# Virtual Care Coordination in VA Primary Care-Mental Health Integration

> **NIH VA I21** · VA GREATER LOS ANGELES HEALTHCARE SYSTEM · 2023 · —

## Abstract

Background:
Among newly initiated Primary Care-Mental Health Integration (PC-MHI) patients, same day access to PC-MHI
from primary care or other select medical clinics (e.g., emergency department/urgent care) is a Veterans
Health Administration (VA) Strategic Analytics for Improvement and Learning (SAIL) performance measure
(mnemonic: pcmhi7). Prompt initiation of mental health care after a medical visit increases the likelihood of
subsequent mental health follow-up visits, enhancing quality of care. Yet, despite the rapid VA virtual care
expansion during COVID-19, factors that influence virtual same day access to PC-MHI are unknown.
Significance:
Preliminary studies from this research group found that in a large VA medical center, PC-MHI same day
access rates were nearly twice as high for in-person visits compared to virtual visits. Accordingly, PC-MHI
patients who initiate care virtually may experience poorer medical and mental health outcomes from loss to
follow-up. This finding reflects a knowledge gap that exists across disciplines in both VA and non-VA settings
regarding effective strategies for virtual care coordination. The proposed study addresses multiple HSR&D
Priority Areas: Access to Care, Mental Health, Primary Care Practice, Virtual Care/Telehealth.
Innovation & Impact:
The proposed research would be the first to characterize factors that influence same day access to PC-MHI
among patients who use virtual care to initiate mental health services, including mutable clinic characteristics
that may be amenable to intervention.
By identifying specific predictors of same day access to PC-MHI from primary care, the proposed study will
advance understanding of factors that affect virtual same day access while also identifying specific targets for
future interventions, improving quality of care, and relatedly, medical and mental health outcomes, for
Veterans who seek PC-MHI care virtually. Moreover, the study will advance scientific knowledge by providing
data to inform strategies for effective interdisciplinary virtual care coordination.
Specific Aims:
1) Identify multi-level characteristics associated with virtual and in-person PC-MHI same day access in
a national VA sample.
2) Assess barriers, facilitators, and strategies for successful virtual care coordination in PC-MHI.
Methodology:
The study will use a mixed methods design. For Aim 1 (Quantitative), a national cohort of Veterans who
initiated PC-MHI mental health services during FY2019 − FY2021 will be identified. PC-MHI same day access
will be determined based on the presence or absence of a primary care or other select medical clinic visit on
the same day as the initial PC-MHI appointment, per the Mental Health SAIL definition. A multi-level
generalized linear model will be used to evaluate predictors of virtual and in-person same day access. For Aim
2 (Qualitative), semi-structured qualitative interviews with PC-MHI mental health providers and primary care
providers from two VA hea...

## Key facts

- **NIH application ID:** 10639607
- **Project number:** 1I21HX003593-01A1
- **Recipient organization:** VA GREATER LOS ANGELES HEALTHCARE SYSTEM
- **Principal Investigator:** Lucinda B Leung
- **Activity code:** I21 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2023
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2023-08-01 → 2025-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10639607

## Citation

> US National Institutes of Health, RePORTER application 10639607, Virtual Care Coordination in VA Primary Care-Mental Health Integration (1I21HX003593-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10639607. Licensed CC0.

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