Veterans Affairs Bolsters Telehealth Offerings

The department expands on its “Anywhere to Anywhere” health initiative.

Imagine snapping a picture of your wound and have it automatically sent to your doctor for medical assessment, all from the comfort of your home. The Veterans Affairs Department is working to make this possible, with just one of multiple telehealth projects.

The San Diego VA Medical Center is piloting a program using computer tablet technology, which allows providers to check on the status and progress of their patients’ healing wounds without having to make appointments or office visits. The tablets have built-in digital cameras, 3-D sensors and computer vision software to capture high-resolution images and automatically measure the size of the wound, according to a VA blog post.

When a patient takes a photo of the wound, the information on the tablet transfers securely onto a cloud-based electronic repository, where providers can view it remotely. Wound measurement data from the 3-D modeling software is graphed on a chart that shows the progression of healing so doctors can see if the wound improving. Based on the results, doctors can make changes to the treatment plan.

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This also improves data accuracy, according to Dr. Kevin Broder, project director for VA’s Wound Image Capture and Storage Innovation. He said in the past, doctors visually estimated if a wound improved based on their memory of the past image.

“This tablet provides recorded, accurate data to track progress,” Broder said in the blog post.

So rather than nurses taking pictures on digital cameras, organizing the information and uploading images, the tablet handles it all. The images and data are stored, but ultimately, the goal is to have these images go directly into a patient's electronic medical record file.

The technology can also benefit other medical specialties.

For example, it can be used to capture the dimensions of a skin lesion and determine if it’s changing in size and needs to be biopsied, leading to earlier cancer detection. It can also be useful for home-based primary and nursing care or in dermatology, prosthetics, orthopedics or podiatry.

And because of the tablet’s efficiency and affordability (less than $900 per unit), VA hopes to deploy this technology across the entire department. The VA San Diego Healthcare System already expanded the pilot program in clinical settings in September, and interest has spread to other VA health care systems.

VA also partners with medical technology company Medtronic as part of its Home Telehealth Devices and Services contract, and the company just launched new VA-based solutions. It expanded its platform of telehealth offerings and integrated diagnostic devices for veterans, including its patient engagement platforms available on the Home Telehealth contract, according to the press release.

The Medtronic Care Management Services has been with VA since 2011, and the solutions are designed to serve chronic, co-morbid patients. The new offerings provide more patient choice and flexibility to better meet individual health needs, and patients can interact with these services from home via a daily health check. It even provides condition education and clinical questions that adapt based on responses.

The information submitted by patients is then organized through the MCMS web-based clinical software so clinicians get a view of their “patient population.” This helps VA care coordinators make better-informed early-care decisions.

These various programs are part of ongoing efforts by VA Secretary Dr. David Shulkin to connect more vets to services. Earlier this year, he and President Donald Trump announced plans to expand access to health care for veterans using telehealth technology and mobile applications.

Shulkin introduced the “Anywhere to Anywhere VA Health Care” initiative, which authorizes VA providers to use telehealth technologies to serve veterans no matter where the provider or the vet is located in the country. He also introduced VA Video Connect, a secure web-enabled video service for veterans to connect with providers by video on their mobile phones or computers, and the Veteran Appointment Request app for changing and scheduling appointments.  

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