Background: Historically the Hematology Clinics at the Robley Rex VA Medical Center (RRVAMC) had a chronically elevated no-show rate (NSR). The major cause of these missed opportunities was patient adherence secondary to transportation, distance traveled, and patients’ lack of concern about their disease. Our hypothesis was that the no-show rates could be significantly reduced by providing virtual hematology services outside the main VA campus.
Methods: A comprehensive review of the hematology patient population was conducted to identify veterans with stable hematologic disorders (SHD), eg, stage 0 chronic lymphocytic leukemia, monoclonal gammopathy of undetermined significance, and chronic anemia. The NSR was determined for 2012. Patients with SHD were identified as potential subjects for the Telehematology Clinic. The clinic was started July 2013 and eventually expanded to a bimonthly clinic that visited 4 of the 6 community-based outpatient clinics. This review compares the RRVAMC Hematology and the Telehematology Clinics’ NSR from March31, 2014, to March 31, 2015.
Results: The Telehematology Clinic has a patient cohort of 57 patients, which will expand to at least 77 patients by May 2016. To date, there have been 157 Telehematology Clinic visits. Most patients have an annual Telehematology Clinic visit and either quarterly or semiannual laboratory studies. The Telehematology Clinic has had a NSR of 3% since 2013. The Hematology Clinic’s NSR decreased from 14% to 12% (P = .09). Comparing the NSR of traditional Hematology Clinics with NSR of Telehematology Clinics is statically significant, P < .0007.
Implications: Telehematology Clinics have proven sustainability with greater adherence and attendance than that of the traditional hematology clinics scheduled within the RRVAMC. The NSR did not decrease significantly and remains greater than our goal of < 10%. Future video supported clinics may increase access and improve NSRs within the veteran population. Our goal in the next year is to increase the frequency of Telehematology Clinics and to expand the clinic population in an effort to reduce our overall NSR.
