OVERVIEW OF TELEHEALTH TVHS 2012 Dr 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 Some Veterans live many miles from a VA medical center, making visits to the doctor an all-day event Others with chronic conditions require constant monitoring, but opt to stay at home rather than in the hospital.

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 Patients at higher risk Need for more frequent biometric monitoring Distance/travel problems Medication compliance issues 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

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 *requires authenticated account

VA Blue Button

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

2012 Telehealth Encounters Tennessee Valley Healthcare System Home Telehealth 9000 CVT 3000 Store & Forward 5500 MyHealtheVet 7000

Nationally VA Telehealth 2011 over 380,000 Veterans used its clinic-based Telehealth services. another 100,000 patients nationwide were enrolled in VA’s Home Telehealth program

QUESTIONS ?