Federated VistA

Interfacility Consults (IFCs) Spokane [668]

The following describes Consults, specifically Interfacility Consults (IFC), for the most recent year of Spokane VistA cut on 2021-05-10.

Local consults - those ordered and fulfilled within this VistA - represent fully 76,683 (72.4%) of the consults created in this VistA during the last full year for which data is available. Of the IFCs, there are more Filler consults (fulfilled by this VistA for another) 25,779 (24.34%) than Placer consults (“placed” elsewhere) 3,460 (3.27%). In terms of IFCs, this is a Filler VistA

ifcAllConsultsCategoryBH

VistA Consults are ordered using consult types called services. Local consults use 364 (67.91%) of the services used in this system, less than their proportion of consults. In other words, more services are employed for ordering IFCs than their numbers would suggest. Notice also that some services used for local consults - 0 - are also used for IFC fulfillment. While services used for placement are exclusively for IFCs, the same is not true for fulfillment.

ifcAllServicesCategoryBH

As seen below, most patients with consults only have local consults and the majority of the balance have both local consults and IFCs (“mixed”).

As a larger Filler VistA, a large number of its patients only have filled IFCs - the patient’s home VistA is elsewhere.

As for users, most tend to only local consults or to a mix of local and filled consults.

ifcPatientsAndUsersCategoryBH

Placer

There are 156 Placer Services - services that route/place consults to 49 other facilities. In VistA, a Placer Service identifies a specific remote (routing) facility which is always the main, default facility of a remote VistA. In this VistA, 11.83% of the IFC Consults are “Placed” and the vast majority go to other facilities in the same VISN, facilities highlighted in bold in the tables below. Placer consults can be broken into four broad classes …

ifcConsultsNServicesPlacedCategoryBH

7 of the Placer Services are for TeleReading to 3 facilities …

ifcTeleReadingOutOtherSankey

Service by Service …

# Placer Service To Facility # Status’
1 TELEDERMATOLOGY (PUGET SOUND) IFC SEATTLE VA MEDICAL CENTER [663] 1,052 COMPLETE [955], DISCONTINUED [88], ACTIVE [8], PENDING [1]
2 DIABETIC TELERETINAL IMAGING IFC (BOISE) FROM CDA BOISE VA MEDICAL CENTER [531] 285 COMPLETE [261], DISCONTINUED [21], PENDING [3]
3 DIABETIC TELERETINAL IMAGING IFC (BOISE) FROM SPO BOISE VA MEDICAL CENTER [531] 181 COMPLETE [161], DISCONTINUED [20]
4 DIABETIC TELERETINAL IMAGING IFC (BOISE) FROM WEN BOISE VA MEDICAL CENTER [531] 45 COMPLETE [29], DISCONTINUED [16]
5 IFC PORTLAND TELEDENTISTRY PORTLAND VA MEDICAL CENTER [648] 4 PENDING
6 DIABETIC TELERETINAL IMAGING IFC (PORTLAND) PORTLAND VA MEDICAL CENTER [648] 2 COMPLETE
7 DIABETIC TELERETINAL IMAGING (PUGET SOUND) IFC SEATTLE VA MEDICAL CENTER [663] 1 DISCONTINUED

46 of the Placer Services denote travel to remote facilities and represent 6.88% of placed consults. These prove to be the exception to the rule that a VistA places most IFCs within its own VISN.

ifcTravelOutOtherSankey

By Facility …

# Facility Service Consults
1 JONATHAN M. WAINWRIGHT VAMC [687] IFC WALLA WALLA TRAVELING VETERAN 37 (15.55%)
2 SOUTHERN ARIZONA VA HCS [678] IFC TUCSON TRAVELING VETERAN 28 (11.76%)
3 PHOENIX VAMC [644] IFC PHOENIX TRAVELING VETERAN 28 (11.76%)
4 LOMA LINDA HCS [605] IFC LOMA LINDA TRAVELING VETERAN 17 (7.14%)
5 SOUTHERN NEVADA HCS [758] IFC LAS VEGAS TRAVELING VETERAN 13 (5.46%)
6 PORTLAND VA MEDICAL CENTER [648] IFC PORTLAND TRAVELING VETERAN 12 (5.04%)
7 NORTHERN CALIFORNIA HCS [612] IFC NORTHERN CALIFORNIA TRAVELING VETERAN 9 (3.78%)
8 BOISE VA MEDICAL CENTER [531] IFC BOISE TRAVELING VETERAN 9 (3.78%)
9 SEATTLE VA MEDICAL CENTER [663] IFC PUGET SOUND TRAVELING VETERAN 8 (3.36%)
10 FORT HARRISON MEDICAL CENTER [436] IFC FORT HARRISON TRAVELING VETERAN 6 (2.52%)
11 NORTHERN ARIZONA HCS [649] IFC NORTHERN ARIZONA TRAVELING VETERAN 6 (2.52%)
12 SPARK M. MATSUNAGA VAMC [359] IFC HONOLULU TRAVELING VET 5 (2.1%)
13 OLIN E. TEAGUE VET CENTER [674] IFC CENTRAL TEXAS TRAVELING VETERAN 5 (2.1%)
14 SIOUX FALLS VA HCS [438] IFC SIOUX FALLS TRAVELING VETERAN 4 (1.68%)
15 WEST LA VAMC [691] IFC GREATER LOS ANGELES TRAVELING VETERAN 3 (1.26%)
16 ROSEBURG VA MEDICAL CENTER [653] IFC ROSEBURG TRAVELING VETERAN 3 (1.26%)
17 SAN DIEGO HCS [664] IFC SAN DIEGO TRAVELING VETERAN 3 (1.26%)
18 ST. CLOUD VA HCS [656] IFC ST CLOUD TRAVELING VETERAN 3 (1.26%)
19 LONG BEACH VAMC [600] IFC LONG BEACH TRAVELING VETERAN 3 (1.26%)
20 DALLAS VA MEDICAL CENTER [549] IFC DALLAS TRAVELING VETERAN 2 (0.84%)
21 BLACK HILLS HCS [568] IFC BLACK HILLS TRAVELING VETERAN 2 (0.84%)
22 GEORGE E. WAHLEN VAMC [660] IFC SALT LAKE CITY TRAVELING VETERAN 2 (0.84%)
23 DUBLIN VAMC [557] IFC CARL VINSON TRAVELING VETERAN 2 (0.84%)
24 HINES, IL VAMC [578] IFC HINES TRAVELING VETERAN 2 (0.84%)
25 IOANNIS A. LOUGARIS VAMC [654] IFC RENO TRAVELING VETERAN 2 (0.84%)
26 AUDIE L. MURPHY MEMORIAL HOSP [671] IFC SOUTH TEXAS TRAVELING VETERAN 2 (0.84%)
27 WEST TEXAS HCS [519] IFC WEST TEXAS TRAVELING VETERAN 2 (0.84%)
28 ROCKY MOUNTAIN REGIONAL VAMC [554] IFC DENVER TRAVELING VETERAN 2 (0.84%)
29 CHEYENNE VA MEDICAL [442] IFC CHEYENNE TRAVELING VETERAN 1 (0.42%)
30 HAMPTON VA MEDICAL CENTER [590] IFC HAMPTON TRAVELING VETERAN 1 (0.42%)
31 ANCHORAGE VA MEDICAL CENTER [363] IFC ANCHORAGE TRAVELING VETERAN 1 (0.42%)
32 RAYMOND G. MURPHY VAMC [501] IFC ALBUQUERQUE TRAVELING VETERAN 1 (0.42%)
33 EL PASO VA HCS [756] IFC EL PASO TRAVELING VETERAN 1 (0.42%)
34 SHREVEPORT VAMC [667] IFC SHREVEPORT TRAVELING VETERAN 1 (0.42%)
35 TENNESSEE VALLEY HCS [626] IFC TENNESSEE VALLEY TRAVELING VETERAN 1 (0.42%)
36 SE LOUISIANA VETERANS HCS [629] IFC NEW ORLEANS TRAVELING VETERAN 1 (0.42%)
37 WILKES-BARRE VAMC [693] IFC WILKES-BARRE TRAVELING VETERAN 1 (0.42%)
38 SAN FRANCISCO VAMC [662] IFC SAN FRANCISCO TRAVELING VETERAN 1 (0.42%)
39 ORLANDO VAMC [10846] IFC ORLANDO TRAVELING VETERAN 1 (0.42%)
40 MINNEAPOLIS VA HCS [618] IFC MINNEAPOLIS TRAVELING VETERAN 1 (0.42%)
41 JACK C. MONTGOMERY VAMC [623] IFC MUSKOGEE TRAVELING VETERAN 1 (0.42%)
42 DURHAM VA MEDICAL CENTER [558] IFC DURHAM TRAVELING VETERAN 1 (0.42%)
43 FARGO VA HCS [437] IFC FARGO TRAVELING VETERAN 1 (0.42%)
44 WILLIAM S. MIDDLETON VAMC [607] IFC MADISON TRAVELING VETERAN 1 (0.42%)
45 BILOXI VAMC [520] IFC BILOXI TRAVELING VETERAN 1 (0.42%)
46 VA NWIHS, OMAHA DIVISION [636] IFC IOWA CITY TRAVELING VETERAN 1 (0.42%)

8 are “Common” Placer Services sent between both filler and placer VistAs. They represent a range of typical administrative (“VIRS”, Lodging, Domiciliary) and care requests to remote facilities (Follow ups). In this VistA, such requests represent 2.77% of placed consults.

Note that equivalent services are filled by this VistA. Those are detailed in the Filler Section below.

ifcCommonOutOtherSankey

By Facility …

# Facility Consults Services
1 SEATTLE VA MEDICAL CENTER [663] 56 (58.33%) IFC PUGET SOUND LODGING REQUEST [51], VIRS IFC COORDINATOR (PUGET SOUND) [4], IFC PUGET SOUND DOMICILIARY ADMISSION REFERRAL [1]
2 WHITE CITY VA MEDICAL CENTER [692] 28 (29.17%) IFC WHITE CITY DOMICILIARY ADMISSION REFERRAL
3 JONATHAN M. WAINWRIGHT VAMC [687] 8 (8.33%) VIRS IFC COORDINATOR (WALLA WALLA) [7], IFC WALLA WALLA DOMICILIARY ADMISSION REFERRAL [1]
4 PORTLAND VA MEDICAL CENTER [648] 3 (3.12%) IFC PORTLAND LODGING REQUEST
5 BOISE VA MEDICAL CENTER [531] 1 (1.04%) VIRS IFC COORDINATOR (BOISE)

The balance, 95, of the Placer Services to 8 facilities, are mainly for specialized clinical services and represent 44.97% of placed consults. Once again, the vast majority go to other facilities in the same VISN but the flow is mainly from smaller facilities to larger with the small placing with the large.

ifcSpecializedOutOtherSankey

By Facility …

# Facility Consults Services
1 BOISE VA MEDICAL CENTER [531] 700 (44.99%) IFC BOISE PCMHI WEN TELEHEALTH [202], IFC BOISE HOME SLEEP STUDY [187], IFC BOISE PHARMACY TELEHEALTH [173], IFC BOISE ECHOCARDIOGRAM NON VISIT [74], TELEHEALTH ADMINISTRATIVE REQUEST (BOI) [23], IFC BOISE PHARMACY TELEHEALTH E CONSULT [15], IFC BOISE SLEEP MEDICINE [10], IFC BOISE PCMHI WEN TELEHEALTH NON VISIT [7], IFC BOISE STRESS TEST NON VISIT [4], IFC BOISE CARDIAC CATHETERIZATION [2], IFC BOISE SARRTP ADMISSION REFERRAL [1], IFC BOISE TELEDENTISTRY [1], IFC BOISE INTEGRATED CARE TELEHEALTH E CONSULT [1]
2 SEATTLE VA MEDICAL CENTER [663] 650 (41.77%) IFC PUGET SOUND ENDOCRINOLOGY NON VISIT [101], IFC PUGET SOUND HEMATOLOGY NON VISIT [90], IFC PUGET SOUND NEUROSURGERY NON VISIT [52], IFC PUGET SOUND NEUROLOGY [33], IFC PUGET SOUND PULMONARY NON VISIT [31], IFC PUGET SOUND VASCULAR SURGERY NON VISIT [29], IFC PUGET SOUND NEUROSURGERY [24], IFC PUGET SOUND RENAL NON VISIT [24], IFC PUGET SOUND NEUROLOGY NON VISIT [23], IFC PUGET SOUND INFECTIOUS DISEASE NON VISIT [18], IFC PUGET SOUND ONCOLOGY NON VISIT [18], IFC PUGET SOUND GASTRO HEPATOLOGY NON VISIT [17], IFC PUGET SOUND GASTROENTEROLOGY NON VISIT [15], IFC PUGET SOUND ENDOCRINOLOGY [14], IFC PUGET SOUND OTOLARYNGOLOGY [12], IFC PUGET SOUND ORTHOPEDICS [11], IFC PUGET SOUND PLASTIC SURGERY [10], IFC PUGET SOUND GENERAL SURGERY NON VISIT [9], IFC PUGET SOUND THORACIC SURGERY NON VISIT [7], IFC PUGET SOUND VASCULAR SURGERY [6], IFC PUGET SOUND OTOLARYNGOLOGY NON VISIT [6], IFC PUGET SOUND RENAL [6], IFC PUGET SOUND ORTHOPEDICS NON VISIT [5], TELEDERMATOLOGY PATHOLOGY IFC (PUGET SOUND) [5], IFC PUGET SOUND REGIONAL AMPUTEE CENTER [5], IFC PUGET SOUND OPIOID SAFETY REVIEW BOARD NON-VISIT [5], IFC PUGET SOUND SCAN ECHO LIVER [5], IFC PUGET SOUND SPINAL CORD INJURY NON VISIT [5], IFC PUGET SOUND SCAN-ECHO IBD [4], IFC PUGET SOUND UROLOGY NON VISIT [4], IFC PUGET SOUND DERMATOLOGY NON VISIT [4], IFC PUGET SOUND DIABETES NON VISIT [4], IFC PUGET SOUND ONCOLOGY [3], IFC PUGET SOUND CARDIOLOGY NON VISIT [3], IFC PUGET SOUND PAIN [3], IFC PUGET SOUND HEMATOLOGY [3], IFC PUGET SOUND DERMATOLOGY [3], IFC PUGET SOUND MENTAL HEALTH NON VISIT [3], IFC PUGET SOUND REHAB NON VISIT [3], IFC PUGET SOUND UROLOGY [2], IFC PUGET SOUND PULMONARY [2], IFC PUGET SOUND INFECTIOUS DISEASE [2], IFC PUGET SOUND GENERAL SURGERY [2], IFC PUGET SOUND OPHTHALMOLOGY NON VISIT [2], IFC PUGET SOUND THORACIC SURGERY [2], IFC PUGET SOUND GASTROENTEROLOGY [2], IFC PUGET SOUND REHAB [1], VISN 20 CANCER CARE NAVIGATION TEAM IFC (PUGET SOUND) [1], IFC PUGET SOUND RHEUMATOLOGY [1], IFC PUGET SOUND RADIATION ONCOLOGY NON VISIT [1], IFC PUGET SOUND CARDIAC SURGERY NON VISIT [1], IFC PUGET SOUND DENTAL [1], IFC PUGET SOUND PLASTIC SURGERY NON VISIT [1], NARS NORTHERN ALLIANCE REFERRALS [1], IFC PUGET SOUND PODIATRY [1], IFC PUGET SOUND GENERAL SURGERY TELEHEALTH(CVT) TUMORBOARD [1], IFC PUGET SOUND GYNECOLOGY NON VISIT [1], IFC PUGET SOUND PODIATRY NON VISIT [1], IFC PUGET SOUND AUDIOLOGY EVALUATION [1]
3 PORTLAND VA MEDICAL CENTER [648] 193 (12.4%) WESTERN TELEMENTAL HEALTH NETWORK IFC [157], IFC PORTLAND ENDOCRINOLOGY [8], IFC PORTLAND NEUROLOGY MOVEMENT DISORDER TELEHEALTH [5], IFC PORTLAND ENT GENERAL [4], IFC PORTLAND LIVER CLINIC GENERAL [4], IFC PORTLAND NEUROLOGY MULTIPLE SCLEROSIS [3], IFC PORTLAND NEUROSURGERY NON VISIT [2], IFC PORTLAND NEUROLOGY MOVEMENT DISORDER [2], IFC PORTLAND NEUROLOGY MULTIPLE SCLEROSIS E CONSULT [1], IFC PORTLAND NEUROSURGERY SPINE [1], IFC PORTLAND CARDIOLOGY GENERAL [1], IFC PORTLAND INFECTIOUS DISEASE E CONSULT [1], IFC PORTLAND ORTHOPEDIC SURGERY NON VISIT [1], IFC PORTLAND VASCULAR SURGERY NON VISIT [1], IFC PORTLAND UROLOGY GENERAL [1], IFC PORTLAND RENAL [1]
4 PALO ALTO VA MEDICAL CENTER [640] 8 (0.51%) IFC PALO ALTO BARIATRIC SURGERY [5], IFC PALO ALTO WAR RELATED ILLNESS INJURY STUDY CONTROL [2], IFC PALO ALTO YOGA WELLNESS TELEPHONE [1]
5 HINES, IL VAMC [578] 2 (0.13%) PRIOR AUTHORIZATION DRUG REQUEST (NATIONAL) IFC
6 ROSEBURG VA MEDICAL CENTER [653] 1 (0.06%) IFC ROSEBURG TELEDENTISTRY
7 JONATHAN M. WAINWRIGHT VAMC [687] 1 (0.06%) VISN 20 CANCER CARE NAVIGATION TEAM IFC (WALLA WALLA)
8 C.W. BILL YOUNG DEPT OF VAMC [516] 1 (0.06%) IFC BAY PINES PTSD MST RESIDENTIAL PROGRAM

Filler

There are 16 Filler Services - services that accept/fill consults from other facilities. In VistA, a single Filler Service may be employed by more than one remote facility and may also be used for purely local consults. In this VistA, 88.17% of the IFC consults are “filled”, mostly from VistAs in the same VISN …

# Filler Service From Facilities # Status’
1 PROSTHETICS IFC MANN-GRANDSTAFF VAMC [15,714] 15,714 (60.96%) COMPLETE [14,215], DISCONTINUED [1,277], PENDING [222]
2 PROSTHETICS IFC MAIL MANN-GRANDSTAFF VAMC [9,812] 9,812 (38.06%) COMPLETE [9,586], PENDING [152], DISCONTINUED [74]
3 IFC SPOKANE TRAVELING VETERAN GEORGE E. WAHLEN VAMC [15], SEATTLE VA MEDICAL CENTER [38], LOMA LINDA HCS [5], LONG BEACH VAMC [4], NORTHERN ARIZONA HCS [3], SOUTHERN NEVADA HCS [13], ANCHORAGE VA MEDICAL CENTER [4], PORTLAND VA MEDICAL CENTER [11], LEXINGTON VAMC-LEESTOWN [1], PALO ALTO VA MEDICAL CENTER [5], JONATHAN M. WAINWRIGHT VAMC [9], JAMES E VAN ZANDT VAMC [1], NORTHERN CALIFORNIA HCS [3], SAN DIEGO HCS [4], BOISE VA MEDICAL CENTER [8], SOUTHERN ARIZONA VA HCS [9], VA NWIHS, OMAHA DIVISION [1], ROSEBURG VA MEDICAL CENTER [3], CHARLESTON VAMC [2], DALLAS VA MEDICAL CENTER [1], TENNESSEE VALLEY HCS [2], PHOENIX VAMC [4], C.W. BILL YOUNG DEPT OF VAMC [1], SAN FRANCISCO VAMC [1], ROCKY MOUNTAIN REGIONAL VAMC [4], PROVIDENCE VAMC [1], FORT HARRISON MEDICAL CENTER [2], EL PASO VA HCS [1], BILOXI VAMC [1], AUDIE L. MURPHY MEMORIAL HOSP [1], SE LOUISIANA VETERANS HCS [3], HINES, IL VAMC [3], SPARK M. MATSUNAGA VAMC [1], ORLANDO VAMC [3], DAYTON [1], MINNEAPOLIS VA HCS [3], ST. CLOUD VA HCS [1], CHEYENNE VA MEDICAL [2], IOANNIS A. LOUGARIS VAMC [2], MIAMI VAMC [1], VA HEARTLAND - WEST, VISN 15 [1], TAMPA FL VAMC [1] 180 (0.7%) COMPLETE [159], DISCONTINUED [21]
4 E CONSULT SPINAL CORD INJURY SOCIAL WORK OUTPATIENT SEATTLE VA MEDICAL CENTER [25] 25 (0.1%) COMPLETE
5 IFC SPOKANE DISCHARGE FOLLOW UP SEATTLE VA MEDICAL CENTER [10], PORTLAND VA MEDICAL CENTER [9] 19 (0.07%) COMPLETE [18], DISCONTINUED [1]
6 IFC SPOKANE INFECTIOUS DISEASE NON VISIT ROSEBURG VA MEDICAL CENTER [8], JONATHAN M. WAINWRIGHT VAMC [2] 10 (0.04%) COMPLETE [9], DISCONTINUED [1]
7 IFC SPOKANE ORTHO HAND BOISE VA MEDICAL CENTER [1], JONATHAN M. WAINWRIGHT VAMC [3] 4 (0.02%) COMPLETE [3], DISCONTINUED [1]
8 VISN 20 CANCER CARE NAVIGATION TEAM IFC (SPOKANE) SEATTLE VA MEDICAL CENTER [3] 3 (0.01%) COMPLETE [2], DISCONTINUED [1]
9 IFC SPOKANE GENERAL ORTHO JONATHAN M. WAINWRIGHT VAMC [3] 3 (0.01%) DISCONTINUED [2], COMPLETE [1]
10 IFC SPOKANE GENERAL SURGERY JONATHAN M. WAINWRIGHT VAMC [3] 3 (0.01%) DISCONTINUED [2], COMPLETE [1]
11 IFC SPOKANE NUTRITION SEATTLE VA MEDICAL CENTER [1] 1 COMPLETE
12 PROSTHETICS REQUEST - MOBILITY WALK AIDS SEATTLE VA MEDICAL CENTER [1] 1 COMPLETE
13 IFC SPOKANE PODIATRY JONATHAN M. WAINWRIGHT VAMC [1] 1 DISCONTINUED
14 IFC SPOKANE LODGING JONATHAN M. WAINWRIGHT VAMC [1] 1 DISCONTINUED
15 IFC SPOKANE OPHTHALMOLOGY JONATHAN M. WAINWRIGHT VAMC [1] 1 DISCONTINUED
16 IFC SPOKANE CARDIOLOGY JONATHAN M. WAINWRIGHT VAMC [1] 1 DISCONTINUED