<--GAT-->
Technology

SCAN-ECHO Improves Care for VA Liver Disease Patients

by U.S. Medicine

August 3, 2018

ANN ARBOR, MI — While specialty care has been associated with improved survival in patients with liver disease, convenient access to specialists isn’t available to all patients.

One way the lack of feasibility of universal access to specialty care has been addressed is virtual modalities, including the SCAN‐ECHO Specialty Access Network, according to a report in the journal Hepatology.1

The telehealth program was implemented by the VHA to address that need, but a study team led by researchers from the Ann Arbor, MI, VAMC and the University of Michigan noted that limited data are available on patient outcomes.

The researchers evaluated the efficacy of a SCAN‐ECHO visit, looking at a regional cohort of 62,237 patients with liver disease in the VHA following implementation of the Ann Arbor SCAN‐ECHO Liver Clinic in June 2011 to March 2015.

The study compared the effect of a SCAN‐ECHO visit on all‐cause mortality to patients with no liver clinic visit. To adjust for the differences among patients who had a SCAN‐ECHO visit vs. those were no visit, the researchers performed propensity score matching on factors which affect the likelihood of a SCAN‐ECHO visit: demographics, geographic location, liver disease diagnosis, severity and comorbidities.

During the study period, 513 patients who had a liver SCAN‐ECHO visit were found within the cohort, the article stated. Patients who had completed a virtual SCAN‐ECHO visit were more likely younger, rural, with more significant liver disease, and evidence for cirrhosis.

In terms of results, propensity adjusted mortality rates using Cox Proportional Hazard Model showed that a SCAN‐ECHO visit was associated with a hazard ratio of 0.54 (95% CI 0.36‐0.81, p = 0.003) compared to no visit.

“Improved survival in patients seen via SCAN‐ECHO suggests that this novel approach may be an effective method to improve access for selected patients with liver disease, particularly in rural and underserved populations where access to specialty care is limited,” study authors concluded.

Project ECHO was developed at the University of New Mexico’s School of Medicine. VA’s Specialty Care Services adopted and expanded this program to transform the delivery of specialty care throughout VA. SCAN-ECHO extends the reach of specialty services and coordinates with the Veteran’s Patient Aligned Care Team (PACT).


1Su GL, Glass L, Tapper EB, Van T, Waljee AK, Sales AE. Virtual Consultations through the Veterans Administration SCAN-ECHO Project Improves Survival for Veterans with Liver Disease. Hepatology. 2018 May 5. doi: 10.1002/hep.30074. [Epub ahead of print] PubMed PMID: 29729194.

Related Articles

RA Fracture Risk Affected by Glucocorticoid Treatment

How much does systemic glucocorticoid exposure increase fracture among patients with newly-diagnosed inflammatory and immune-modulated conditions, including rheumatoid arthritis.

Obesity, Weight-Loss Both Worsen RA U.S. Medicine

Obese patients with rheumatoid arthritis report greater disability in cross-sectional studies, but what that means over the long term has not been studied often.


U.S. Medicine Recommends


More From technology

Technology

New House Subcommittee Will Oversee VA EHR Implementation

The House Committee on Veterans' Affairs is gearing up for greater oversight of VA's electronic health record implementation with the creation of a new oversight subcommittee.

Technology

Remote Disease Management Program Improves Outcomes in the Northwest

A telehealth-based chronic disease management program which included clinical pharmacy specialists (CPS) had positive outcomes on primary care outcomes in a rural area, according to a new study.

Technology

Tele-ICU Program Reduces Transfers of VA’s ICU Patients

Most intensive care units (ICUs) in smaller, community, and regional hospitals aren’t able to support intensivist staffs to provide advanced critical care.

Technology

Amid Concerns, VA Says It Is ‘Turning a Corner’ on Cybersecurity

The management and upkeep of information technology structures has historically been a challenge for federal agencies.

Technology

VA Inks Contract for Massive New Health Record System

Calling it one of the largest IT contracts in the federal government, with a ceiling of $10 billion over a decade, then-VA Acting Secretary Robert Wilkie announced that the agency signed a contract with Cerner for its new electronic health record (EHR).

Facebook Comment

Subscribe to U.S. Medicine Print Magazine

U.S. Medicine is mailed free each month to physicians, pharmacists, nurse practitioners, physician assistants and administrators working for Veterans Affairs, Department of Defense and U.S. Public Health Service.

Subscribe Now

Receive Our Email Newsletter

Stay informed about federal medical news, clinical updates and reports on government topics for the federal healthcare professional.

Sign Up