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FCW : February 2014
are combining to take telemedicine into the mainstream. VA spurred by aging veteran population When the history of telemedicine is written, signi cant credit will go to the Department of Veterans Affairs for leading the way in deploying telemedi- cine on a large scale. In scal 2013, more than 600,000 veterans accessed VA care using telemedicine programs --- for a total of more than 1.7 million episodes of care. And the reach of VA s telehealth serv- ices is growing by about 22 percent a year. The agency is currently in the midst of a pilot program that allows veterans to enter vital information into an online tool that is accessible via mobile phones, tablets or desktop PCs to help their caregivers manage chronic conditions. VA is launching another service that allows larger, better-resourced hospitals to con- nect with smaller facilities to provide remote support for intensive care. VA did not get into telemedicine out of an inherent interest in tech- nology, said Dr. Adam Darkins, who leads national telehealth programs at the agency. Rather, VA of cials wanted to help aging veter- ans with chronic disease live independently, for clinical and nancial reasons. Although VA has a network of 152 hospitals and more than 1,100 other caregiving facilities, it still faced the problem of having to cover a lot of territory in terms of reaching veterans. Additionally, of cials found that 45 percent of those requiring treatment resided in counties clas- sified as rural by the U.S. Census Bureau. So beginning in 2003, VA began a deliberate policy of building a nation- al telemedicine program to expand its reach, reduce travel costs and increase the levels of care available to veterans. VA runs three basic types of tele- medicine programs: Clinical video is designed to replicate face-to-face interactions between caregivers and patients using videoconferencing; home monitoring allows doctors to keep tabs on patients with chronic conditions such as diabetes; and the teleradiology service on VA s My HealtheVet website allows clinicians to share imaging information on indi- vidual cases for help in diagnostics and care. Increasingly, veterans of the wars in Iraq and Afghanistan are accessing telemedicine for mental health serv- ices, including treatment of post- traumatic stress disorder. Last year, VA tested a program that allows veter- ans to access those services from their homes via a secure video connection. It reached 2,284 veterans in the pilot phase, and Darkins anticipates reach- ing 7,000 this year as the program is expanded. The program poses some chal- lenges from a network management perspective, said Peter Whitson, dep- uty executive director for enterprise systems engineering at VA s Of ce of Information and Technology. "Because it s video, it can be bandwidth-inten- Assistant Secretary of Veterans Affairs Tommy Sowers (far left) speaks with a patient doing physical therapy from his home with the help of a videoconferencing connection at a VA medical center. Sowers, joined by Director Deborah Amdur, visited the center to learn more about its telemedicine programs. AP IMAGES / WILSON RING
March 15, 2014