VA Paves the Way with Telehealth

Dr. Darkins delivered a keynote address at last week’s annual HIMSS Government Health Information Technology Conference in Washington, DC.  Dr. Darkins believes that in the not too distant future, the term telehealth is likely to disappear, because the use of these types of technologies will become a common part of healthcare.

VA is recognized as a leader in telehealth development and implementation, and the number of veterans receiving care via telehealth is growing by 22% annually.  VA’s goal is to provide the right care at the right place at the right time.  For most patients, the preferred site of care is in the home or the local community.  Telemedicine makes that possible.

VA categorizes their telehealth initiatives into six different programs: 

• Clinical Video Telehealth 
• Home Telehealth 
• Store and Telehealth 
• Teleradiology 
• Secure Messaging 
• Mobile Health 

VA’s Clinical Video Telehealth program allows veterans to receive specialty consultations through real-time video connections with clinicians.  This prevents the need for veterans to travel outside of their area to receive care, which can be an arduous task for many.  Also, video consultations work well for VA, because the department doesn’t face the same state licensing roadblocks as other organizations.  State licensing requirements restrict treatment by out-of-state doctors even via telemedicine, but VA’s network of doctors are able to treat patients throughout the system.

VA’s Home Telehealth program was established to try and help veterans with chronic diseases live independently.  Home telehealth equipment checks symptoms and measure vital signs in the home and links to VA’s EHR.  Such devices make care more convenient for patients with conditions such as diabetes, chronic heart failure, chronic obstructive pulmonary disease (COPD), depression or post-traumatic stress disorder.

VA’s Store & Forward Telehealth program allows acquisition of clinical images at sites close to the patient.  The need for this program and technology stemmed from diabetic eye disease.  Veterans can now have their primary care physician administer an eye exam and transfer the image to an ophthalmologist.  The program has since been ported to dermatology.

VA also has some unique challenges to telehealth.  Interoperability is a hurdle.  The entire telemedicine industry is working toward standardization and interoperability.  Additionally, VA must invest in its own training of clinicians in telehealth technology and the business processes surrounding the programs.  These concepts are not taught in medical school.  Also providing technical support for clinicians and patients is a challenge.

VA plans to continue to chart the way in telemedicine on a grand scale, to be able to provide the care veterans need when and where they need it.