Naval Branch Health Clinic & VA Outpatient Clinic Key West 2010 VA/DoD Joint Venture Conference Naval Branch Health Clinic Key West & VA Outpatient Clinic Key West CAPT Julie Miavez, OIC, NBHC Key West Dr. Hector Ramirez, ACOS, Ambulatory Care VA Miami Dr. Douglas Eaton, CMO, VA Key West

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Naval Branch Health Clinic & VA Outpatient Clinic Key West 3 New Initiatives – Projects Closed NEW INITIATIVES OVER THE PAST YEAR: Rural Health Care Community Based Outpatient Clinic Interactive education and training Collaborative information exchange PROJECTS OR EFFORTS THAT WERE CLOSED OR FAILED IN THE LAST YEAR: Computerized patient record systems do not interact (CPRS/Vista versus (AHLTA)

Naval Branch Health Clinic & VA Outpatient Clinic Key West 4 Joint Venture Performance Measures PMs USED TO TRACK JV SUCCESS: Revenue generated Access to care and missed opportunities DATA SOURCES USED FOR THE PMs: Reimbursable amounts to the VA and DoD Rates –Psychiatry OUTCOMES FOR EACH PM LISTED: FY 2010 –$1,346,354 DVAMC – Miami –$ 194,161 Key West 12% missed opportunities and 97% utilization

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Naval Branch Health Clinic & VA Outpatient Clinic Key West 6 Access to Military Installation Procedures REQUIRED ACCESS PROCESS and POLICIES FOR VA BENEFICIARIES and/or EMPLOYEES TYPE OF VISITOR ID BADGE* PRIOR COORDINATION VA APPOINTMENT DOCUMENTATION / VERIFICATION VISITOR CENTER VA EMPLOYEE DVA VA PATIENT DVA VA PATIENT ESCORT STATE X VA PATIENT VISITOR STATEX * Enter Type of ID Required: ( DoD, DVA, GOVT, State, Post or Base)

Naval Branch Health Clinic & VA Outpatient Clinic Key West 7 Access to Care and Referral Management ISSUES RELATED TO ACCESS TO CARE & REFERRAL MANAGEMENT: AHLTA does not communicate with VA VISTA/CPRS Separate standards for Audiology/Spirometry testing Limited Physical Therapy services at VA for DoD RESOLUTIONS TO ISSUES RELATED TO ACCESS TO CARE & REFERRAL MANAGEMENT: Not resolved Access is through network physical therapy

Naval Branch Health Clinic & VA Outpatient Clinic Key West 8 Future Initiatives and/or Proposals NEAR TERM (1-2 YEARS) INITIATIVES: Propose amending sharing agreement –Data collection for inclusion of Teledermatology Increase Psychiatry active duty referrals to VA LONG TERM (>2 YEARS) GOALS / INITIATIVES / STRATEGIES: Using DoD/VA Joint Venture Key West as a model for future sites –Homestead Air Reserve Base