VA Palo Alto Health Care System

 

Clinical Video Telehealth: The Future is Now

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A patient and his medical provider communicate via Video Technology Conferencing (VTC).

A patient and his medical provider communicate via Video Technology Conferencing (VTC).

Tuesday, December 14, 2010

In a dedicated effort to meet the medical and mental health needs of Veterans, VA Palo Alto is expanding health care services to Veterans in geographic areas with the use of Video Technology Conferencing (VTC) equipment. We can fulfill Secretary Shinseki's Patient Centered initiative to increase care to rural areas by offering Telehealth, or virtual mental health and medical care through the use of VTC. VAPAHCS has broadened the availability of services and increased patient-centered programs and care.

Telehealth improves efficiency and satisfaction in the delivery of health care to Veterans. Patients can drive to their local Community Based Outpatient Clinic (CBOC) and see a specialist via teleconference over a secure, encrypted line. With care being brought to the patient, VTC technology allows Veterans and health care providers to actually see each other on either small all-in-one units (VTEL units) or larger TV monitors equipped with cameras. Medical technology also allows for additional examination and care. Telehealth care serves our Veterans who are greatly inconvenienced by traveling or cannot otherwise see a provider. Many Veterans are familiar with webcams or Skype and the idea is the same, however VTC is inaccessible by outside parties and is never recorded.

Currently, the services and programs that are offered for Veterans include:

  • Clinical Video Telehealth (CVT)
  • Care Coordination Home Telehealth Care (CCHT)
  • Store and Forward/TeleRetinal
  • TeleRadiology

Through the use of CVT, patients can access the best care for Telemental Health, Polytrauma Traumatic Brain Injury (TBI) Medical Doctor visits, TelePain, Tele-GI, Tele-Spinal Cord Injury (SCI), Tele-Rehabilitation, and Tele-Rural Health Care.

For Polytrauma patients, the advent and advancements of Telehealth technology allow a patient to see multiple providers in one day at one location.  Telemental Health patients avoid long drives that may trigger Post Traumatic Stress Disorder (PTSD) symptoms, and older Veterans avoid dangerous drives. Mental Health Care services to date include OIF/OEF Case Management, OIF/OEF Family Services, individual therapy, PCT Treatment, Medication Management, Group Counseling, and Addiction Therapy Services.

CCHT provides services and case management of patients in the home.

Store and Forward allows retinal images to be stored and forwarded to specialists for further evaluation.

Teleradiology allows for the reading of complex images by specialists at larger facilities.

Patients and providers are positive about and receptive to Telehealth. Participating CBOCs include: Menlo Park, Sonora, Stockton, Modesto, Livermore, San Jose, Monterey, Fremont, and Capitola. Some Telehealth programs are presently only available at a limited number of CBOCs, for example, the Polytrauma Telehealth Traumatic Brain Injury (TBI) Evaluations are offered at Modesto, Monterey and Stockton CBOCs.

"I like VTEL," said one Veteran in Sonora. "It's really convenient because I had to travel two hours to see the nearest psychiatrist. This is much nicer and it's only 10 minutes from my house. I would recommend it to other people. It's nice, convenient and easy."

Video teleconferencing appointments save Veterans time and money, reduce wait times, and provide the same exemplary care that Veterans expect from VAPAHCS.  Participation in Telehealth is voluntary and a Veteran can choose to return to face-to-face appointments at any time.

Case managers, mental health care providers, social workers, and physicians are knowledgeable about the possibility of participating in Telemental Health and can determine if Telehealth is appropriate for patients.  To learn more about Telehealth within the VA, visit the Office of Care Coordination Web site.

Together, we can offer care without boundaries, expand services across CBOCs, across VISNs, and eventually across the country. VAPAHCS has benchmark services to offer, such as training from experts at the National Center for PTSD, treatment from the Spinal Cord Injury (SCI) Center, and evaluation for Traumatic Brain Injury by the Polytrauma Network Site doctors. Within VISN 21, the success of the Telemental Health PCT treatment was cited by the VISN 21 lead for Telehealth in a research presentation.

VISN 21's success with Telehealth has been so great that at VAPAHCS, we are expected to grow by 50% in Fiscal Year 2011. We plan to meet this goal by increasing the relationships and services between disciplines, increasing services offered, expanding care to Veteran Centers, and recruiting more providers. Expansion is a given - and with the enthusiasm of providers, staff, and patients, the possibilities are endless.