{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T13:06:23Z","timestamp":1789391183231,"version":"build-2803163510"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100007181","name":"Quality Enhancement Research Initiative","doi-asserted-by":"publisher","award":["HX0003205-01"],"award-info":[{"award-number":["HX0003205-01"]}],"id":[{"id":"10.13039\/100007181","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J GEN INTERN MED"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although home visits improve outcomes among older adults, expanding the reach of geriatric home-based programs has been constrained by physical, cognitive, and technological barriers common among older persons as well as facility barriers (e.g., limited staffing).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the effectiveness of a hybrid-virtual home visit model (TeleGRACE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A quality improvement project with an observation cohort design using propensity score weighting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Community-dwelling older adults with a geriatric syndrome after discharge from a hospital stay or emergency department (ED) visit at one large Department of Veterans Affairs (VA) facility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>A hybrid-virtual home visit involving a telehealth technician in the patient\u2019s home and geriatric clinical team members participating remotely.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Measures<\/jats:title>\n                    <jats:p>The primary outcomes were all-cause mortality, nursing home placement, inpatient readmission, and ED visits within 90 days or 1 year of enrollment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Results<\/jats:title>\n                    <jats:p>\n                      TeleGRACE patients (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200976) were more likely than usual care patients (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009319) to receive clinical services within 90\u00a0days (e.g., assistive devices: 78.7% versus 18.9%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). In analysis using inverse probability weighting, the 1-year risk of nursing home placement was lower in TeleGRACE than in usual care: hazard ratio (HR) 0.20 (95% CI: 0.07\u20130.53). The risk of ED visits was higher among TeleGRACE patients both at 90 days (HR 1.32 [1.02\u20131.72]) and 1 year (HR 1.28 [1.04\u20131.76]). No differences between groups were identified for nursing home placement at 90 days, or hospitalizations or mortality at 90 days or 1 year.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The results indicate that a hybrid-virtual home visit model may improve care and outcomes for high-risk, community-dwelling older persons; future studies are needed to confirm whether this model reduces nursing home placement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11606-026-10580-7","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T12:45:08Z","timestamp":1789389908000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of Hybrid-Virtual Home Visits for Comprehensive Geriatric Management: A Quality Improvement Project"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3048-2536","authenticated-orcid":false,"given":"Dawn M.","family":"Bravata","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony J.","family":"Perkins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley L.","family":"Schwartzkopf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura J.","family":"Myers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa M.","family":"Damush","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaina K.","family":"Preddie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Myers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcos","family":"Montagnini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cathy C.","family":"Schubert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,14]]},"reference":[{"issue":"4","key":"10580_CR1","doi-asserted-by":"publisher","first-page":"84","DOI":"10.3390\/geriatrics3040084","volume":"3","author":"JS Powers","year":"2018","unstructured":"Powers JS, Eubank KJ. Geriatrics Evaluation and Management in the Veterans Administration-An Historical Perspective. Geriatrics (Basel). 2018;3(4):84. https:\/\/doi.org\/10.3390\/geriatrics3040084.","journal-title":"Geriatrics (Basel)."},{"key":"10580_CR2","unstructured":"Geriatric Evaluation: VHA Directive 1140.04. (2017)."},{"issue":"4","key":"10580_CR3","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1016\/j.gerinurse.2020.06.006","volume":"41","author":"A Richard-Eaglin","year":"2020","unstructured":"Richard-Eaglin A, Campbell JG, Utley-Smith Q. The aging veteran population: Promoting awareness to influence best practices. Geriatr Nurs. 2020;41(4):505-507. https:\/\/doi.org\/10.1016\/j.gerinurse.2020.06.006.","journal-title":"Geriatr Nurs."},{"issue":"22","key":"10580_CR4","doi-asserted-by":"publisher","first-page":"2623","DOI":"10.1001\/jama.298.22.2623","volume":"298","author":"SR Counsell","year":"2007","unstructured":"Counsell SR, Callahan CM, Clark DO, et al. Geriatric care management for low-income seniors: a randomized controlled trial. Jama. 2007;298(22):2623-33. https:\/\/doi.org\/10.1001\/jama.298.22.2623.","journal-title":"Jama."},{"issue":"12","key":"10580_CR5","doi-asserted-by":"publisher","first-page":"3598","DOI":"10.1111\/jgs.18013","volume":"70","author":"CC Schubert","year":"2022","unstructured":"Schubert CC, Perkins AJ, Myers LJ, et al. Effectiveness of the VA-Geriatric Resources for Assessment and Care of Elders (VA-GRACE) program: An observational cohort study. J Am Geriatr Soc. 2022;70(12):3598-3609. https:\/\/doi.org\/10.1111\/jgs.18013.","journal-title":"J Am Geriatr Soc."},{"issue":"7","key":"10580_CR6","doi-asserted-by":"publisher","first-page":"1503","DOI":"10.1111\/jgs.14179","volume":"64","author":"CC Schubert","year":"2016","unstructured":"Schubert CC, Myers LJ, Allen K, Counsell SR. Implementing Geriatric Resources for Assessment and Care of Elders Team Care in a Veterans Affairs Medical Center: Lessons Learned and Effects Observed. J Am Geriatr Soc. 2016;64(7):1503-9. https:\/\/doi.org\/10.1111\/jgs.14179.","journal-title":"J Am Geriatr Soc."},{"key":"10580_CR7","doi-asserted-by":"publisher","unstructured":"Elkan R, Kendrick D, Dewey M, et al. Effectiveness of home based support for older people: systematic review and meta-analysis. BMJ (Clinical research ed). 2001;323(7315):719\u201325: https:\/\/doi.org\/10.1136\/bmj.323.7315.719.","DOI":"10.1136\/bmj.323.7315.719"},{"issue":"Suppl 1","key":"10580_CR8","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1007\/s11606-023-08460-5","volume":"39","author":"CC Schubert","year":"2024","unstructured":"Schubert CC, Penney LS, Schwartzkopf AL, et al. Expanding Access to Comprehensive Geriatric Evaluation via Telehealth: Development of Hybrid-Virtual Home Visits. J Gen Int Med. 2024;39(Suppl 1):36-43. https:\/\/doi.org\/10.1007\/s11606-023-08460-5.","journal-title":"J Gen Int Med."},{"issue":"2","key":"10580_CR9","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1111\/jgs.16982","volume":"69","author":"MKW Cheng","year":"2021","unstructured":"Cheng MKW, Allison TA, McSteen BW, Cattle CJ, Lo DT. The Adoption of Video Visits During the COVID-19 Pandemic by VA Home Based Primary Care. J Am Geriatr Soc. 2021;69(2):318-320. https:\/\/doi.org\/10.1111\/jgs.16982.","journal-title":"J Am Geriatr Soc."},{"issue":"9","key":"10580_CR10","doi-asserted-by":"publisher","first-page":"2404","DOI":"10.1111\/jgs.17163","volume":"69","author":"AV Kalicki","year":"2021","unstructured":"Kalicki AV, Moody KA, Franzosa E, Gliatto PM, Ornstein KA. Barriers to telehealth access among homebound older adults. J Am Geriatr Soc. 2021;69(9):2404-2411. https:\/\/doi.org\/10.1111\/jgs.17163.","journal-title":"J Am Geriatr Soc."},{"issue":"11","key":"10580_CR11","doi-asserted-by":"publisher","first-page":"1417","DOI":"10.1177\/07334648211028393","volume":"40","author":"E Franzosa","year":"2021","unstructured":"Franzosa E, Gorbenko K, Brody AA, et al. \"There Is Something Very Personal About Seeing Someone's Face\": Provider Perceptions of Video Visits in Home-Based Primary Care During COVID-19. J Appl Gerontol: Off J South Gerontol Soc. 2021;40(11):1417-1424. https:\/\/doi.org\/10.1177\/07334648211028393.","journal-title":"J Appl Gerontol: Off J South Gerontol Soc."},{"issue":"2","key":"10580_CR12","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1080\/07317115.2019.1655510","volume":"43","author":"LR Moo","year":"2020","unstructured":"Moo LR, Gately ME, Jafri Z, Shirk SD. Home-Based Video Telemedicine for Dementia Management. Clin Gerontol. 2020;43(2):193-203. https:\/\/doi.org\/10.1080\/07317115.2019.1655510.","journal-title":"Clin Gerontol."},{"issue":"8","key":"10580_CR13","doi-asserted-by":"publisher","first-page":"573","DOI":"10.7326\/0003-4819-147-8-200710160-00010","volume":"147","author":"EAD von Elm","year":"2007","unstructured":"von Elm E AD, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. Ann Intern Med. 2007;147(8):573-577.","journal-title":"Ann Intern Med."},{"issue":"12","key":"10580_CR14","doi-asserted-by":"publisher","first-page":"1900","DOI":"10.1016\/j.jamda.2022.10.012","volume":"23","author":"ES McConnell","year":"2022","unstructured":"McConnell ES, Xue TM, Levy CR. Veterans Health Administration Models of Community-Based Long-Term Care: State of the Science. J Am Med Dir Assoc. 2022;23(12):1900-1908.e7. https:\/\/doi.org\/10.1016\/j.jamda.2022.10.012.","journal-title":"J Am Med Dir Assoc."},{"issue":"4","key":"10580_CR15","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1177\/0733464818825050","volume":"39","author":"R Bruening","year":"2020","unstructured":"Bruening R, Sperber N, Miller K, et al. Connecting Caregivers to Support: Lessons Learned From the VA Caregiver Support Program. J Appl Gerontol. 2020;39(4):368-376. https:\/\/doi.org\/10.1177\/0733464818825050","journal-title":"J Appl Gerontol."},{"key":"10580_CR16","doi-asserted-by":"publisher","unstructured":"Van Houtven CH, Smith VA, Berkowitz TSZ, et al. Predictors of discharge from the VA Caregiver Support Program. Am J Manag Care. 2022;28(8):e289-e295. https:\/\/doi.org\/10.37765\/ajmc.2022.89202.","DOI":"10.37765\/ajmc.2022.89202"},{"issue":"12","key":"10580_CR17","doi-asserted-by":"publisher","first-page":"2120","DOI":"10.1007\/s11606-018-4653-x","volume":"33","author":"ES Wong","year":"2018","unstructured":"Wong ES, Yoon J, Piegari RI, Rosland AM, Fihn SD, Chang ET. Identifying Latent Subgroups of High-Risk Patients Using Risk Score Trajectories. J Gen Intern Med. 2018;33(12):2120-2126. https:\/\/doi.org\/10.1007\/s11606-018-4653-x.","journal-title":"J Gen Intern Med."},{"issue":"4","key":"10580_CR18","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1097\/MLR.0b013e31827da95a","volume":"51","author":"L Wang","year":"2013","unstructured":"Wang L, Porter B, Maynard C, et al. Predicting risk of hospitalization or death among patients receiving primary care in the Veterans Health Administration. Med Care. 2013;51(4):368-73. https:\/\/doi.org\/10.1097\/MLR.0b013e31827da95a.","journal-title":"Med Care."},{"issue":"7","key":"10580_CR19","doi-asserted-by":"publisher","first-page":"1136","DOI":"10.1111\/j.1532-5415.2006.00791.x","volume":"54","author":"SR Counsell","year":"2006","unstructured":"Counsell SR, Callahan CM, Buttar AB, Clark DO, Frank KI. Geriatric Resources for Assessment and Care of Elders (GRACE): a new model of primary care for low-income seniors. J Am Geriatr Soc. 2006;54(7):1136-41. https:\/\/doi.org\/10.1111\/j.1532-5415.2006.00791.x.","journal-title":"J Am Geriatr Soc."},{"issue":"1","key":"10580_CR20","doi-asserted-by":"publisher","first-page":"908","DOI":"10.1186\/s12913-018-3689-2","volume":"18","author":"B Kinosian","year":"2018","unstructured":"Kinosian B, Wieland D, Gu X, Stallard E, Phibbs CS, Intrator O. Validation of the JEN frailty index in the National Long-Term Care Survey community population: identifying functionally impaired older adults from claims data. BMC Health Serv Res. 2018;18(1):908. https:\/\/doi.org\/10.1186\/s12913-018-3689-2.","journal-title":"BMC Health Serv Res."},{"key":"10580_CR21","unstructured":"Hybrid Hospital-Wide Readmission Measure with Electronic Health Record Extracted Risk Factors (Version 1.2) (Centersfor Medicare & Medicaid Services(CMS)). 2023."},{"key":"10580_CR22","unstructured":"2024 Condition-Specific Excess Days in Acute Care Measures Updates and Specifications Report. 2024."},{"issue":"4","key":"10580_CR23","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1097\/naq.0000000000000118","volume":"39","author":"LE Price","year":"2015","unstructured":"Price LE, Shea K, Gephart S. The Veterans Affairs's Corporate Data Warehouse: Uses and Implications for Nursing Research and Practice. Nurs Adm Q. 2015;39(4):311-8. https:\/\/doi.org\/10.1097\/naq.0000000000000118.","journal-title":"Nurs Adm Q."},{"issue":"3","key":"10580_CR24","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1007\/s10742-018-0178-3","volume":"18","author":"BM Vincent","year":"2018","unstructured":"Vincent BM, Wiitala WL, Burns JA, Iwashyna TJ, Prescott HC. Using Veterans Affairs Corporate Data Warehouse to identify 30-day hospital readmissions. Health Serv Outcomes Res Methodol. 2018;18(3):143-154. https:\/\/doi.org\/10.1007\/s10742-018-0178-3.","journal-title":"Health Serv Outcomes Res Methodol."},{"key":"10580_CR25","unstructured":"Affairs USDoV. The Researcher's Guide to VA Data: VA Information Resource Center. https:\/\/www.virec.research.va.gov\/Intro\/About-VIReC.asp#Websites. Accessed 1 Apr 2025."},{"key":"10580_CR26","doi-asserted-by":"publisher","unstructured":"Apaydin EA, Paige NM, Begashaw MM, Larkin J, Miake-Lye IM, Shekelle PG. Veterans Health Administration (VA) vs. Non-VA Healthcare Quality: A Systematic Review. J Gen Intern Med. 2023;38(9):2179\u20132188. https:\/\/doi.org\/10.1007\/s11606-023-08207-2.","DOI":"10.1007\/s11606-023-08207-2"},{"issue":"15","key":"10580_CR27","doi-asserted-by":"publisher","first-page":"1637","DOI":"10.1001\/jama.2015.13480","volume":"314","author":"JS Haukoos","year":"2015","unstructured":"Haukoos JS, Lewis RJ. The Propensity Score. Jama. 2015;314(15):1637-8. https:\/\/doi.org\/10.1001\/jama.2015.13480.","journal-title":"Jama."},{"issue":"1","key":"10580_CR28","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1093\/biomet\/70.1.41","volume":"70","author":"PR Rosenbaum","year":"1983","unstructured":"Rosenbaum PR, Rubin DB. The central role of the propensity score in observational studies for causal effects. Biometrika. 1983;70(1):41-55.","journal-title":"Biometrika."},{"issue":"19","key":"10580_CR29","doi-asserted-by":"publisher","first-page":"2937","DOI":"10.1002\/sim.1903","volume":"23","author":"JK Lunceford","year":"2004","unstructured":"Lunceford JK, Davidian M. Stratification and weighting via the propensity score in estimation of causal treatment effects: a comparative study. Statistics in medicine. 2004;23(19):2937-2960.","journal-title":"Stat Med."},{"issue":"1","key":"10580_CR30","first-page":"250","volume":"188","author":"F Li","year":"2019","unstructured":"Li F, Thomas LE, Li F. Addressing extreme propensity scores via the overlap weights. Am J Epidemiol. 2019;188(1):250-257.","journal-title":"Am J Epidemiol."},{"issue":"23","key":"10580_CR31","doi-asserted-by":"publisher","first-page":"2417","DOI":"10.1001\/jama.2020.7819","volume":"323","author":"LE Thomas","year":"2020","unstructured":"Thomas LE, Li F, Pencina MJ. Overlap weighting: a propensity score method that mimics attributes of a randomized clinical trial. Jama. 2020;323(23):2417-2418.","journal-title":"Jama."},{"key":"10580_CR32","doi-asserted-by":"publisher","unstructured":"Li F, Morgan K, Zaslavsky A. Balancing Covariates via Propensity Score Weighting. Journal of the American Statistical Association. 09\/23 2016;113. https:\/\/doi.org\/10.1080\/01621459.2016.1260466.","DOI":"10.1080\/01621459.2016.1260466"},{"issue":"2","key":"10580_CR33","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1080\/08959420.2017.1414538","volume":"30","author":"KS Thomas","year":"2018","unstructured":"Thomas KS, Cote D, Makineni R, et al. Change in VA Community Living Centers 2004-2011: Shifting Long-Term Care to the Community. J Aging Soc Policy. 2018;30(2):93-108. https:\/\/doi.org\/10.1080\/08959420.2017.1414538.","journal-title":"J Aging Soc Policy."},{"issue":"7","key":"10580_CR34","doi-asserted-by":"publisher","first-page":"2118","DOI":"10.1007\/s11606-019-05568-5","volume":"35","author":"W Duan-Porter","year":"2020","unstructured":"Duan-Porter W, Ullman K, Rosebush C, et al. Interventions to Prevent or Delay Long-Term Nursing Home Placement for Adults with Impairments-a Systematic Review of Reviews. Journal of general internal medicine. 2020;35(7):2118-2129. https:\/\/doi.org\/10.1007\/s11606-019-05568-5.","journal-title":"Journal of general internal medicine."},{"key":"10580_CR35","doi-asserted-by":"publisher","first-page":"1909","DOI":"10.2147\/ijgm.S354101","volume":"15","author":"MJ Maniaci","year":"2022","unstructured":"Maniaci MJ, Maita K, Torres-Guzman RA, et al. Provider Evaluation of a Novel Virtual Hybrid Hospital at Home Model. Int J Gen Med. 2022;15:1909-1918. https:\/\/doi.org\/10.2147\/ijgm.S354101.","journal-title":"Int J Gen Med."},{"key":"10580_CR36","doi-asserted-by":"publisher","first-page":"205031212210925","DOI":"10.1177\/20503121221092589","volume":"10","author":"MJ Maniaci","year":"2022","unstructured":"Maniaci MJ, Torres-Guzman RA, Garcia JP, et al. Overall patient experience with a virtual hybrid hospital at home program. SAGE Open Med. 2022;10:20503121221092589. https:\/\/doi.org\/10.1177\/20503121221092589.","journal-title":"SAGE Open Med."},{"key":"10580_CR37","doi-asserted-by":"publisher","first-page":"3177934","DOI":"10.1155\/2022\/3177934","volume":"2022","author":"MR Paulson","year":"2022","unstructured":"Paulson MR, Maita K, Avila FR, et al. Colectomy Complicated by High-Output Ileostomy Managed in a Virtual Hybrid Hospital-at-Home Program. Case Rep Surg. 2022;2022:3177934. https:\/\/doi.org\/10.1155\/2022\/3177934.","journal-title":"Case Rep Surg."},{"issue":"7","key":"10580_CR38","doi-asserted-by":"publisher","first-page":"1338","DOI":"10.1016\/j.jamda.2021.05.016","volume":"22","author":"CS Ritchie","year":"2021","unstructured":"Ritchie CS, Gallopyn N, Sheehan OC, et al. COVID Challenges and Adaptations Among Home-Based Primary Care Practices: Lessons for an Ongoing Pandemic from a National Survey. J Am Med Direct Assoc. 2021;22(7):1338-1344. https:\/\/doi.org\/10.1016\/j.jamda.2021.05.016.","journal-title":"J Am Med Direct Assoc."},{"issue":"2","key":"10580_CR39","doi-asserted-by":"publisher","first-page":"e0148096","DOI":"10.1371\/journal.pone.0148096","volume":"11","author":"C Ritchie","year":"2016","unstructured":"Ritchie C, Andersen R, Eng J, et al. Implementation of an Interdisciplinary, Team-Based Complex Care Support Health Care Model at an Academic Medical Center: Impact on Health Care Utilization and Quality of Life. PloS one. 2016;11(2):e0148096. https:\/\/doi.org\/10.1371\/journal.pone.0148096.","journal-title":"PloS one."},{"key":"10580_CR40","first-page":"385","volume":"2018","author":"M Donahue","year":"2018","unstructured":"Donahue M, Bouhaddou O, Hsing N, et al. Veterans Health Information Exchange: Successes and Challenges of Nationwide Interoperability. AMIA Annu Symp Proc. 2018;2018:385-394.","journal-title":"AMIA Annu Symp Proc."},{"issue":"3","key":"10580_CR41","first-page":"1i","volume":"18","author":"TR Martin","year":"2021","unstructured":"Martin TR, Gasoyan H, Pirrotta G, Mathew R. A National Survey Assessing Health Information Exchange: Readiness for Changes to Veterans Affairs Access Standards. Perspect Health Inf Manag. Summer 2021;18(3):1i.","journal-title":"Perspect Health Inf Manag. Summer"},{"issue":"11","key":"10580_CR42","doi-asserted-by":"publisher","first-page":"1757","DOI":"10.1016\/j.jamda.2022.03.007","volume":"23","author":"KH Magid","year":"2022","unstructured":"Magid KH, Galenbeck E, Haverhals LM, et al. Purchasing High-Quality Community Nursing Home Care: A Will to Work With VHA Diminished by Contracting Burdens. J Am Med Dir Assoc. 2022;23(11):1757-1764. https:\/\/doi.org\/10.1016\/j.jamda.2022.03.007.","journal-title":"J Am Med Dir Assoc."}],"container-title":["Journal of General Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11606-026-10580-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11606-026-10580-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11606-026-10580-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T12:45:12Z","timestamp":1789389912000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11606-026-10580-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,14]]},"references-count":42,"alternative-id":["10580"],"URL":"https:\/\/doi.org\/10.1007\/s11606-026-10580-7","relation":{},"ISSN":["0884-8734","1525-1497"],"issn-type":[{"value":"0884-8734","type":"print"},{"value":"1525-1497","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,14]]},"assertion":[{"value":"11 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 September 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This project was conducted as a program evaluation and was considered quality improvement and not research. Therefore, no human subjects research approval was sought.","order":1,"name":"Ethics","label":"Ethics Statement","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they do not have a conflict of interest.","order":2,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The sponsor had no role in the design, methods, data collections, analyses, or preparation of this manuscript.","order":3,"name":"Ethics","label":"Sponsor\u2019s Role","group":{"name":"EthicsHeading","label":"Declarations"}}]}}