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VIONE - Medication Optimization and Polypharmacy Reduction Initiative
Share PrintVIONE is a clinician and patient-friendly methodology - VIONE (Vital, Important, Optional, Not needed, Every medication has an indication) used by physicians, nurse practitioners, physician assistants, nurses, and pharmacists to address polypharmacy risk. VIONE is an option for review of medications consistent with Age Friendly 4 Ms. It has global relevance and offers a viable solution to polypharmacy while improving patient safety and quality of life. VIONE indirectly facilitates a greener environment and decreases preventable adverse polypharmacy related outcomes across the continuum of clinical care. It exemplifies concepts of High Reliability Organizations.
Origin:
January 2016, Eugene J. Towbin Healthcare Center (North Little Rock)
Adoptions:
138 successful, 2 in-progress
Awards and Recognition:
Diffusion of Excellence Promising Practice, Gears of Government Winner, VHA Shark Tank Winner, FY 2022 HeRO team award, International Hospital Federation's Austco Excellence Award, ... Diffusion of Excellence Promising Practice, Gears of Government Winner, VHA Shark Tank Winner, FY 2022 HeRO team award, International Hospital Federation's Austco Excellence Award, National Diffusion Award
Partners:
Academic Affiliations, Clinical Services, Diffusion of Excellence, Discovery, Education, and Affiliate Networks, Geriatrics and Extended Care, Health Services Research & Development
Recent Updates
Overview
Problem
Solution
Results
Links
- Provides a national, real-time view of VIONE de-prescribing activities VIONE Implementation Dashboard
- VIONE Team acknowledgement of the field and stakeholders in reaching the 1 Million Veteran Impacted Milestone. VIONE 1 Million Veteran Impact Statement
Diffusion tracker
Does not include Clinical Resource Hubs (CRH)
Multimedia
Images
An Air Force Veteran tells Dr. Battar, “The lesser medicines I have to take, the better off I am.”
Videos
Dr. Battar delivers a fun and informative TED-style talk at the 2018 VHA Innovation Experience Conference.
Implementation
Timeline
-
Day 1
Contact the VIONE Team at VAVIONE@va.gov -
Weeks 1 and 2
Recruit Team and Enlist Stakeholder Support -
Weeks 3 and 4
Establish VIONE Discontinuation Order Reasons, and VIONE Polypharmacy Note Template in CPRS with the help of your Clinical Applications Coordinator. -
Weeks 3 and 6
Attend Virtual VIONE Academy, or facility specific VIONE Education/Information meeting facilitated by VIONE Team. -
Weeks 4 and 8
Begin encounters with Veterans using VIONE methodology and track progress using the VIONE Discontinuation Dashboard, VIONE PIM Deprescribing Dashboard, or VIONE Implementation Dashboard. -
Week 9
Grow your VIONE footprint
Core Resources
| Resource type | Resource description |
|---|---|
PEOPLE |
|
Files
- VIONE Implementation and HRO Crosswalk VIONE - Federal Practitioner | Dec 2019
- VIONE Congressional Acknowledgement Arkansas Congressional Records
Links
Support Resources
Files
- VIONE brief 2 page document VIONE Vignette last updated March 2023
- VIONE National Footprint and Impact to date VIONE National Footprint
Risks and mitigations
| Risk | Mitigation |
|---|---|
| Lack of buy-in | Find a charismatic practice champion |
| Lack of funding, planning, and staff | Use pre-implementation checklist to be sure the implementing site is adequately prepared. If not prepared, make adjustments and allocate resources prior to starting implementation. |
Contact
Comment
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Email VAVIONE@va.gov with questions about this innovation.
About
Origin story
Original team
Sara Swathy Battar
Medical Director, Geriatrics & Extended Care
Kimberly Dickerson, PharmD
VIONE Program Manager, CAVHS
Timothy Cmelik
Chief of Pharmacy, Little Rock VAMC
Chris Sedgwick, PharmD
VISN Pharmacy Analytics Program Manager
Margie Scott
Medical Center Director, Little Rock VAMC
Ashleigh Wallace-Lacey, PharmD
VISN Pharmacy Analytics Program Manager
This is great. I like it. We are very enthusiastic in this implementation
I'm calling myself an "honorary" practice team member. VIONE is an incredibly practical and impactful promising practice that is poised to become a VHA standard in clinical practice. It is also led by an amazing team.