title: Implementation of a novel occupational and environmental medicine specialty teleconsultation service: the VHA experience.
abstract: OBJECTIVE
  Occupational and environmental medicine (OEM) physician specialty practices continue to grow in scope and intensity across the Veterans Health Administration. This study characterizes the implementation of a novel, nationwide telemedicine program that provides OEM specialty consultation to providers across the Veterans Health Administration.
  
  
  METHODS
  We examined provider requests and specialist responses for a 6-month pilot from May to October 2013. Characteristics of consult users, determinants of case complexity, and specific applications of OEM specialty expertise were identified.
  
  
  RESULTS
  Over a 6-month period, employee occupational health providers consulted the OEM telemedicine pilot a total of 65 times. Employee occupational health providers without formal training repeatedly identified complex cases related to work and disability.
  
  
  CONCLUSIONS
  The program has created a new system management solution to deliver expert, in-depth consultation and real-time provider education in OEM.
authors: From the Occupational Health Group (Dr Eaton, Dr Mohammad, Dr Kirkhorn, Ms Gerstel-Santucci, and Dr McPhaul), Office of Public Health, Veterans Health Administration; War Related Illness and Injury Study Center (Dr Eaton), Washington DC VA Medical Center; Center for Healthcare Organization and Implementation Research (Dr Mohr), Department of Veterans Affairs, VA Boston Healthcare System, Jamaica Plain; Department of Health Policy and Management (Dr Mohr), Boston University School of Public Health, Mass; Department of Internal Medicine (Dr Mohammad), VA Connecticut Healthcare System/Yale Occupational and Environmental Medicine Program, Yale University School of Medicine, New Haven, Conn; and Office of Occupational Medicine (Dr Hodgson), Occupational Safety and Health Administration, Washington, DC.
authors: Jennifer L
authors: JL
authors: Eaton
authors: David C
authors: DC
authors: Mohr
authors: Amir
authors: A
authors: Mohammad
authors: Steven
authors: S
authors: Kirkhorn
authors: Christina
authors: C
authors: Gerstel-Santucci
authors: Kathleen
authors: K
authors: McPhaul
authors: Michael J
authors: MJ
authors: Hodgson
mesh_terms: D019550:Environmental Medicine / Q000458:organization & administration*; D006801:Humans; D007400:Interprofessional Relations; D016272:Occupational Health; D009787:Occupational Medicine / Q000458:organization & administration*; D016730:Program Development; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D019114:Remote Consultation / Q000458:organization & administration*; D014481:United States; D014493:United States Department of Veterans Affairs; D014938:Work Capacity Evaluation