Sara Espinoza, MD, M.Sc, AGSF. Dr. Espinoza performs geriatric assessments, supervises all interdisciplinary team members and overs all aspects of the project.
Becky Powers, MD performs geriatric assessment working with interdisciplinary team members to provide geriatric assessments by e-consult or tele-medicine.
Cynthia Stewart, Licensed Clinical Social Worker, triages all consults for social services needs and refers as appropriate.
Rebecca Rottman-Sagebiel, Pharm.D., BCPS, CGP reviews all medications, and makes recommendations for medication interventions to improve geriatric syndromes.
The project is also supported by a data analyst for data management (Daniel MacCarthy) and a biostatistician (Chen-pin Wang, Ph.D.).
Point of Contact: Penny (Bertha) Flores, Bertha.Flores@va.gov; (210) 617-5300, ext. 14837
The goal of the GRECC Connect VIRTUAL Geriatrics San Antonio project is to provide Geriatrics expertise to rural veterans and providers in South Texas. Our interdisciplinary team provides expert clinical consultation to medically complex older veterans via e-consultation and CVT. Another goal of the program is to provide clinically-based education, through the consultation process, to the rural PCPs we serve.
CBOC providers consult our GRECC Connect VIRTUAL Geriatrics team through a CPRS generated consult. All consultations receive an initial e-consultation, which includes a comprehensive chart review and telephone visit with the patient and caregiver for administration of standardized geriatric assessments to screen for disability, depression, executive impairment, and caregiver burden. Formal recommendations are made to the consulting provider. CVT visits are scheduled for patients after initial e-consultation to address more complex patient needs as needed.
Sawey K, Royall D, Powers B, Taylor V, Wang C, Espinoza S. Increased Disability in Instrumental Activities of Daily Living is Associated with Executive Impairment in Rural Veterans Referred for Geriatrics e-Consultation. Accepted for presentation at the 2016 Annual Scientific Meeting of the American Geriatrics Society.
Our GRECC Connect VIRTUAL Geriatrics team has been providing a Dementia Caregiver Support and Education Program on a monthly basis at the Audie Murphy VA Hospital since 2014. Classes cover topics ranging from understanding the types of dementia and its symptoms to caregiver stress, dementia- related behaviors, and late-stage dementia. This program became so popular with the caregivers at Audie Murphy, that we have expanded this program to the Kerrville VA Medical Center, which is within our healthcare system, and serves rural veterans. We hold monthly caregiver support and education classes via V-tel with caregivers in Kerrville. In the future, our goal is to implement the REACH VA caregiver program (a VA telephone support and education program) to provide much needed support for caregivers of rural veterans. This modality would be useful to reach caregivers who cannot travel to either the San Antonio or Kerrville medical centers.