Checking in on veteran care and telehealth in 2015

Towards the end of 2014, the Department of Veteran’s Affairs (VA) made an announcement regarding the current and future state of its telehealth program in 2014 and 2015. As the midpoint of 2015 has come and gone, a look back on the current state of telehealth within the VA and, in general, is telling. A recent study found that telemedicine was an effective means for providing talk therapy to veterans, yet earlier in the year, a report was issued that indicated that opportunities to use telehealth in treating veterans were being missed. To what extent is the VA continuing to follow its intentions set in 2014 and pursuing telehealth more vigorously and to what extent is the agency coming up short on this goal?

2014 announcement

In October of 2014, a press release issued by the VA summed up the VA’s accomplishments with regard to telehealth in 2014. Overall, the VA stated that in fiscal year (FY) 2014, the VA used its national telehealth programs to serve over 690,000 veterans. In other words, over 12 percent of the enrolled VA health care population used telehealth services and the total of telehealth visits was over two million. In the release, Robert A. McDonald, the Secretary of the VA, suggested: “A brick-and-mortar facility is not the only option for health care. We are exploring how we can efficiently and effectively deliver health care services to better serve our veterans and improve their lives. Telehealth is one of those areas we have identified for growth.”

Current VA telehealth status

The VA telehealth webpage currently showcases two types of telehealth offered or supported by the agency, synchronous and asynchronous. According to the VA, synchronous telehealth is “real time or Clinical Video Telehealth that requires the presence of the parties at the same time and a communication link between them that allows a real-time interaction to take place.” Asynchronous telehealth, or “Store and Forward Telehealth” as the VA also refers to it as, rests on the collection of medical data, which is then transmitted to a provider for review at a later date.

report released by the Office of Inspector General (OIG) in April of 2015 indicated that during FYs 2012 and 2013 the VA was continuing to miss opportunities to provide telehealth to those who may be able to benefit most from it. Yet, the FY 2016 Annual Budget Submission stated that expanded telehealth services were increasingly delivered to veterans in 2013 and 2014. Specifically, “between 2013 and 2014 there was a 34 percent increase in clinical video telehealth (CVT) encounters and a 62 percent increase in CVT to home encounters.”

Study

As the VA attempts to step up efforts in the field of telehealth, a recent study found that “telemedicine can just as effective as in-person visits for delivering talk therapy for older veterans with depression.” The study compared two groups of veterans all above the age of 58. Each of the groups received behavioral activation treatment, one group in person and the other through video conferencing technology. While the lead researcher concluded that, based on the findings, the therapy worked whether it was delivered in person or using telemedicine, an accompanying editorial raised concerns with regard to the absence of professionals on site to help during telemedicine sessions if emergencies arise.

Up next

In March of this year, the VA submitted its FY 2016 budget, which stated its intentions to increase telehealth services from 2014,when it served 717,000 veterans through telehealth encounters, to serving 1.1 million veterans in 2016. Watch for those increases as well as more oversight and audits of the 2015 VA telehealth program in the future.