Population Health Insights

VA Connected Care Chief: Telehealth Is 'Going to Become Health Care'

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For advocates of remote patient monitoring, virtual visit technology, and other technology-based care methods, telehealth isn’t just a current trend to be navigated, but something much more integral and long-term, reflecting the very future of healthcare delivery in the United States.

“This is going to become health care,” says Dr. Neil Evans of telehealth. A physician board certified in both Internal Medicine and Clinical Informatics, Dr. Evans also serves as Chief Officer for the Office of Connected Care (OCC) at the U.S. Department of Veterans Affairs (VA).

In an interview with FCW’s Adam Mazmanian, Dr. Evans predicts that telehealth itself will eventually cease to be considered as something apart from the traditional care setting, and instead accepted and embraced as an integral, essential component of the care continuum.

Telehealth “lets us overcome distances and geography, to connect, to allow the system to run more efficiently where we can match where we have a demand for services but we don't have the supply of providers to meet that,” Dr. Evans told Mazmanian. “We can now match that demand for services with a supply of providers located elsewhere.”

‘By 2020 … Telehealth Is Part of the Job’

Dr. Evans is speaking of the VA’s efforts to integrate new technologies into its operations, which have been rapidly accelerating since the 2017 announcement of a far-reaching series of telehealth expansions in 2017 designed to offset the agency’s highly publicized difficulties in staffing and skyrocketing patient wait times. 

With a budget slated for well over $1 billion for both 2018 and 2019, the VA’s current lineup of telehealth services is ambitious, including:

  • The development and launch of VA Video Connect, a video conferencing app in the spirit of FaceTime or Skype, that, since its launch, has already seen 48,000 “ad hoc” patient visits, involving 22,700 veterans and 4,500 unique VA doctors, nurses or other clinicians.
  • The goal of integrating patient data into the Video Connect app and leverage Bluetooth technology to transmit real-time signs and data to doctors and clinicians.
  • The VA Mission Act, which gives eligible VA providers the power to treat patients who live in other states, granting a certain level of immunity for state-imposed sanctions on care interactions crossing state lines (as they often do with virtual visits)
  • The establishment of 11 “tele-hubs” for mental health care and 9 for primary care throughout the United States
  • The implementation of “point-to-point" telehealth services, available at 900 sites of VA care and spans more than 50 specialties

“The VA also is looking to make technology and connectivity available to veterans where infrastructure is lacking,” notes Mazmanian. “For patients without home broadband, VA can make available tablets that operate over cellular connections — including customized models that can support plug-in peripherals that collect and send data from blood pressure monitors as well as Apple iPads that support Video Connect visits.”

The VA Office of Connected Care & ‘Anywhere to Anywhere’ Initiative

The telehealth strategy is also part of the agency’s “Anywhere to Anywhere” initiative, created with the goal of alleviating the fallout from all of those clinical vacancies — vacancies that most adversely affect patients living in rural or remote areas

To that end, Dr. Evans holds an important role heading up the OCC, a new adjunct to the agency that works to streamline its dramatic telehealth expansion. Dr. Evans and the OCC gathers together under one roof the disparate efforts the agency has made towards digitalized care over the past few decades. These include:

  • VA Telehealth Services (listed above)
  • My HealtheVet, a decade-old web-based Personal Health Record service for veterans
  • The VHA Innovation Program, a series of annual competitions soliciting ideas for innovating technologies to enhance the care process
  • VA Mobile, a series of apps offering veterans and providers “safe and secure access” to VA records from a mobile device.

Citing a 92% percent satisfaction rate among VA facility patients, Dr. Evans makes his predictions for the future of telehealth and of care delivery on firm ground. But he’s not the only leader speaking in such terms.

“By 2020 it will be a routine experience that — for all of our clinicians — telehealth is part of the job,” acting head of the Veterans Health Administration (VHA) Carolyn Clancy said last month, per Mazmanian. “This is not a unique, boutique activity.”

“Telehealth now is its own industry, but the end goal is that healthcare will include telehealth and the ‘tele’ part will go away,” agrees healthcare attorney Sean Sullivan in a conversation with Healthcare Informatics. “But more legislation needs to happen, as well as more regulation and guidance from CMS.”

How Reimbursement Limits Block Telehealth Expansion

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