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OVERVIEW OF TELEHEALTH TVHS 2012 Dr. David A Baker, MD, MBA Clinical 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 risk oNeed for more frequent biometric monitoring o Distance/travel problems o Medication compliance issues o Educational gaps Disease Management Protocols Diabetes Heart Failure COPD CAD Hypertension Depression PTSD Substance Use Disorder Weight Management Future 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 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 24 My HealtheVet Pharmacy • 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 25 *requires authenticated account VA Blue Button 26 My HealtheVet Secure Messaging* • 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. *requires authenticated account 27 2012 Telehealth Encounters Tennessee Valley Healthcare System • • • • Home Telehealth CVT Store & Forward MyHealtheVet 9000 3000 5500 7000 Nationally VA Telehealth • 2011 over 380,000 Veterans used its clinicbased Telehealth services. • another 100,000 patients nationwide were enrolled in VA’s Home Telehealth program QUESTIONS ?