Intermountain is launching a new virtual anticoagulation specialty care (VASC) service to better manage outpatient anticoagulant therapy for adult patients across the system. The new service is being rolled out in phases starting soon.
Anticoagulants, like warfarin, prevent blood clots in patients with conditions at a higher risk. VASC will allow anticoagulation patients to be closely monitored by specialized anticoagulation providers through expanded remote-monitoring capabilities. VASC will reduce care variation and will enable clinical best practices to be applied and measured consistently across Intermountain.
About half of Intermountain’s patients on warfarin treatment are now managed by 70+ primary care clinicians and their care teams. The other half are managed by Intermountain’s anticoagulation clinics. In a phased transition over the next three years, Intermountain will use specialized anticoagulation management to serve patients systemwide.
Expected benefits from VASC:
- Improve patient outcomes
- Decrease complications and associated medical expenses (i.e., fewer bleeding and clotting events)
- Improve care transitions
- Peri-procedural anticoagulation management
- Anticoagulant selection
- Appropriate duration of therapy
VASC is also designed to improve affordability for patients. Many patients will experience lower out-of-pocket costs as care transitions from hospital-based clinics to Medical Group clinics. Billing will be standardized. Patients who haven’t historically been billed for services will now receive a bill for anticoagulation management. In addition to billing for routine lab interpretation and management, patients will be billed once a year for enrollment/annual anticoagulation expert evaluation.
VASC will also relieve some workload from busy primary care providers and practices. VASC will routinely update and consult with primary care on patients’ treatment plans.
Who should use VASC? Any warfarin anticoagulated adult patient managed at an Intermountain outpatient setting should use VASC. The hospital staff will continue to manage anticoagulation during hospitalization. Pediatric patients will continue to be managed by their current anticoagulation provider.
What will VASC look like? Three hub locations for VASC will offer in-person and telehealth warfarin management by pharmacists and APPs. The hubs will be located at McKay-Dee Hospital, Intermountain Medical Center, and St. George Regional Hospital. Satellite locations will partner with each hub. At-home remote monitoring options will be available for patients who meet criteria. VASC clinic hours will be Monday through Friday from 8 a.m. to 4:30 p.m. On-call care will be offered after-hours for urgent issues.
What will the phased transition look like? Clinics currently performing warfarin anticoagulation management outside the VASC structure will be contacted approximately six weeks prior to the service transition and given specific details about what to do next. During this process there will be opportunities to discuss and address questions from clinicians, leaders, and patients. Warfarin anticoagulation management including initiation and bridging will be included in the first phase of the rollout. Direct oral anticoagulant (DOAC) management will be incorporated later.
How will VASC impact clinical operations? Existing hospital-based anticoagulation clinics will transition to the Medical Group during the phased implementation starting in 2022. No jobs will be lost as part of this program. In fact, new jobs will be created to support VASC as the implementation roadmap is initiated.
What can referring primary care providers, clinics, and care teams expect?
Before the transition, a VASC clinician will contact the primary care provider or care team to introduce the new program, discuss transitions, explain referral workflows, and answer questions.
Each VASC site will continue to reach out to referring clinics to coordinate care and share aggregate outcomes for their location.
All anticoagulation management will be documented in iCentra and available for clinicians to review at any time.
Please send any questions or concerns about VASC to Marni Chandler at marni.chandler@imail.org or 801-503-4231.