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Veterans can have access to health care in the palm of their hand 

January 29, 2019

FORT MEADE — Veterans, it is as easy as clicking on a link in an email, and you could have access to your doctor, nurse, specialist, or a provider at the Black Hills Health Care System (BHHCS) at Fort Meade. Telehealth refers to the use of technology, such as a computer or cell phone, to provide health care services in situations where the provider and the patient are in different locations.

“The Veterans Administration starting using telehealth 10-15 years ago, but usage has really picked up in the past two years. It has become very popular and usage is up as technology continues to improve and gets easier to use,” said Jill Tobin, facility telehealth coordinator.

There are three types of telehealth: home telehealth, clinical video telehealth (to home and to a specialty clinic), and store and forward. Home telehealth is a registered nurse monitoring patients with chronic illnesses from their homes on a daily basis. The Clinical Video Telehealth (CVT) encompasses two types: CVT to clinic, and to home (VA Video Connect). Store and forward is the third type of telehealth, which means an image is taken, stored, and forwarded to a specialist to read, and the results are then sent back to the provider. Examples of this are tele-dermatology, tele-retinal, tele-wound, and another type of image using fibroscan, which is done in the hepatitis C clinic.

At the BHHCS, telehealth as a whole uses approximately 300-350 encounters or visits per week. It is estimated that this fiscal year alone, about 1.22 percent of the veteran population uses VA Video Connect telehealth technology, and it is expanding weekly.

“Mental health sessions are the biggest stakeholder and user of the telehealth technology and care,” said Tobin. “Instead of the veteran coming into the facility, the psychologist, or social worker, are seeing patients on their smart device.”

The 19,000 veterans that are part of the BHHCS services territory are from parts of North Dakota, Wyoming, Nebraska, Montana, and western South Dakota.

“Think of the young veteran that is working a full-time job; they can schedule and attend their appointment over their lunch break and go to a quiet place and have the privacy to do that appointment versus driving to Fort Meade,” said Theresa Forbes, director of public affairs. “It keeps the veteran invested in the system and cuts down on the disruption in their day.”

Telehealth has many benefits for the veteran including avoiding travel, increasing one-on-one contact with specialists throughout the United States, and in many cases getting an appointment much earlier, having no co-pay (for VA Video Connect or home telehealth), and decreasing time away from home and work. Benefits for the veterans hospital include cost savings for specialty care using internal resources, which might save up to $1,000 per specialty visit.

“We are bringing the service to the veteran at their location from Fort Meade,” said Charles Henderson, connected care coordinator. “The VA has created programs, resources and tools to take the service to them, especially those in need of mental health care.”

A veteran can sign up for the service fairly easily by asking their doctor, physician’s assistant, or social worker, if their situation or followup appointments would work using telehealth.

“This is a win-win as the veterans are more likely to make their appointments, and it is convenient,” Tobin added.

The VA mobile health technologies, apps that are available, will allow the veteran to view and communicate with the care team, and the veteran can even gain access to their health information and records on the go.

Home telehealth is where a nurse could monitor patients with chronic diseases or a new diagnosis with a device that will take blood pressure, oxygen level, and weight, and the data is sent in every day.

A veteran can get information to access telehealth by first visiting with their doctor or provider, and assistance is then made available to get connected. A test of the system was demonstrated, and once the app was downloaded, it took about 15 seconds to get connected and be speaking with Henderson.

Health care appointments, doctor visits, specialists visits, health care monitoring is available to veterans on their mobile device, laptop, desktop, or I-pad and is a tool in managing their health. If veterans need to see a specialist, dermatologist, cardiologist, endocrinologist, amputee, or gastroenterologist, and don’t want to travel or go to a community provider, the VA can provide these services using clinical video telehealth and connect them virtually.

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