Evidence map›Paper›PMID 38028943›Full record

ArticleFrontiers in health services2023

Sustainment of the TeleSleep program for rural veterans.

Jeffrey K Belkora, Linda Ortiz DeBoque, Robert L Folmer, Annette M Totten, Katherine Williams, Mary A Whooley, Eilis Boudreau, Charles W Atwood, Michelle Zeidler, Talayeh Rezayat and 2 more

Registry-linked trialAbstract read
In one paragraph

Article in Frontiers in health services, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05419323 (Improving Access to Sleep Apnea Care), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05419323 completednot on this map

Improving Access to Sleep Apnea Care: A Pragmatic Study of New Consultation Models

TypeobservationalSponsorVA Office of Research and DevelopmentRan2020 to 2026Enrolled6,501ConditionsObstructive Sleep Apnea (OSA)
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Jeffrey K BelkoraSan Francisco VA Health Care System, San Francisco, CA, United States.
Linda Ortiz DeBoqueVA Portland Health Care System, Portland, OR, United States.
Robert L FolmerVA Portland Health Care System, Portland, OR, United States.
Annette M TottenDepartment of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, United States.
Katherine WilliamsMeasurement Science Quality Enhancement Research Initiative, San Francisco VA Health Care System, San Francisco, CA, United States.
Mary A WhooleyMeasurement Science Quality Enhancement Research Initiative, San Francisco VA Health Care System, San Francisco, CA, United States.
Eilis BoudreauDepartment of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, United States.
Charles W AtwoodPulmonary Section and Sleep Medicine, VA Pittsburgh Healthcare System, Pittsburgh, PA, United States.
Michelle ZeidlerPulmonary, Critical Care, and Sleep Medicine, VA Greater Los Angeles Health Care System, Los Angeles, CA, United States.
Talayeh RezayatSan Francisco VA Health Care System, San Francisco, CA, United States.
Priyanka ChilakamarriSan Francisco VA Health Care System, San Francisco, CA, United States.
Kathleen F SarmientoSan Francisco VA Health Care System, San Francisco, CA, United States.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: In fiscal year 2021, the Veterans Health Administration (VHA) provided care for sleep disorders to 599,966 Veterans, including 189,932 rural Veterans. To further improve rural access, the VA Office of Rural Health developed the TeleSleep Enterprise-Wide Initiative (EWI). TeleSleep's telemedicine strategies include tests for sleep apnea at the Veteran's home rather than in a sleep lab; Clinical Video Telehealth applications; and other forms of virtual care. In 2017 and 2020, VHA provided 3-year start-up funding to launch new TeleSleep programs at rural-serving VA medical facilities. Methods: In early 2022, we surveyed leaders of 24 sites that received TeleSleep funding to identify successes, failures, facilitators, and barriers relevant to sustaining TeleSleep implementations upon expiration of startup funding. We tabulated frequencies on the multiple choice questions in the survey, and, using the survey's critical incident framework, summarized the responses to open-ended questions. TeleSleep program leaders discussed the responses and synthesized recommendations for improvement. Results: 18 sites reported sustainment, while six were "on track." Sustainment involved medical centers or regional entities incorporating TeleSleep into their budgets. Facilitators included: demonstrating value; aligning with local priorities; and collaborating with spoke sites serving rural Veterans. Barriers included: misalignment with local priorities; and hiring delays. COVID was a facilitator, as it stimulated adoption of telehealth practices; and also a barrier, as it consumed attention and resources. Recommendations included: longer startup funding; dedicated funding for human resources to accelerate hiring; funders communicating with local facility leaders regarding how TeleSleep aligns with organizational priorities; hiring into job classifications aligned with market pay; and obtaining, from finance departments, projections and outcomes for the return on investment in TeleSleep.

Indexed as

implementation sciencemaintenancesleep medicinesustainmenttelemedicine

Identifiers

PMID38028943
PMCPMC10668014

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.