Lt. General Patricia D. Horoho, Surgeon General of the U.S. Army, appeared on April 9th before the Senate Subcommittee on Defense to describe how the defense health program is progressing. She described how telehealth is being used by Army clinicians to offer care in multiple medical disciplines across 18 time zones in over 30 countries and territories.
Horoho reports, “The Army has provided over 34,000 real-time patient encounters and consultations between providers in garrison in FY 2013 and over 2,300 additional encounters in operational environments. The Army has requested $21 million for telehealth in FY 15.”
The Army provides care via telehealth in 28 specialties, tele-behavioral health accounts for 85 percent of the total telehealth volume in garrison and 57 percent in operational environments. In addition, over 2,000 portable clinical video teleconferencing systems have been deployed to support behavioral health providers across the globe.
The Army has developed the Behavioral Health Data Portal (BHDP) a web-based application that tracks and reports in real-time on the soldier’s treatment and progress at each session. The BHDP tracks clinical outcomes and satisfaction in behavioral health clinics and is now in use in all military treatment facility behavioral health clinics serving active duty soldiers with over 30,000 data collections per month
According to reports from the military, the Army’s Medicine Secure Messaging Service (AMSMS) connected to all 52 of their Military Treatment Facilities (MTF) worldwide has almost been implemented. As of March 1, more than 234,000 Army Medicine healthcare beneficiaries and almost 3,000 Army providers have signed up for the service. Now patients and providers are able to communicate via a network on non-urgent healthcare concerns.
AMSMS allows beneficiaries to view their electronic personal healthcare record, request appointments, request medication refills or renewals, as well as allows providers to send important preventative care updates to their patients.
Lt General (Dr.) Thomas W. Travis Surgeon General for the Air Force, told the Senators at the same hearing that secure messaging has been deployed throughout the Air Force medical system and includes more than 305,000 enrolled users sending over 41,000 messages per month.
He also mentioned, “Last year the Air Force launched their telehealth initiative called Project ECHO with one specialty to address complicated diabetes management at three military treatment facility pilot sites.”
He added, “Now in our second year, the Air Force has added chronic pain management, traumatic brain injury, behavioral health, dermatology, ENT, and acupuncture for a total of seven live ECHO specialty series. The Air Force is planning to add four more specialties in addiction, infectious disease, neurology, and dental this coming year. In addition, continuing medical education accreditation have been granted for six of the seven ECHOs.
The Senate Committee also heard Vice Admiral Matthew L. Nathan, MC, USN, and Surgeon General of the Navy discuss the Navy’s activities related to telehealth. So far, a Program Management Office involved in telehealth has been established within the Bureau of Medicine and Surgery, along with two regional project offices at Navy Medicine East in Portsmouth VA and Navy Medicine West in San Diego.
Also, the Naval Hospital at Camp Lejeune has initiated programs to support a broad spectrum of clinical services that includes pediatric subspecialty consultations, tele-ICU, tele-behavioral health, tele-insomnia, teleneurology, orthopedic consult services, tele-pain, and Battalion Aid Station consultative services. Navy Medicine East is also initiating a large teleradiology program to provide after hours and subspecialty coverage throughout the region.
In addition, a Memorandum of Agreement was signed between Navy Medicine West and the Army’s Pacific Regional Medical Command (PRMC) to collaborate on telehealth initiatives in the Pacific. WESTPAC Medical Alliance the military treatment facility on Guam, Okinawa, and Yokosuka provides patients with tele-critical care, tele-behavioral health, and provider-to-provider tele-consultations.