHO-Liver, and is responsible for fielding consultations and identifying patients whose cases would be suitable to present during bi-weekly SCAN-ECHO sessions. “We would love to have local providers act as champions for liver disease. Patients with chronic liver disease would be able to see their own providers in a setting closer to home that they’re much more comfortable with.”
Dave Bialy, PA-C, is a VAAAHS Primary Care Provider and Hepatitis C Specialist, uses SCAN-ECHO to treat patients with Hepatitis C. “The SCAN-ECHO project has allowed me to treat more complex cases because I have been able to discuss the case with the experts to gain better insight on what is occurring with the patient and what problems to be on the lookout for. The conference gives me the information I need to correctly diagnose and treat the patient.”
“As far as the SCAN-ECHO with the liver team in Ann Arbor, I think has been a great experience, they are available, they are supportive, they have the support and we consequently have their support which is a very positive thing," said former Chief of Medicine for the Saginaw VAMC Nicholas Haddad, MD. “There are behavioral interactions we can advise about. It’s very rewarding being part of an innovative way of delivering health care for those patients who might not otherwise seek treatment.”