Telehealth Monitor

President Obama’s ambitious plan to establish a lifetime electronic record for service members and veterans will improve delivery of benefits, speed processing of claims and, over time, open VA health care to any veteran, regardless of their medical condition or income level.

VA Secretary Eric Shinseki first raised the idea of a more sophisticated electronic record system, and linked it to automatic enrollment by all veterans in the VA health system, during a House hearing in February.

This week, through a press spokeswoman, Shinseki confirmed that universal access to VA health care is integral to the administration’s plan to develop as quickly as possible a 21st Century electronic record system.

“Secretary Shinseki and the whole [VA] team believe that ‘uniform registration’ ” in the VA health system “is an essential part of the lifetime virtual record,” said Katie Roberts, his press secretary, in an e-mail.

Shinseki and Defense Secretary Robert Gates were with the president April 9 in the Old Executive Office Building when Obama announced to an audience of veterans a “huge step toward modernizing the way VA health care is delivered and [VA] benefits are administered.”

Obama described a comprehensive electronic record system, to be developed and used jointly by the Department of Defense and VA, which would hold all service-related documents, administrative and medical, on individuals from the time they enter service until “they are laid to rest.”

via Military Update: Health record plan may open VA to all veterans | Stars and Stripes.

President Obama said yesterday that his administration will create an electronic record for veterans that will “contain their administrative and medical information from the day they first enlist to the day that they are laid to rest.”

Research has shown that the handoff of medical information — between individuals and hospital systems — can be dangerous. Incomplete, incomprehensible or misunderstood data can contribute to medical error or substandard care.

While the Defense Department’s hospitals and the Veterans Affairs medical system have electronic records, they are not seamlessly connected — a problem Obama said he is determined to solve.

“Currently, there is no comprehensive system in place that allows for a streamlined transition of health records between DOD and the VA,” the president said during a briefing at the Eisenhower Executive Office Building that was attended by the secretaries of those two departments as well as patients and practitioners from Washington area hospitals and military and VA facilities.

via Obama Seeks to Create Seamless Transition of Electronic Medical Records Between DOD and VA – washingtonpost.com.

INDIANAPOLIS – A large study of ethnically and racially diverse individuals with diabetes has found that home telemonitoring of their health resulted in significantly fewer deaths than in a similar group that was not monitored. Diabetes is the sixth leading cause of death in the United States.

The study of 387 diabetics and 387 individuals without diabetes appears in the March 2009 issue of the Journal of Telemedicine and Telecare.

The researchers, led by Neale Chumbler, Ph.D., professor of sociology at Indiana University-Purdue University Indianapolis’s School of Liberal Arts and a Regenstrief Institute research scientist, used home telemonitoring technology to support timely transmission of diabetics’ symptoms and health status at least once a day to a nurse coordinator who managed the process and acted upon the information when necessary or when requested by the patient.

“People want the freedom to remain in their homes. Telehealth appears to provide a safety net that will allow some of them – such as the growing number of individuals with diabetes – to age in place and to live where they want to live,” said Dr. Chumbler, a medical sociologist who studies access to care and is associate chief of the Center of Excellence on Implementing Evidence-based Practice at the Roudebush VA Medical Center in Indianapolis.

Unless diabetes symptoms are closely monitored, the risk of death from the disease increases significantly. Approximately 25 percent of VA patients have diabetes.

The telemonitoring study, which followed VA patients with diabetes for four years, also provided educational resources to trial participants. “This study demonstrates the effectiveness of chronic care management for diabetes and the feasibility of using telehealth to carry it out,” said Dr. Chumbler.

The magnitude and significance of home telehealth effects on mortality for those with diabetes had not previously been demonstrated. This new study contributes to the growing list of scientific evidence regarding the effectiveness of care monitoring for a variety of chronic conditions. “Telemonitoring may be one of the most effective and cost effective ways of helping individuals avoid constant visits to their doctor’s office or hospitalization.”

via Telehealth for diabetes promotes aging at home, not in the hospital.

Inside the Veterans Affairs TeleHealth Clinic in Craig, veterans can sit down and talk with their physician about any medical problems they have. The physician can check the patient’s heartbeat, listen to lungs and check for warning signs of skin cancer —from Grand Junction or Denver.

The TeleHealth Clinic, which recently was selected as a “Site of Excellence,” uses specialized equipment to have video conferencing in Craig with a physician several hours away.

To highlight the advantages of using the TeleHealth technology, Tom Feliu, of Rocket Media Group in Fairfax, Va., and his film crew taped a documentary about the clinic in Craig. They began filming Wednesday at the clinic.

Feliu said the reason behind the film is to get veterans who wouldn’t otherwise consider using this technology to take advantage of it.

“We want to focus on the people who have used it and know that it works,” he said.

Rocket Media Group has worked for the VA before, filming documentaries about technology. The documentary about the TeleHealth Clinic will be shown to veterans living in rural communities throughout the country and as a promotional tool.

Craig was the third location for the film, after Buffalo, N.Y., and Puerto Rico.

via Craig Daily Press / Documentary features Craig TeleHealth Clinic.

Veterans with chronic conditions such as diabetes, high blood pressure, chronic obstructive pulmonary disease and heart failure can be monitored at home using special telehealth technologies provided to them by the Michael E. DeBakey VA Medical Center in Houston.

The Health Buddy is a simple piece of equipment similar to an answering machine that can be placed anywhere in a veteran’s home where there is a power outlet and a working telephone jack. It is friendly, convenient and easy to use.

Specific questions about the veteran and his or her illness are programmed into the Health Buddy. The veteran simply answers the questions each day. Information obtained such as blood pressure and blood glucose, along with other patient information, allows a care coordinator to anticipate and prevent avoidable problems. Coordinators monitor the information daily and contact the patient for any medication adjustments or schedule any appointments necessary to keep the veteran as healthy as possible.

The Health Buddy does not replace routine medical appointments; it simply enhances primary care. The new technology has become increasingly popular with veterans because it provides greater access to medical care. Veterans take a more active role in their wellbeing and have peace of mind knowing their health care providers have up-to-date information. They know someone is looking out for their welfare.

via ‘Health Buddy’ helps vets live a healthier lifestyle > Conroe Courier > News Archives > Houston Community Newspapers Online – News Around Town.

For veterans who have a health problem like diabetes, chronic heart failure, chronic obstructive pulmonary disease (COPD), depression or post-traumatic stress disorder, getting treatment can be complex and inconvenient.

For some, especially older veterans, conditions like these can make it difficult for them to remain living independently in their own home and make it necessary for them to go into a nursing home where their symptoms and vital signs (pulse, weight, temperature etc) can be checked frequently. Having this information means physicians and nurses can change medications or other treatments and prevent serious health problems from developing.

Now there are new technologies that make it possible to check on symptoms and measure vital signs in the home. Special devices (home telehealth) can do this and are easy to use. Home telehealth can connect a veteran to a VA hospital from home using regular telephone lines.

VA has found that not every patient is suitable for this kind of care. But, for those that are CCHT can help them to remain at home and live independently.

via Care Coordination Services – Home Telehealth.

FOR IMMEDIATE RELEASE
January 5, 2009

VA Data Show Home Health Technology Improves Access to Care
Peake: Entire Health Care System More Effective

WASHINGTON – Veterans with chronic conditions can manage their health and avoid hospitalization by using special technology provided by the Department of Veterans Affairs (VA) in their homes, according to a recent study.

“The study showed that home telehealth makes health care more effective because it improves patients’ access to care and is easy to use,” said Secretary of Veterans Affairs Dr. James B. Peake. “A real plus is that this approach to care can be sustained because it’s so cost-effective and more veteran-centric. Patients in rural areas are increasingly finding that telehealth improves their access to health care and promotes their ongoing relationship with our health care system.”

The study found a 25 percent reduction in the average number of days hospitalized and a 19 percent reduction in hospitalizations for patients using home telehealth. The data also show that for some patients the cost of telehealth services in their homes averaged $1,600 a year – much lower than in-home clinician care costs.

The authors of the study in the current issue of the journal Telemedicine and e-Health are VA national telehealth staff members. The study looked at health outcomes from 17,025 VA home telehealth patients.

VA’s home telehealth program cares for 35,000 patients and is the largest of its kind in the world. Clinicians and managers in health care systems, as well as information technology professionals, have been awaiting the results of the telehealth study, said Dr. Adam Darkins, chief consultant in VA’s care coordination program, who led the study.

“The results are not really about the technology, but about how using it helps coordinate the full scope of care our patients need,” said Darkins. “It permits us to give the right care in the right place at the right time.”

VA’s Under Secretary for Health, Dr. Michael J. Kussman, said the key to the program’s success is VA’s computerized patient record system. “Data obtained from the home such as blood pressure and blood glucose, along with other patient information in the electronic system, allows our health care teams to anticipate and prevent avoidable problems,” he said.

VA health care officials emphasize that home telehealth does not necessarily replace nursing home care or traditional care but can help veterans understand and manage chronic conditions such as diabetes, hypertension and chronic heart failure. Patients’ partnership with the medical team can delay the need for institutional care and maintain independence for an extended time.

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