Jason Saleem’s VA Study Published in Top Informatics Journal

Jason Saleem, PhD

The Journal of the American Medical Informatics Association, considered one of the top medical informatics journals in the world, has published the work of Jason Saleem, Assistant Professor in Industrial Engineering, and his PhD student Jacob Read. Saleem has been working with the U.S. Department of Veterans Affairs (VA) on “Annie,” a virtual care tool that connects Veterans to health care advice and monitoring.

Saleem said the acceptance of the journal article was on an accelerated time frame due to its relevance to our current pandemic. “Usually when you submit something, it takes one to three months to get peer-reviewed, but because it was COVID-related, the initial peer-review was turned around very rapidly,” he said. “With the article, our goal is to have this study impact other health care systems while the pandemic is still going on.”

Veterans can connect with Annie through a phone or computer and have text messaging capabilities. Annie has numerous clinical and social protocols such as tobacco cessation and hypertension, and when the pandemic hit, Saleem’s VA colleagues quickly put together a protocol for Coronavirus precautions to add it to the existing health protocols.

“What Jacob and I were involved in was to analyze a survey that went out to all Veterans involved with the Annie Coronavirus Precautions protocol to see what the impact was, and it was significant,” said Saleem. Over 1000 Veterans responded.

According to Saleem, the protocol is simple – every other day Annie will send a text message to the Veteran inquiring, ‘Are you feeling well today?’ If the answer is no, Annie follows up with more questions and probes to help the Veteran understand if their symptoms warrant contacting the VA. On the alternate days, Annie sends them some advice such as making sure to wear a mask in public.

Saleem said it saved significant healthcare resources because the text messages are guiding them on what they should be doing and influenced a large portion of them not to interact with a healthcare provider because Annie provided the information they sought.  The Annie messages also make them feel secure. “They feel like the VA is looking out for them,” he said.

Responses from an open-ended survey question about the helpfulness of Annie’s messages included the following:

• “It made me feel better that someone cares about me and my health.”
• “They gave me a sense that, despite all the chaos, there was someone that cared just about me.”
• “Annie keeps reminding us on precautions, love how she keeps asking how we are feeling. She’s there for us!! As is the VA!!”

“The VA gets beat up in the media quite a bit, so it feels good to put something positive out there,” said Saleem.

The Coronavirus Precautions protocol through Annie was made available in the journal article, so Saleem said he hopes that other healthcare organizations can use it to save resources and help manage patients during the pandemic as well.

“Making these virtual care tools easy to access is critically important,” said Saleem. “It feels good to do something tangible. With COVID-19, nothing else really seems to matter right now. If we’re able to do work that relates in some way to this pandemic, we have a greater sense of purpose.”