April 20, 2020
Many of the freedoms we enjoy in America are due to the service of United States veterans, which currently number approximately 18 million. Those freedoms come at a cost, though, as countless veterans suffer from a wide range of physical and mental health issues. According to the U.S. Department of Veterans Affairs, in a given year roughly 11-20% of veterans who served in Operations Iraqi Freedom and Enduring Freedom experience post-traumatic stress disorder (PTSD), while approximately 12 out of every 100 Gulf War/Desert Storm veterans do. An estimated 30% of veterans of the Vietnam War have also had PTSD in their lifetime.
Unfortunately, not all receive the treatment they require. The National Council for Behavioral Health notes that less than half of returning veterans in need get any treatment for mental health issues. Tragically, this contributes to the staggering finding that approximately 20 veterans each day die by suicide.
One newer technology being utilized to improve treatment for veterans is telehealth. Also known as telemedicine, it employs technologies such as remote patient monitoring, video conferencing, and mHealth (mobile health) to provide healthcare services to a range of patients. For veterans, it is often used to treat mental health issues.
Veterans who live in rural areas are less likely to receive mental health treatment than those living in urban locales. However, telehealth, or, in this case, telepsychiatry, can lead to positive health outcomes for veterans. It has been shown to decrease psychiatric hospitalizations by 31%, increase access to and referrals for care, and reduce travel burdens. In addition, it is effective at providing relief when there is a shortage of specialists, decreasing care burden for general physicians who are not experts in mental healthcare and even reducing physician burnout.
Two newer programs at the Medical University of South Carolina (MUSC) and Warriors Research Institute have been implemented to serve veterans through telehealth. MUSC received a $900,000 grant from the National Institute of Mental Health's Small Business Innovation Research program to test its mHealth device- Zeriscope. The device is designed to attach to a veteran’s clothing disguised as a shirt button. It can then capture images the veteran is seeing while speaking in real-time with a therapist, as well as monitor heart rate and galvanic skin responses like sweat gland activity. This enables the veteran to communicate with care providers about the experience of undergoing PTSD, harnessing both self-reported symptoms and biological markers.
Warriors Research Institute, a Baylor Scott & White Research Institute center, was awarded a $500,000 grant from the Texas Veterans Commission Fund for Veterans' Assistance. This grant will assist in expanding evidence-based mental health treatment to Texas veterans and their families at no cost. The program features a telehealth clinic administered by clinicians. Veterans are able to communicate with providers through live video conferencing on computers or mobile devices. Each clinician involved in the program has had military and veteran cultural awareness training.
Some of the biggest advancements in implementing telehealth to benefit veterans have come through the Veterans Health Administration (VHA). This is the largest integrated healthcare system in the U.S and a component of the Department of Veterans Affairs (VA), which serves more than nine million veterans annually. The VHA proffers care at a total of 1,255 facilities comprised of 170 VA Medical Centers and 1,074 outpatient sites.
However, obstacles to care for some veterans include distance to a facility and long wait times. Approximately 40 percent of veterans reside outside a 50-mile radius of VHA medical centers, including a majority of Vietnam-era veterans. The VA maintains that “[rural veterans] are older (56% are over 65), poorer (52% earn less than $35,000 per year) and sicker (a greater number of co-morbidities) than their urban counterparts.”
The average time between emergency room arrival and admission is longer at almost three-quarters of hospitals within the VA system, than that of other hospitals. Nonetheless, there are positive strides in telehealth throughout the VA. The agency delivered more than 2.6 million episodes of telehealth care in 2019, a 17% increase from 2018’s 2.29 million episodes.
The Department of Defense created a Federal Electronic Health Record Modernization (FEHRM) office in 2019. Through this office, a new mobile application called VA Launchpad for Veterans was created. In addition to improving access to telehealth for veterans and their caregivers, the app offers easier sharing of electronic health record (EHR) data. It also allows the organization of several existing healthcare tools and resources into one location.
A comparable tool is My HealtheVet, which allows veterans to access medical records, refill prescriptions, ask their physicians questions and more, from their computer. The system reduces not only unnecessary appointments but also time on the phone and wait times for veterans to get VA appointments.
My HealtheVet is one of four major telehealth initiatives administered by the VA through its Office of Connected Care (OCC). These are the other three:
Two new studies indicate these telehealth initiatives have proven advantageous to numerous veterans. A study published in JAMIA Open surveyed 6,745 patients with a median age of 56 who received video telehealth tablets from 86 VA facilities in 18 geographic regions. Of the patients, a little over half lived in rural areas, and approximately 75% had a diagnosed mental illness. Of the telehealth coordinators who completed the survey, 88% agreed that the tablet initiative aligned with their facility’s strategic plan, and 86% agreed that patients responded well to the initiative.
Another study, published by Psychiatric Services, described a program where veterans with mental health barriers to healthcare access received a video-enabled tablet. The study noted that the initiative “appeared to improve access to a continuity of mental health services while also improving clinical efficiency by decreasing missed opportunities for care.”
Telehealth is one aspect of a larger shift in healthcare towards creating technology that improves the delivery and accuracy of medical care. At MLS Group of Companies, where we offer independent medical review services for health payers, optimizing the security and accessibility of our technology is a top priority. Whether improving the navigability of our review portal or ensuring our system-wide cybersecurity measures are robust and updated, our team is dedicated to delivering a secure product. Learn more about the services we provide and how we demonstrate our commitment to maintaining the highest standards for healthcare cybersecurity.
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