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Clinical Trial
. 2025 Aug 11;12(8):ofaf485.
doi: 10.1093/ofid/ofaf485. eCollection 2025 Aug.

Dissemination and Implementation of a Telehealth-Enabled Program for Providing Infectious Disease Expertise in Rural Settings

Robin L P Jump  1   2 , Taissa A Bej  3 , Amanda Vivo  4 , Brigid M Wilson  3   5 , Corinne Kowal  3 , Sunah Song  3   6 , Sara Abdelrahim  3 , Geneva Wilson  4   7 , Amelia Milner  3 , Alexandria Nguyen  3 , Keri L Rodriguez  8 , Nicole Beyer  8 , Zachary Michaels  8 , Carla Amundson  9 , Kristina L Bajema  10   11 , Abigail Beck  12 , Jason P Burnham  13   14 , Christopher J Crnich  15   16 , Dimitri M Drekonja  9   17 , Lauren Epstein  18   19 , Tola Ewers  15   16 , Daniel J Livorsi  20   21 , Muthu Narayan  9   17 , Federico Perez  3   5 , Christopher D Pfeiffer  10   11 , Rabeeya W Sabzwari  22   23 , Ahmed M Salti  10 , Danielle Tate  13 , Tammy Walkner  20 , Andrew S Webster  18   19 , Charlesnika T Evans  4   7
Affiliations
Clinical Trial

Dissemination and Implementation of a Telehealth-Enabled Program for Providing Infectious Disease Expertise in Rural Settings

Robin L P Jump et al. Open Forum Infect Dis. .

Abstract

Background: Telehealth can facilitate improving antibiotic use and related antimicrobial stewardship activities in facilities underserved by infectious diseases (IDs) expertise. We describe implementation of the Department of Veterans Affairs (VA) videoconference antimicrobial stewardship team (VAST) to connect multidisciplinary teams from rural VA medical centers (VAMCs) with geographically distant ID experts.

Methods: We implemented VASTs at 10 rural VAMCs from September 2021 to February 2024. VASTs consisted of regular meetings between rural VAMCs and an off-site ID expert who met by videoconference to discuss clinical cases, emphasizing recommendations for antibiotic prescribing. The VA Corporate Data Warehouse was used to collect information on patient medical encounter information. Interviews with healthcare professionals and surveys assessed perceptions of and experiences with VASTs.

Results: VASTs completed 624 clinical encounters on 531 unique patients. Half (53%) of the encounters required >20 minutes. The most frequently discussed infections were respiratory tract (35%), skin and soft tissue (19%), and genitourinary (17%). Of the 73 (53% of 138 contacted) professionals who responded to the survey, >90% perceived VASTs as improving the quality of veteran care and agreed that recommendations were timely. All 24 interviewees identified VASTs as meeting an important need at the rural site and that the virtual system facilitated collaboration.

Conclusions: These findings indicate successful implementation of a telehealth program to disseminate ID and antimicrobial stewardship expertise to rural VAMCs. This is a strong model augmenting antimicrobial stewardship in other healthcare systems.

Keywords: antimicrobial stewardship; electronic consultation; telehealth; veterans.

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Conflict of interest statement

Potential conflicts of interest. R. L. P. J. and F. P. have received research funding from AbacusLabs, Pfizer, and Merck. R. L. P. J. has participated in advisory boards for Pfizer, Merck, and GlaxoSmithKline. All other authors report no potential conflicts.

Figures

Figure 1.
Figure 1.
The number of consults completed at each VAST site, stratified by the length of time to complete the encounter.
Figure 2.
Figure 2.
International classification of diseases-10th edition (ICD-10) codes specific to infectious disease syndromes associated with VAST consults at each site. The Other category includes gastrointestinal, renal, dental, neurological, and vascular infections.
See this image and copyright information in PMC

References

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