The “Capitol Hill Steering Committee on Telehealth and Healthcare Informatics” briefing on July 9th sponsored by the Institute for e-Health Policy www.e-healthpolicy.org discussed vital health issues related to the Department of Defense and the Department of Veterans Affairs. Speakers from the Defense Health Agency (DHA and the Veterans Health Administration (VHA) commented on the many advances and challenges military medicine and the veterans’ healthcare systems face.
Karen S. Guice M.D. Principal Deputy Assistant Secretary of Defense for Health Affairs discussed how the Military Health System (MHS) operates using a very unique partnership of medical educators, medical researchers, and healthcare providers and support personnel worldwide. This enables MHS to respond anytime, anywhere to provide care on the battlefield, assist in times of natural disasters, and provide care when humanitarian crises arise around the globe.”
As Dr. Guice explained, “The integration of military services with the VA is vital if all service members, Tricare, and Medicare beneficiaries are to be treated since today’s service members go in and out of the military and VA system to receive care. She also mentioned that it is very important to deliver patient-centered care but this can’t really be effective if the military and the veteran community aren’t taking advantage of new electronic tools to further improve communication between patients and their healthcare teams.”
According to Lt. Gen (Dr) Douglas J. Robb, Director Defense Health Agency, a single enterprise solution is needed to provide core shared services to the TRICARE Health plan, to provide pharmacy benefits, deal with public health surveillance, integrate health IT, provide education and training, and manage facilities and budget resources effectively.
Tackling EHR modernization, Mary Ann Rockey Deputy Program Executive Officer for the DOD Healthcare Management Systems Modernization and Integrated EHR Program, is directing efforts needed to provide for the seamless sharing of standardized health data among MHS and, VA, along with private sector providers.
She explained, “This will necessitate modernizing EHR software and systems to help support DOD clinicians. To work effectively with the private sector, the EHR modernization program has conducted more than four industry day presentations with vendor representatives and government officials.
DOD’s goal is to acquire an off-the-shelf solution to replace DOD legacy EHRs. To help DOD competitively acquire, test, deliver, and successfully transition to a state-of-the-market EHR system, three draft Request for Proposals were released in January, March, and June. The final RFP is set for release later this fiscal year.
Discussing important issues from the VHA’s viewpoint, Terry Cullen M.D, Director, Health Informatics for VHA, reports that veterans now have access to 151 medical centers and nearly 1,400 community-based outpatient clinics where they can get full service care.
She said, “This means that sharing services with others in the population is very important but this can only be done by integrating health IT into the system. It is very important to use a team model and provide the best of care at the point-of-care in order to treat veterans throughout their lifetime.”
To further explain efforts at the VHA specific to telehealth, Adam Darkins, M,D, Director for National Telehealth Programs, pointed out how the VA’s real-time Clinic-Based Video Telehealth (CVT) effectively links four Polytrauma Rehabilitation Centers to each other and to 17 Polytrauma Network Sites. CVT is also able to provide help with telerehabilitation, and telesurgery.
According to Dr. Darkins, “Home telehealth is becoming very important in treating many chronic illnesses with many veteran patients regularly using home telehealth devices to coordinate their care. He added, “In addition, using store-and-forward telehealth is particularly beneficial for teleretinal imaging especially for people that already have complications of diabetes and for patients with dermatology issues.”
From the industry stakeholder’s point of view, Bettina Experton M.D CEO of Humetrix Inc. discussed the effectiveness of the VA’s iBlueButton powered mobile app and how it actually puts care coordination in the hands of veterans. The technology lets veterans download their VA, DOD, Medicare and other health records on their smartphones and then share this information with their doctors.
However, according to Experton, a major concern is that veterans and providers aren’t always told how useful the technology can be to maintain their health. To increase the use of iBlueButton, information needs to be given to active duty military personnel when they are discharged, when wounded soldiers are discharged from a MHS facility, when young veterans first access the VA Health system, and when veterans need to know how to access care outside of the VA.