{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T22:50:16Z","timestamp":1792623016739,"version":"4.5.0"},"reference-count":17,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T00:00:00Z","timestamp":1751932800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T00:00:00Z","timestamp":1751932800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["# S1 13-P00738"],"award-info":[{"award-number":["# S1 13-P00738"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["INQUIRY"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:p>Age Friendly Health Systems (AFHS) promote geriatric best practices to improve healthcare quality, minimize harms and support older adults\u2019 care preferences. AFHS-designated clinics consistently address the Geriatric 4Ms: Mentation, Mobility, Medication, and What Matters Most. The VA Eastern Colorado Health Care System tele-Palliative Care clinic achieved AFHS Level 1 and 2 recognition in 2021, becoming the first AFHS-designated telemedicine clinic in the nation. An interprofessional team and older Veterans guided planning and implementation. Using existing staff and clinic workflows, we consistently addressed the Geriatric 4Ms during visits. Specific metrics include: (1) AFHS Level 1 and 2 recognition, (2) maintenance in addressing Geriatric 4Ms in tele-Palliative Care, (3) number of patients served, (4) travel-miles saved. FY23-24, we conducted 192 AFHS tele-Palliative Care visits, 81% with rural\/highly rural Veterans. We served 108 unique patients (FY23:57; FY24:51; percent decrease\u2009=\u200910.5%). Compared to Colorado\u2019s Veteran population, Veterans from racial\/ethnic minority backgrounds and women were underrepresented; older Veterans were overrepresented. In FY23\/FY24, the majority of patients were White (82%\/73%), not Hispanic\/Latino (83%\/73%), male (100%\/98%), and \u226565 (90%\/89%). All 4Ms were addressed for 86% (FY23) and 76% (FY24) of unique patients. AFHS tele-Palliative Care saved Veterans\/caregivers 23\u2009622 (FY23) and 18\u2009632 (FY24) miles of travel. Congruent with AFHS, Palliative Care focuses on physical, emotional, and psychosocial aspects of serious illness. AFHS designation in a tele-Palliative Care clinic is novel nationally. We demonstrated that evidence-based care can be provided to every older adult, regardless of care modality, without expanding staff or changing clinical workflows.<\/jats:p>","DOI":"10.1177\/00469580251352727","type":"journal-article","created":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T14:26:49Z","timestamp":1752071209000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Establishing First Age-Friendly Health System Tele-Palliative Care Clinic \u2013 Facilitators, Challenges, Lessons Learned to Improve Care for Rural, Older Veterans"],"prefix":"10.1177","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-1849-6058","authenticated-orcid":false,"given":"Stephanie","family":"Hartz","sequence":"first","affiliation":[{"name":"Rocky Mountain Regional VA Medical Center, Aurora, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Garbin","sequence":"additional","affiliation":[{"name":"Rocky Mountain Regional VA Medical Center, Aurora, CO, USA"},{"name":"University of Colorado Anschutz Medical Campus, Aurora, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney","family":"McGuire","sequence":"additional","affiliation":[{"name":"Rocky Mountain Regional VA Medical Center, Aurora, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill","family":"Steagall","sequence":"additional","affiliation":[{"name":"Rocky Mountain Regional VA Medical Center, Aurora, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6686-2561","authenticated-orcid":false,"given":"Jocelyn","family":"McCauliff","sequence":"additional","affiliation":[{"name":"Rocky Mountain Regional VA Medical Center, Aurora, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1922-7320","authenticated-orcid":false,"given":"Kathryn Allen","family":"Nearing","sequence":"additional","affiliation":[{"name":"Rocky Mountain Regional VA Medical Center, Aurora, CO, USA"},{"name":"University of Colorado Anschutz Medical Campus, Aurora, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,7,8]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"Age-Friendly Health Systems. Institute for healthcare improvement. Accessed October 29 2024. https:\/\/www.ihi.org\/networks\/initiatives\/age-friendly-health-systems"},{"key":"e_1_3_3_3_2","unstructured":"2021 Enrollee data findings report. 508 Compliant. U.S. Department of veterans affairs. Published 2021. Accessed October 30 2023. https:\/\/www.va.gov\/VHASTRATEGY\/SOE2021\/2021_Enrollee_Data_Findings_Report-508_Compliant.pdf"},{"key":"e_1_3_3_4_2","unstructured":"HIA Tip Sheet: Geriatric 5Ms. U.S. Department of veterans affairs. Published 2019. Accessed October 30 2023. https:\/\/www.va.gov\/covidtraining\/docs\/HIA_TipSheet_Geriatric_5Ms_19.pdf"},{"key":"e_1_3_3_5_2","unstructured":"AGS Geriatric 5Ms Competencies for Medical Students. American geriatrics society. Published 2021. Accessed October 30 2023. https:\/\/adgap.americangeriatrics.org\/sites\/default\/files\/media\/files\/AGS%20Geriatric%205Ms%20Competencies%20for%20Medical%20Students.pdf"},{"key":"e_1_3_3_6_2","unstructured":"Age-Friendly Health Systems Recognition. Institute for Healthcare Improvement. Accessed October 29 2024. https:\/\/www.ihi.org\/age-friendly-health-systems-recognition"},{"key":"e_1_3_3_7_2","unstructured":"VA Age-Friendly Health Systems Initiative. VA.gov | Veterans Affairs. Updated May 21 2024. Accessed October 29 2024. https:\/\/www.va.gov\/geriatrics\/pages\/VA_Age_Friendly_Health_Systems_Initiative.asp"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.19082"},{"key":"e_1_3_3_9_2","unstructured":"U.S. Department of Veterans Affairs. 2023 Annual Report. ECO_FNL_BJM_20240227.pdf. Published February 27 2024. Accessed October 30 2023. ECO_FNL_BJM_20240227.pdf"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.2196\/43684"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.3390\/pharmacy12020061"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1080\/28324897.2024.2336899"},{"key":"e_1_3_3_13_2","unstructured":"Centers for Disease Control and Prevention (CDC). STEADI - Older Adult Fall Prevention. STEADI - Older Adult Fall Prevention. Published July 25 2024. Accessed October 29 2024. https:\/\/www.cdc.gov\/steadi\/index.htm"},{"key":"e_1_3_3_14_2","unstructured":"Veterans Health Administration. VA.gov | Veterans affairs. Updated January 29 2024. Accessed October 29 2024. https:\/\/www.va.gov\/HEALTH\/visns.asp"},{"key":"e_1_3_3_15_2","unstructured":"Office of Policy and Planning. VA.gov | Veterans Affairs. Updated March 26 2025. Accessed October 29 2024. https:\/\/www.va.gov\/vetdata\/Veteran_Population.asp Planning O of P and. VA.gov | Veterans Affairs."},{"key":"e_1_3_3_16_2","unstructured":"Age-Friendly Health Systems. Institute for Healthcare Improvement personal communication April 29 2025."},{"key":"e_1_3_3_17_2","unstructured":"O\u2019Neill N. The Eight Principles of Patient-Centered Care. Oneview Healthcare. Published February 8 2022. Accessed October 30 2024. https:\/\/oneviewhealthcare.com\/blog\/the-eight-principles-of-patient-centered-care"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2018.08.005"}],"updated-by":[{"DOI":"10.1177\/00469580251391549","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000}},{"DOI":"10.1177\/00469580261450809","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000}}],"container-title":["INQUIRY: The Journal of Health Care Organization, Provision, and Financing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00469580251352727","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00469580251352727","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00469580251352727","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T11:10:26Z","timestamp":1777461026000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00469580251352727"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,8]]},"references-count":17,"alternative-id":["10.1177\/00469580251352727"],"URL":"https:\/\/doi.org\/10.1177\/00469580251352727","relation":{},"ISSN":["0046-9580","1945-7243"],"issn-type":[{"value":"0046-9580","type":"print"},{"value":"1945-7243","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,8]]},"article-number":"00469580251352727"}}