OVERVIEW OF TELEHEALTH

TVHS2012

Dr. David A Baker, MD, MBAClinical Informatics Officer

TVHS

WHAT is Telehealth

• Telecommunications and videoconferencing• HT – Home Telehealth• CVT – Clinical Video Telehealth• S&F – Store and Forward images• MHV - My HealtheVet Patient Portal• Video to Home – coming

WHY - Telehealth

• Telehealth in VA helps ensure veteran patients get the right care in the right place at the right time.

• Easier access to CARE– Travel time and cost, convenience– Decrease barriers to CARE– Increase efficiency of CARE

• Patient Demand

Home Telehealth

• Not Home Health • Telehealth Equipment/Nursing/case

management• Ability to monitor veterans with chronic

diseases (COPD, DM, HTN, PTSD, CHF, Depression)

• MOVE (Weight management)

WHO - Home Telehealth

o Patients at higher riskoNeed for more frequent biometric

monitoringo Distance/travel problemso Medication compliance issueso Educational gaps

Disease Management ProtocolsDiabetesHeart FailureCOPDCADHypertensionDepressionPTSDSubstance Use DisorderWeight ManagementFuture DMP's are under consideration or

development ( SCI, smoking cessation, chronic kidney disease

hepatitis C, multiple sclerosis, palliative care, mild TBI, dementia)

Health Buddy

CVT – Clinical Video Telehealth

• Local – Go to the local VA Clinic• Connect to a Provider miles away• Use videoconferencing equipment• Great for education

– Preventive Health/MOVE – weight management– Nutrition– Diabetic Education

• Excellent for many Mental Health• Groups and Individual clinics

CVT – Clinical Video Telehealth

• Medication Management• Pharm D

– Pain meds– Lipids/cholesterol– Diabetic meds

CVT – Clinical Video Telehealth

• Almost same as a face to face exam but NOT

• Not always a substitute for an in person visit

• More difficult for some specialty services needing a hands on physical exam

CVT - Telehealth

• Education • Mental Health• Medication Management• Heart Failure• Motorized Wheelchair Clinic• Neurology – movement disorders• Podiatry• Infectious Disease

Video-conferencing Equipment

• Monitor and Camera

Video-conferencing Equipment

• Electronic Stethoscope

Video-conferencing Equipment

• Electronic Stethoscope

Video-conferencing Equipment

• Electronic Stethoscope

Video-conferencing Equipment

• Electronic Otoscope

Video-conferencing Equipment

• Electronic Otoscope

Video-conferencing Equipment• Electronic Hand Held Camera• Oral• Skin lesions• Wounds• Neck Veins

Store & Forward - Telehealth

• Diabetic Retinal Screening• Dermatology• Wound Care• Podiatry

Telehealth - Store & Forward

• Tele - Retinal Equipment

Video to Home - Telehealth

Video to Home - Telehealth

• Real time care in the home• Pilot underway• Barriers to overcome• Patient equipment and internet access• Knowledge• Technical support

My HealtheVet - Telehealth

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My HealtheVet Research Health

• Healthy Living Centers• Disease and Condition

Centers• Mental Health Resources• Medical Libraries• Service Related Conditions• MedlinePlus®• My HealtheVet Learning

Center• Monthly feature articles

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• VA Prescription Refills• VA Prescription Refill History• Self-entered medications,

herbals, over-the-counters (OTCs), and supplements

• VA Medications List*• My Complete Medications

List (VA and self-entered)*

Over 27.5 million VA prescription refill requests since launched in August 2005

*requires authenticated account

My HealtheVet Pharmacy

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VA Blue Button

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My HealtheVet Secure Messaging*

*requires authenticated account

• eHealth Clinical Service for non-urgent communication with patient’s health care team

• Veterans can request appointments, prescription renewals, ask health and/or administrative questions, etc.

2012 Telehealth EncountersTennessee Valley Healthcare

System

• Home Telehealth 9000 • CVT 3000• Store & Forward 5500• MyHealtheVet 7000

Nationally VA Telehealth

• 2011 over 380,000 Veterans used its clinic-based Telehealth services.

• another 100,000 patients nationwide were enrolled in VA’s Home Telehealth program

QUESTIONS ?