VA Division Saves $742,000 With Telehealth - InformationWeek

InformationWeek is part of the Informa Tech Division of Informa PLC

This site is operated by a business or businesses owned by Informa PLC and all copyright resides with them.Informa PLC's registered office is 5 Howick Place, London SW1P 1WG. Registered in England and Wales. Number 8860726.

08:25 AM

VA Division Saves $742,000 With Telehealth

Northwestern Veterans Affairs network deploys videoconferencing, remote monitors to care for far-flung wounded warriors, extend reach of specialists.

Health IT On Display: HIMSS12 Preview
Health IT On Display: HIMSS12 Preview
(click image for larger view and for slideshow)
A single veterans hospital in rural Oregon saved more than $88,000 in travel expenses during fiscal year 2011 by shifting 3,224 patient encounters from in-person visits to telehealth services, according to a nursing executive there. The entire U.S. Department of Veterans Affairs' (VA) Northwest Health Network, also known as Veterans Integrated Service Network (VISN) 20, was able to trim upwards of $742,000 from its budget during the same period by facilitating 23,580 remote consultations.

"In the VA, we actually pay for miles," Tracy Weistreich, associate director for patient care services at the VA Roseburg Healthcare System, noted at the annual Telehealth Alliance of Oregon meeting in Portland last week. Roseburg is a small town off Interstate Highway 5 in southwestern Oregon, about halfway between Medford and Eugene, and the medical center there, like so many VA installations, has been dealing with an influx of wounded warriors from the Iraq and Afghanistan wars.

Roseburg's rural location makes employee recruitment and retention difficult, Weistreich said, and the patient population is scattered across a wide geographic area. Those conditions present a ripe opportunity for telehealth to extend scarce resources, allowing physicians and advanced-practice nurses to handle more patients and other clinical staff to provide whatever aspects of care they are legally allowed to practice.

[ Most of the largest healthcare data security and privacy breaches have involved lost or stolen mobile computing devices. For possible solutions, see 7 Tools To Tighten Healthcare Data Security. ]

"Providers need to work to their licenses," said Joseph Ronzio, Vancouver, Wash.-based telehealth coordinator for the VA Northwest Health Network. "The technology just supports their work."

The VA is well known for its embrace of telehealth, but Ronzio said that VISN 20 might be the largest telemedicine implementation in the world. The system serves sparsely populated Alaska, as well as Oregon, Washington State, and remote sections of California and Montana.

Roseburg, like the entire VA organization, offers multiple forms of telehealth. Clinical videoconferencing facilitates group and individual mental health, group education, management of implantable cardiac defibrillators, endocrinology, and chaplain services, and assists the amputation clinic, Weistreich said. For home telehealth, the VA offers interactive voice response, which Weistreich said many patients like when phoning in information, as well as support for Viterion TeleHealthcare monitoring devices.

The health system also offers teledermatology and retinal imaging services via store-and-forward technology.

Weistreich, a registered nurse with a doctoral degree, told the story of "Joe," a typical Roseburg VA telehealth patient who lost both legs to an explosive device in Iraq and suffers from post-traumatic stress disorder (PTSD). Joe's anger-management problems cost him his home and job, too.

The VA found him housing more than 40 miles from the Roseburg campus, and Joe no longer drives, so he has to rely on family and friends for transportation. Chronic fatigue and pain also make it difficult for him to travel.

His part-time work schedule was sporadic, and it was difficult for him to take time off, plus he has been reluctant to come to the VA for treatment, in part because he has felt a stigma about his PTSD diagnosis, Weistreich said.

Instead of trying to get Joe to travel to Roseburg, the VA arranged for him to "see" his doctors, therapists, and counselors while sitting in front of a telehealth cart at a clinic much closer to home. He has been participating in a PTSD therapy group and receiving individual mental health counseling, wound care, and spiritual ministry remotely, Weistreich reported. His wounds are healing and he only has had to visit Roseburg once in the past three months.

VA clinicians in Roseburg interact with Joe over a secure online video connection, while a technician or licensed practical nurse on the patient's end helps with the exam. Doctors, nurses, and therapists at the VA can document each encounter in the organization's electronic health record in real time, according to Weistreich. Some mental health services can be provided in the patient's home.

The VA technically classifies home telemental health as a pilot program; otherwise the government would have to pay for each patient's broadband Internet connection. But other telehealth services are part of regular care. "Telehealth is absolutely not a pilot in the VA. It is an established program," Weistreich declared.

The technology merely bridges the distant between patient and caregiver. "Telehealth changes the location where healthcare services are routinely provided and supports veterans' preferences to live in the least restrictive settings possible," Weistreich said, echoing the VA's telehealth philosophy.

Healthcare providers must collect all sorts of performance data to meet emerging standards. The new Pay For Performance issue of InformationWeek Healthcare delves into the huge task ahead. Also in this issue: Why personal health records have flopped. (Free registration required.)

We welcome your comments on this topic on our social media channels, or [contact us directly] with questions about the site.
Comment  | 
Print  | 
More Insights
Newest First  |  Oldest First  |  Threaded View
Lisa Henderson
Lisa Henderson,
User Rank: Apprentice
2/9/2012 | 1:54:37 AM
re: VA Division Saves $742,000 With Telehealth
I don't want to get into the whole implications behind this statement: "The VA technically classifies home telemental health as a pilot program; otherwise the government would have to pay for each patient's broadband Internet connection." But Joe, having served our country, desrves a broadband connection, as well as all the positive support he his receiving from the telehealth programe.

Lisa Henderson, InformationWeek Healthcare, contributing editor
2021 Outlook: Tackling Cloud Transformation Choices
Joao-Pierre S. Ruth, Senior Writer,  1/4/2021
Enterprise IT Leaders Face Two Paths to AI
Jessica Davis, Senior Editor, Enterprise Apps,  12/23/2020
10 IT Trends to Watch for in 2021
Cynthia Harvey, Freelance Journalist, InformationWeek,  12/22/2020
White Papers
Register for InformationWeek Newsletters
The State of Cloud Computing - Fall 2020
The State of Cloud Computing - Fall 2020
Download this report to compare how cloud usage and spending patterns have changed in 2020, and how respondents think they'll evolve over the next two years.
Current Issue
2021 Top Enterprise IT Trends
We've identified the key trends that are poised to impact the IT landscape in 2021. Find out why they're important and how they will affect you.
Flash Poll