In the Journals

Telehealth VA program aids in identification of liver transplant candidates

The Specialty Care Access Network-Extension of Community Healthcare Outcomes program, or SCAN-ECHO, is a telehealth-based program created by the Richmond Veterans Affairs in 2011 to increase specialty care to patients being considered for orthotopic liver transplantation.

According to Venkata Rajesh Konjeti, MD, and colleagues, the program was designed to transfer subspecialty hepatology and liver transplant knowledge to non-transplant providers. SCAN-ECHO was highly effective in identifying non-candidates for transplantation without further tests in a recent study conducted by Konjeti and colleagues.

“Our data indicate that a telehealth-based triage reduces futile transplant evaluations by approximately 60%,” Konjeti and colleagues wrote. “It is also possible that knowledge diffusion through SCAN-ECHO played a role in reducing referrals of transplant non-candidates.”

Centers can request an initial triage through SCAN-ECHO for transplant candidates. A hepatologist at the VA transplant center reviews the data and provides assessment of candidacy over a tele-conference.

To determine the efficacy of the program, the researchers compared transplant evaluation outcomes between 91 referrals triaged through SCAN-ECHO with 99 direct referrals.

Results showed that patients triaged through the program were less likely to be deemed non-candidates for transplantation at referral and after complete workup compared with direct referrals. Additionally, fewer patients in the program group were turned down for transplantation due to psychosocial issues, comorbidities or hepatocellular carcinoma progression beyond Milan criteria.

“We believe that expanding SCAN-ECHO to other solid organ transplant centers within the VA and elsewhere has the potential to improve access, reduce costs and minimize futile testing of patients,” the researchers wrote. – by Talitha Bennett

Disclosure: The authors report no relevant financial disclosures.

The Specialty Care Access Network-Extension of Community Healthcare Outcomes program, or SCAN-ECHO, is a telehealth-based program created by the Richmond Veterans Affairs in 2011 to increase specialty care to patients being considered for orthotopic liver transplantation.

According to Venkata Rajesh Konjeti, MD, and colleagues, the program was designed to transfer subspecialty hepatology and liver transplant knowledge to non-transplant providers. SCAN-ECHO was highly effective in identifying non-candidates for transplantation without further tests in a recent study conducted by Konjeti and colleagues.

“Our data indicate that a telehealth-based triage reduces futile transplant evaluations by approximately 60%,” Konjeti and colleagues wrote. “It is also possible that knowledge diffusion through SCAN-ECHO played a role in reducing referrals of transplant non-candidates.”

Centers can request an initial triage through SCAN-ECHO for transplant candidates. A hepatologist at the VA transplant center reviews the data and provides assessment of candidacy over a tele-conference.

To determine the efficacy of the program, the researchers compared transplant evaluation outcomes between 91 referrals triaged through SCAN-ECHO with 99 direct referrals.

Results showed that patients triaged through the program were less likely to be deemed non-candidates for transplantation at referral and after complete workup compared with direct referrals. Additionally, fewer patients in the program group were turned down for transplantation due to psychosocial issues, comorbidities or hepatocellular carcinoma progression beyond Milan criteria.

“We believe that expanding SCAN-ECHO to other solid organ transplant centers within the VA and elsewhere has the potential to improve access, reduce costs and minimize futile testing of patients,” the researchers wrote. – by Talitha Bennett

Disclosure: The authors report no relevant financial disclosures.