Telehealth Services at the VA

Adam Darkins, Chief Consultant for Telehealth Services at the Veterans Administration discussed the scope of the VA’s telehealth services at the ATA Federal Telemedicine Policy Summit held in June in Washington D.C. Darkins anticipates that the VA’s telehealth services will grow by around 29 percent annually.

The VA is moving forward in three specific areas that includes Clinical Video Telehealth (CVT), Home Telehealth, and Store and Forward Telehealth (SFT). The total for these three areas have provided individuals with 1,429,424 telehealth episodes of care and 49 percent of these individuals live in rural areas.

The CVT program alone provided care for 148,385 patients in FY 2012 with care encompassing 44 clinical specialties. The system links hospitals with hospitals using real-time video conferencing technology on the VA’s Clinical Enterprise Video Conferencing Network (CEVN).

Over 6,600 clinical video conferencing units are Commercial-Off-The-Shelf (COTS) products purchased under contract. These units interconnect via direct dial Internet Protocol (IP) connection to a national dial-plan.

As for home telehealth 119,535 patients received care in FY 2012 for chronic conditions in their homes. The home telehealth program uses COTS technologies in the home to link to VA information technology support. Standardized business processes are used with the systematic coding of activity and then routine outcomes data is available at the national, regional, and local level.

The VA’s Store and Forward Telehealth (SFT) program cared for 263,444 patients in FY 2012. SFT enables patients to get their clinical images done at sites close to their home, then the images are sent to be interpreted and reported back to the patient.

Currently, the major areas for SFT care involves teleretinal imaging, teledermatology, and telepathology. In teledermatology alone, in FY 2012, 27,000 patients received care. New VA programs under development include telewound care, telespirometry, and telecardiology.

The VA has been very active in developing their telemental health program that includes services for all mental health conditions but the focus is on PTSD, depression, bipolar disorder, behavioral pain, and evidence-based psychotherapy.

In FY 2012 alone, the VA delivered over 217,000 telemental health consultations to over 76,000 patients and in FY 2012 the National Telemental Health Center concept provided 1,251 video encounters to 427 patients at 24 sites in 13 states.

Chronic disease management provided home telehealth devices in FY 2012 to help 7,100 patients with chronic mental health conditions to live independently. Of these patients, 1,304 took part in video consultation directly coming into their homes via CEVN.