Volume 10 Supplement 1

7th Annual Conference on the Science of Dissemination and Implementation in Health

Open Access

Disseminating information systems across the Atlantic: Collaboration between U.K. National Health Service and U.S. Department of Veterans Affairs

  • D Keith McInnes1Email author,
  • Thomas K Houston2,
  • Susan S Woods3,
  • Kathleen L Frisbee4 and
  • Neil C Evans4
Implementation Science201510(Suppl 1):A62

https://doi.org/10.1186/1748-5908-10-S1-A62

Published: 14 August 2015

Introduction

Patients with chronic health conditions benefit from frequent monitoring and encouragement to maintain good health. Virtual care technologies (mHealth, texting) tethered to electronic health records provide a platform for frequent communication. After implementing "Florence," referred to as Flo, a text messaging system to enable patients to report measures such as blood pressure, the United Kingdom's National Health Service (NHS) worked with the US Department of Veterans Affairs (VA) to develop a similar system, named "Annie" after Annie Fox, a military nurse and first woman to receive the Purple Heart.

Methods

NHS and VA consulted via email, conference calls, and an in-person seminar to inform design and implementation in VA. At the seminar NHS presented 10 case studies of Florence, and break-out groups listed lessons learned. Also informing the design of Annie, pre-implementation studies were conducted including a survey and live text-messaging with Veterans to assess acceptability, usability, and usefulness.

Results

Lessons learned from NHS included that the system should be customizable by clinicians and administrators, fit patients' daily lives, and have a simple user interface. In pre-implementation studies, participants (n = 106) reported they own cell phones (89%), of which 5% are smart phones. Most respondents (88%) were interested in text messaging for health purposes. In a test of text message appointment reminders, usability and ease of use were highly rated, and over 90% of Veterans wanted the service to continue. Downward trends were observed for patient missed appointments, cancelled appointments, and emergency room use.

Discussion

Highly collaborative, cross-national dissemination improved and accelerated VA implementation of a patient communication system. Empiric and pilot data (from both countries) informed the development and garnered leadership support for the system. Lessons from VA's implementation will flow back to Florence, in a collaborative process improvement cycle.

Primary source of funding

US Department of Veterans Affairs

Authors’ Affiliations

(1)
Center for Healthcare Organization and Implementation Research, VA New England Healthcare System
(2)
eHealth Quality Enhancement Research Initiative, VA New England Healthcare System
(3)
Maine VA Healthcare System
(4)
Connected Health Office, Veterans Health Administration

Copyright

© McInnes et al. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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