DOD’s Use of Telehealth

The GAO report published November 14, 2017 describes how the Department of Defense (DOD) uses telehealth for active duty service members and other beneficiaries. The report “Department of Defense: Telehealth Use in FY 2016” was presented to Congressional Committees and the public.

The National Defense Authorization Act for FY 2017, includes a provision for GAO to examine several issues related to DOD’s delivery of healthcare. The report describes DOD’s use of telehealth for active duty service members and other beneficiaries.

GAO reviewed DOD data on the volume of telehealth encounters and the category listing telehealth encounters. This data is determined by where the DOD healthcare services are provided, the type of beneficiaries receiving the service, and which military service is the provider for the service. GAO also looks at DOD data as to the type of clinical services provided via telehealth and the geographic location of providers.

Telehealth services provided by DOD fall into two broad categories. The first is synchronous or real time telehealth encounters characterized by the use of interactive, electronic communication exchange in a least two directions in the same time period.

The second category is asynchronous or referred to as store and forward telehealth encounters which involve the transmission of medical images or information in one direction at a time via electronic communications.

DOD’s direct care component includes about 50 military hospitals and 370 clinics comprising their military treatment facilities. Direct care is also provided through TRICARE, DOD’s purchased care component and also provided through networks of civilian providers. Health assessments and diagnoses, treatments and intervention, and clinical consultations are provided through direct care

In July 2017, DOD revised their TRICARE policy to expand the range of healthcare services that DOD can provide with telehealth as well as the eligible patient locations in their purchased care component. Purchased care is provided through networks of civilian providers.

Services provides through purchased care include clinical consultations and office visits, individual psychotherapy and psychiatric diagnostic interview exams, pharmacologic management, plus end-stage renal disease related services when appropriate and medically necessary.

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