Expanding Access to Telemedicine

Army Lt. Col. (Dr.), Director of the Virtual Medical Center (VMC) at the Brooke Army Medical Center at Joint Base San Antonio-Fort Sam Houston, https://www.jbsa.mil,  explains why the Military Health System (MHS) is using Telemedicine Privilege by Proxy.

The military’s use of the Telemedicine Privilege by Proxy system plays a crucial role in meeting MHS’s major clinical needs which is to expand access to limited specialty care resources wherever the patient is located, especially to small, remote locations.

The Telemedicine Privilege by Proxy system, a centralized process, has made it up to 30 times faster for providers to get permission to deliver care virtually at military hospitals and clinics. Now it only takes three to five days down from 90 days or more to get permission to deliver care virtually.

The system is able to confirm providers’ credentials and privileges at their primary military facilities and enables providers to have the same privileges for virtual care at other facilities. This makes it possible for doctors to have quick access to patients at different locations when needed.

Telemedicine Privilege by Proxy is for virtual health visits only as it does not authorize a provider to physically practice at a patient’s facility. However, this restriction does not impede the providers ability to deliver high quality care, since the MHS has a number of evidence-based virtual health options that Telemedicine Privilege by Proxy providers can use.

The new standard synchronous method used to meet with patients in real time is MHS Video Connect, which is a virtual health platform that allows patients to meet virtually with their military health provider via secure live video on any internet connected device.

However, telemedicine doesn’t always require video as in many cases, most MHS virtual health is done by phone. For emergency cases, the VMC’s Advanced Virtual Support for Operational Forces hotline, or ADVISOR, is able to connect service members or providers anywhere in the world 24/7 to specialty providers on call.

For non-urgent requests, the VMC’s Global Teleconsultation Portal enables providers to refer cases to an appropriate Telemedicine Privilege by Proxy specialist who generally responds within 24-72 hours.