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across the VA system.
Additionally, the VA Connect appli-
cation that launched a year ago allows in-home users to connect with doctors, mental health specialists, nurses, fam- ily members and health care proxies to conduct medical visits, follow-up care and psychotherapy. Since launching, VA Connect, available via Android and Apple app stores, has logged 48,000 ad hoc patient visits involving 22,700 vet- erans and 4,500 VA providers, Evans told FCW.
VA has implemented point-to-point telehealth at 900 sites in more than 50 specialties. Evans said that so far, clinical video telehealth has generated a 92 percent satisfaction rate among patients.
‘Not a unique, boutique activity’
VA teams are able to provide care across state lines thanks in part to the VA Mission Act of 2018, which extends new regulatory protections to VA tele- health providers. Specifically, the law blocks states from imposing sanctions on providers that are recognized by VA as eligible to deliver telemedicine care even if they are out of compliance with state licensing provisions.
The proliferation of telehealth ser- vices means that a video visit with a patient is part of the everyday work of VA clinicians.
“By 2020, it will be a routine expe- rience that for all of our clinicians, telehealth is part of the job,” Carolyn Clancy, acting head of VHA, told a panel of senators in May. “This is not a unique, boutique activity.”
VA’s budget for telehealth backs that up. In 2018, the agency has a $1.3 billion telehealth budget, and officials expect to spend $1.2 billion in 2019 and $955 million to build and support telehealth services and technology.
For Evans, the video chat is just the latest tool clinicians need to do their jobs. Every physician delivering outpa- tient care uses the telephone to com- municate with patients, and telehealth is simply the next technology.
“It’s going to become what we do in health care,” Evans said. “We’ve been... essentially, helping build out the tech- nology infrastructure necessary so that every primary care provider and every mental health provider can offer a video visit [and] can integrate that into how they deliver care.”
The emphasis on telehealth also allows VA to reduce the stress on its nationwide system, which has more than 30,000 clinical vacancies. Patients
software. VA Video Connect can be used for mental health sessions or quick follow-up visits to see whether a new medication is effective or how a patient is recovering from a procedure. Provid- ers initiate visits and invite patients and other providers, generating a unique and temporary URL for each visit to ensure that only invitees can attend.
Evans said VA is working on inte- grating patient data into VA Video Connect. One enhancement in the
works would allow Bluetooth-connected devices to transmit vital signs and data to VA providers in real time. Officials also plan to give digital stetho- scopes to patients so that providers can lis- ten to heart and lung sounds through VA Video Connect, he added.
Officials want to make the same tech- nology and connec- tivity available to all
veterans. For patients without home broadband access, VA supplies tab- lets that operate via cellular connec- tions, including customized models with peripheral devices that collect and send data from blood pressure monitors and Apple iPads that sup- port VA Video Connect visits.
In addition, the department is part- nering with veterans service organiza- tions on a pilot program to put tele- health tablets in various locations, such as Veterans of Foreign Wars posts, so patients could arrange a telehealth visit close to home. VA offi- cials are exploring partnerships with other agencies to offer telehealth sites, including the U.S. Postal Service.
“There are other potential partners we can think of where we could essen- tially create endpoints for veterans to receive care if they couldn’t receive it at the home because of a technology barrier,” Evans said. n
“By 2020, it
will be a routine
experience that for
all of our clinicians,
telehealth is
in rural areas are often particularly hard-hit by the shortage of providers, whether they are seeking care through VA or through local providers under the Veterans Choice Program.
In response, VA has established 11 tele-hubs nationwide for mental health care and nine for primary care so that practitioners elsewhere can deliver services to underserved locations until vacancies can be filled.
“We can start to leverage telehealth, which lets us overcome distances and geography, to connect, to allow the sys- tem to run more efficiently where we can match where we have a demand for services but we don’t have the supply of providers to meet that,” Evans said.
Overcoming technology barriers
The VA Video Connect app for home use has a streamlined interface and intuitive commands and buttons that don’t look much different from videoconferencing
part of the job.” — CAROLYN CLANCY, VHA
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