Research News

Interactive Specialty Care Maps

May 17, 2023

The purpose of the Interactive Specialty Care Maps Application is to provide leadership with more efficient and intuitive methods to understand the delivery of specialty care in both VA and community healthcare, trends in this care over time, and information to optimize resource allocation. Building upon prior VA Collaborative Evaluation Center (VACE) specialty care map efforts, this informatics tool has been significantly updated and expanded. The revised specialty care maps could help support decision making at the VISN and medical center level around “build or buy” questions related to adding targeted specialty care capacity and services for more efficient and timely care for Veterans within VA. The maps address three central questions:

• How many Veterans living within 60-minutes of a facility that offers a specialty service are going to the community for care – and how has this changed over time?
• How many Veterans living near VA facilities not currently offering the specialty service are going to the community vs. VA for care – and how has this changed over time?
• If services were added to a facility not offering care right now, how many Veterans eligible for MISSION Act care due to drive time criteria would become ineligible if services were introduced at the facility? In other words, where might you bring care back from the community into VA?

For example, to assess how specialty care maps of gastrointestinal (GI) procedure volume and cost are utilized within VISN 20, investigators identified catchment areas utilizing traffic-aware 60-minute drive-time areas around VA healthcare facilities over a six-month period. VACE then conducted an interactive demonstration of the maps to VISN 20 (Northwest Network) providers to assess acceptability and gather feedback and suggestions. Participants responded positively to the maps and most agreed they might assist them in seeing the volume of specific services—and understanding where services are being outsourced to the community. Specifically, they described the maps as being potentially useful for:

• Seeing what services are available and volume of services provided.
• Identifying potential areas to increase care or start new services.
• Where there is enough volume to warrant expansion in VA.
• Where the most money is being spent on community care.
• Helping negotiate contracts for community care.
• Providing another way to understand the needs of Veterans in particular catchment areas.

For this Rapid Response QUERI project, VACE partnered with the GI National Program. For more information, please contact Michael Ho, MD, PhD (Michael.Ho@va.gov), Acting Director, HSR&D’s Center of Innovation for Veteran-Centered & Value-Driven Care.