In what may prove to be a useful innovation, the U.S. Department of Veterans Affairs (VA) is preparing a major expansion of its telehealth (aka, telemedicine) offerings. What adds interest to this effort is that veterans will be able to access telehealth services in such settings as selected posts run by the Veterans of Foreign Wars (VFW) and American Legion, as well as in some Walmart stores.
Many in healthcare view telehealth as key to bringing healthcare services to outlying, rural, and remote areas that lack critical medical services. And, a new telehealth initiative proposed by the VA could further advance that effort by helping bring the advanced technology into the mainstream healthcare arena.
Dubbed the “Advancing Telehealth through Local Access Stations” (ATLAS) initiative, the goal is to provide veterans living in rural or remote areas with the best possible care. And, of course, many types of healthcare services require clinical laboratory testing. Thus, labs with access to VA patients in remote areas of the country should be looking for opportunities to collaborate with the VA.
Medical laboratory leaders will find it useful to follow the progress of this initiative, because when the VA completes a major project such as this proposed telehealth program, the results often serve as a proof-of-concept that can lead to wider acceptance among Medicare and private insurers of similar projects in the civilian community.
As part of the partnership:
- Philips will equip 10 VFW and American Legion posts with its telehealth technology;
- Walmart will dedicate store space and technical support to host VA-led telehealth appointments in select stores across the country; and,
- T-Mobile will provide 70,000 wireless service lines that will enable veterans to use the VA’s encrypted, secure Video Connect telehealth app without incurring charges regardless of their data plan.
VA Already Largest Telehealth Provider in America
With the 2017 launch of its “Anywhere to Anywhere, Together” program, the VA quickly became the nation’s largest telehealth provider. In fiscal year 2018, the VA held more than one million video telehealth encounters—a 19% increase over the prior year—the VA stated in a news release. Of the one-million plus video encounters, 105,300 were conducted using the VA Video Connect application on mobile devices or home computers.
At the time of the 2011-2015 United States Census, five million of the nation’s roughly 20 million veterans lived in rural areas.
“[The VA’s telehealth program] totally changes the VA’s footprint for delivering care,” Deborah Lafer Scher, Executive Advisor to the Secretary, Secretary’s Center for Strategic Partnerships, US Department of Veterans Affairs, told the Federal News Network. “We mapped out where our veterans are in greatest concentration against VA facilities, and then we put the Walmart map on top of that. Ninety percent of veterans live within 10 miles of a Walmart. Ninety percent of veterans don’t live within 10 miles of a VA medical center. This totally changes their ability to access care in a way that works for their lives.”
Another appealing aspect of the VA’s telehealth service is its simplicity. According to Becker’s Hospital Review, users can access the service automatically from their personal computers, mobile phones, or tablets by clicking a link sent to them prior to a telehealth encounter.
“Connectivity is that simple: the veteran need not install an app, change their behavior, worry about passwords or administrative rights,” Becker’s notes. “They just connect. Simply. Easily. Moving forward, these efforts will be extended further. Imagine a veteran that is hard of hearing joining a video encounter and getting the settings on [his or her] hearing aid device tweaked on the fly.”
Such advances led VA Secretary Wilkie to declare in his opening remarks at the Anywhere to Anywhere, Together summit, “We are on the cusp of the most transformative period in the history of the Department of Veterans Affairs. Virtual care is the future of medicine. It is our most powerful emerging tool,” the VA’s blog reported.
Regulation a Barrier to Telehealth Adoption
Yet, the road to wide spread use of Medicare/Medicaid telehealth may not be smooth. Law firm Epstein Becker Green in their 2018 Telemental Health Laws Survey found reimbursement and regulatory barriers continue to block widespread adoption of telehealth services.
“Despite Medicaid’s fewer restrictions on telehealth coverage as compared to its Medicare counterpart, there is limited federal guidance or information regarding the implementation of telehealth services in state Medicaid programs or coverage parameters for states choosing to offer such services,” the attorneys stated in a press release.
Becker’s Hospital Review cited other issues slowing telehealth adoption as well, including reliability and accuracy, access, and security. However, Becker’s also highlighted a 2018 Deloitte survey that showed 67% of physicians polled stated that making virtual care technologies more interoperable would lead to greater adoption rates of telehealth services.
As an ever-growing number of veterans receive their healthcare through telehealth services, clinical laboratories and anatomic pathology groups should look for opportunities to collaborate with the VA to provide diagnostic testing services to our great former service men and women.
—Andrea Downing Peck