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Cancer Prevention at Your Fingertips, Empowering Veterans Through Mobile Application

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In the United States, Colorectal Cancer (CRC) is the third leading cause of cancer-related deaths in men and women and the second most common cause of cancer deaths when men and women are combined. As a "digital front door" to address this phenomenon, Annie uses a series of navigational reminders for optimal performance of colonoscopies; devising an inclusive means of combating the growing burden of cancer through early detection and prevention. Now, the organization has in place the components of an effective no-show mitigation strategy, driving our strategic priorities as a High Reliability Organization (HRO), as Annie empowers, educates, and engages each Veteran from the convenience of their home.

This innovation is emerging and worth watching as it is being assessed in early implementations. See more emerging innovations.

Adoptions:

16 successful, 1 in-progress

Partners:

Office of Connected Care

Tags:

Access to Care Continuity of Care High Reliability Information Technology Oncology Outpatient Care Rural Health Specialty Care Surgery Telehealth
Contact Team

Overview

Problem

From May through July 2020, 22% of scheduled colonoscopies were cancelled at Houston VA’s gastrointestinal (GI) clinic. The reasons for cancellations included inadequacy of bowel prep, transportation issues, non-compliance with medication guidelines, manifested risks and no shows. Cancelled and missed colonoscopy appointments adversely affect patient outcome ... See more

Solution

A colon preparation protocol was developed by the nursing staff in the GI clinic in collaboration with an oncology nurse navigator utilizing Annie, a Short Message Service (SMS) text messaging capability that promotes self-care for Veterans enrolled in the VA health care system. Annie provided the ability to automatically send self-care reminders to the Vete ... See more

Images

Annie Brochure - Front

Annie Brochure - Back

Results

Cancellations were monitored by chart auditing. Bowel preparation quality was based on the Boston Bowel Preparation Scale (BBPS) as documented by the endoscopist. A cost analysis was conducted to assess the financial impact of the Annie program. The same day cancellation rate decreased from 22% pre-implementation of the Annie protocol to 14% in the post-impl ... See more

Metrics

  • Same day cancellation rate decreased from 22% pre-implementation of the Annie protocol to 14% in the post-implementation of the Annie protocol.
  • The GI clinic Boston Bowel Prep Score score amongst Veterans enrolled in the Annie program was 8.4 compared to a score of 7.8 amongst non-enrolled Veterans.
  • A cost analysis revealed a potential cost savings of $213,357 in the 3-month period post implementation of the Annie protocol.

Diffusion tracker

Does not include Clinical Resource Hubs (CRH)

Statuses

CA: Palo Alto VA Medical Center (Palo Alto, California) CO: Grand Junction VA Medical Center (Grand Junction, Colorado) FL: C.W. Bill Young Department of Veterans Affairs Medical Center (Bay Pines) IA: Iowa City VA Medical Center (Iowa City, Iowa) MA: Jamaica Plain VA Medical Center (Jamaica Plain) MN: St. Cloud VA Medical Center (St. Cloud) NM: Northwest Metro VA Clinic (Northwest Metro New Mexico) NY: James J. Peters Department of Veterans Affairs Medical Center (Bronx) OH: Dayton VA Medical Center (Dayton) OK: Jack C. Montgomery Department of Veterans Affairs Medical Center (Muskogee, Oklahoma) OR: Portland VA Medical Center (Portland, Oregon)
  • Started adoption on 02/2024.
TN: Lt. Col. Luke Weathers, Jr. VA Medical Center (Memphis) TX: Harlingen VA Clinic (Harlingen) TX: Michael E. DeBakey Department of Veterans Affairs Medical Center (Houston)
  • Started adoption on 08/2020.
TX: North Central Federal VA Clinic (North Central Federal) TX: Olin E. Teague Veterans' Center (Temple)

IL: Captain James A. Lovell Federal Health Care Center (North Chicago)

There are no unsuccessful adoptions for this innovation.

Multimedia

Images

Annie Team

Annie reach 1000th Veteran

Veteran using Annie

Staff in Action

Videos

ANNIE APP FOR VETERANS

Colon Cancer is a Silent Killer

Implementation

Timeline

  • 3 months
    Performed situational analysis, achieved stakeholder buy-in, leveraged early adopters, and formulated implementation task force.
  • 3 months
    Developed implementation action plan, followed by execution, and evaluation to assess response to interventions and address limitations. Staff would need to protect 2-5 hours/day for patient enrollment.

Departments

  • Cancer care
  • Gastroenterology
  • Marketing
  • Administration
  • Nursing services
  • Information technology
  • My HealtheVet coordinator

Core Resources

Resource type Resource description
PEOPLE
  • Project Facilitator – ( 2 hours/week during implementation phase; 1 hour/week for sustainment)
  • Clinician-(2-5 hours/day)
  • Department Champion ( 2 hours/week during implementation phase; 1 hour/week for sustainment)
PROCESSES
  • Annie Clinician (End-User) Training
  • Annie Facility POC Training
  • Annie User Manual
TOOLS
  • Cellular data and internet connectivity

Files

Links

  • Annie is a VA service that sends automated text messages to Veterans to help them stay focused on their self-care. Annie app for Clinicians
  • Annie for Clinicians allows clinicians to use and create care protocols that allow patients to easily submit their health readings back to Annie. Annie User Manual

Optional Resources

Resource type Resource description
PEOPLE
  • Clinical Application Coordinator (1-2 hours/week)
  • Facility Annie Clinical Adoption Lead (1-2 hours/week)

Support Resources

Resource type Resource description
PEOPLE
  • Facility Annie POC
  • Annie National Orion Team
PROCESSES
  • Ongoing consultation, problem solving, resource sharing, and implementation support
TOOLS
  • Staff visit and staff training (optional)

Risks and mitigations

Risk Mitigation
Technology limitations Developed a clear and concise instructional script
Facility Readiness ( adaptation to culture change) Staff training

Contact

Comment

Comments and replies are disabled for retired innovations and non-VA users.

VA User (HPDP Program Manager) posted

Can anyone speak to the 2-5hr/day clinician requirement? GI is interested and I'd love to provide additional details. kimberly.gardner@va.gov Feel free to reach out on teams!

VA User (HPDP Program Manager) deleted

This comment has been deleted.

VA User (Registered Nurse) Innovation adopter posted

This is awesome! We are just getting this rolled out to our veterans as staff testing has been completed @ VA Central Iowa HCS

1

Email

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Search tags

Access to Care Continuity of Care High Reliability Information Technology Oncology Outpatient Care Rural Health Specialty Care Surgery Telehealth