Implementing the VI in Hospitals/Clinics/Medical Outreach

Greetings from Nashville,

I hope you are well.

I am looking for guidance on the best way to implement the VI in health care settings - hospitals, clinics, medical outreach teams, etc. Health care settings seem to be a natural environment for the VI, as the VI is a tool to capture someone's known health status. If more physicians used this tool, we would have a better idea if folks are under-reporting or over-reporting their illnesses.

In Nashville, there are a number of medical providers who are interested in implementing the VI. However, I am reluctant to train them on using the VI because the current VI survey is a self-reporting survey. It is not a tool that lends well to objective medical information that a physician could provide. In other words, I would fear that a patient experiencing homelessness would be handed a VI survey while sitting in the waiting room for an appointment...there is nothing on the survey that would require a physician to be there, to give input, etc.

So, we all know that the VI rocks the house!! But, can it or should it be tweaked before we implement it in health care settings? Should we use the current version of the VI for "survey blitzes" with volunteers and develop another "medical" version of the VI for physicians?

Thanks a bunch for your help with this. Robb Nash - a nurse practitioner in Nashville who staffs a respite clinic for the homeless - wants to help think through this with us. Here are some of his initial questions that could help get this discussion going:

"What experience do people have with the VI in terms of clinically ranking a person's acuity of illness? For example, one person's hypertension is not anothers, nor is one person's CD4 count and viral load equal to anothers. Given that, how are people using the VI to accurately rank folks for services/housing based on their health? Is anyone out there using the VI along with some more clinically objective addendum?" - Robb Nash, Clinical Instructor, Vanderbilt School of Nursing

So, is there room for objective medical evidence in the VI? If so, how do we incorporate it? If we want physicians to be involved in the reporting of health conditions, how do we structure the survey so that a physician can use it best?

Thanks again. Take it easy. Peace.