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FCW : February 2014
Health IT 0 December 2013 FCW.COM 22 February 2014 FCW.COM sive," he said. "It also requires that we have in place suf cient management and monitoring tools and employing things like quality of service to make sure that other traf c doesn t dimin- ish the quality of those video sessions. And that s a pretty big challenge on the scale that we have at VA." Although such pilot projects are not predominantly about technology, Dar- kins stressed the importance of get- ting the clinical and IT people working together for a variety of reasons. "It s not just a question of saying: Have we got the telecommunications and have we got the clinical model?" he said. "We then have to think about how we have to train the clinicians to be able to do it. We have to think about how we have to put help-desk support for both patients and clini- cians in place. The volume of care we re providing is such that we re providing care that s mission critical, and we roll it out with that in mind." The interoperability hurdle The growing telemedicine industry is still working toward standardization and interoperability. VA, for instance, has the ability to videoconference at facilities linked across its wide-area network, but outside organizations sometimes have different standards and security requirements, which can make it dif cult to operate on the same platform. Darkins said remote monitoring devices have some standards for data elements related to vital signs, but there s still more work to be done. "My belief is...the device in the home needs to be standardized," he added. Increased standardization and interoperability would pave the way toward the integration of telemedicine with electronic health records (EHRs), said Stewart Ferguson, CIO of the Alaska Native Tribal Health Consor- tium, a nonpro t organization based in Anchorage that provides health serv- ices to about 130,000 Alaska Natives and American Indians. He is a pioneer in developing telemedicine programs and related IT services. Alaska is a special case when it comes to telemedicine. The aver- age village has about 300 people and very few doctors or nurses. For such remote populations, it s often tele- health or no health care at all. Com- munity health aides provide telemedi- cine services for communicating with general practitioners, and acute cases are sent to regional facilities or the state s medical center in Anchorage. VA HAS THE ABILITY TO VIDEOCONFERENCE AT FACILITIES LINKED ACROSS ITS WIDE-AREA NETWORK. RENO.VA.GOV
March 15, 2014