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War Related Illness and Injury Study Center

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WRIISC Referral Process

WRIISC Referral

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What is the Referral Process?

  • Like many specialty consultations, WRIISC encourages Veterans’ primary care providers (PCPs) or Patient Aligned Care Teams (PACTs) to make WRIISC referrals. WRIISC consults that come from Veteran’s primary care providers optimize the likelihood that Veterans referred to WRIISC are appropriate referrals and that WRIISC recommendations are followed by the Veteran’s PACT team.  
  • Environmental health coordinators and clinicians can help facilitate the WRIISC referral process by encouraging Veterans who meet WRIISC eligibility criteria to ask their VA PACTs about a WRIISC referral and providing PACTs information on the WRIISC program, and referral process.
  • WRIISC referrals are completed initially as e-consults with clinical recommendations provided to the referring provider. Some WRIISC consults may only receive e-consults if more evaluations or records are needed. In other cases, additional WRIISC services like WRIISC comprehensive, multi-disciplinary evaluations and environmental exposure assessments may be offered as needed.   These services may be offered through telehealth and/or on-site evaluations.
  • WRIISC Referrals are completed using the Inter Facility Consult (IFC) in VA’s Computerized Patient Record System (CPRS). Detailed instructions available here.

What Information is Needed to Complete a WRIISC IFC?

  • In the WRIISC IFC, please provide a specific, medically unexplained clinical question that WRIISC can help address. (Example - Veteran complains of pain and fatigue since deployment. During past year, Veteran has been seen by pain, sleep, and psychiatry clinics. The Veteran has no symptom improvement despite treatment evaluations and follow-up. We request your assistance with this Veteran.)
  • If workups are completed outside of VA, please have results in VA medical record for review.
  • Veterans who do not have initial workups for symptoms or had workups in the remote past will be asked to complete these evaluations first.
  • Local Environmental Health Registry exams are important first steps in evaluating deployment environmental exposure concerns. VA registries are important surveillance tools. If a VA Registry exam has not been conducted, this may be recommended. Registry exams can be scheduled by contacting your local VA Environmental Health Coordinator.
  • If military environmental exposure concerns persist after VA Registry evaluation, please list environmental exposure concerns on the WRIISC consult.

How are Referrals Triaged?

Once a WRIISC IFC is placed, referrals are triaged to the appropriate regional WRIISC based on VA Medical Center Location (see map below). There are 3 WRIISC sites at VA Medical Centers in East Orange NJ, Washington DC, and Palo Alto CA.

 

 

Map of the three WRIISC service areas

 

  • Once the IFC consult is received, the first step in triaging consults is for WRIISC staff to conduct medical record reviews to evaluate deployment status, presence of workups for symptoms, and eligibility for WRIISC services.
  • Each WRIISC consult receives a medical record review, and WRIISC consults are completed initially as e-consults with clinical recommendations provided to the referring provider.
  • Additional WRIISC services like WRIISC comprehensive, multi-disciplinary evaluations and environmental exposure assessments may be offered as needed.

Who Can I Contact For More Information?

If you have any questions about WRIISC services, please contact the WRIISC closest to you.

  • For the CA WRIISC, this number is 1-888-482-4376.
  • For the DC WRIISC, this number is 202-745-8249.
  • For the NJ WRIISC, this number is 973-676-1000 ext. 2500.