VA telehealth services grow by 70 percent with significant utilization, cost savings


This last fiscal year was a watershed for the Veterans Administration Department's telehealth services, which provided nearly 1.4 million consultations to almost 500,000 patients, 30 percent of whom live in rural areas where they may otherwise have limited access to VA healthcare, according to a presentation (.pdf) from Adam Darkins, VA chief consultant for telehealth services.

Overall, the VA's telehealth services are growing by 70 percent annually with some significant reductions in utilization and cost savings, Darkins says.

Home-based telehealth services reduced bed days of care by 53 percent and hospital admissions by 30 percent, while clinical video telehealth reduced bed days of care by 28 percent for mental healthcare, according to the presentation. Cost savings from home telehealth amounted to $1,999 per annum per patient. And, home VA telehealth services enabled 41,483 patients to live independently in their own homes, instead of requiring long-term institutional care, including 7,095 patients with chronic mental health conditions.

In the case of telemental health, the VA says it in fiscal 2012 delivered more than 200,000 consultations to over 75,000 patients. The VA's telemental health services cover all mental health conditions with a focus on post-traumatic stress disorder, depression, compensation and pension exams, bipolar disorder, behavioral pain and evidence-based psychotherapy.

Training remains a challenge for the VA's telehealth services. Telehealth training is not offered in medical schools or included in health professional curricula. In addition, more than 60 requirements exist for establishing new telehealth programs that are beyond the competency of most individual VA staff, Darkins says.

As a result, the VA has standardized operations manuals that form the basis for curricula for telehealth services that are developed in conjunction with designated subject matter experts. This content is disseminated via multi-media and social media networks, as 98 percent of telehealth training in the VA takes place virtually.

The VA's vision is that "all VHA staff delivering telehealth services have standardized training and performance support to competently deliver these services." Last year, more than 4,000 staff received telehealth training in the VA through 1,800 unique training events and support was provided for system-wide competency testing for the department's three specific telehealth applications--Clinical Video Telehealth, Store and Forward Telehealth, and Home Telehealth.

For more:
-download Darkins's presentation (.pdf)

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