The second element of the VA Telehealth Services umbrella, Store-and-Forward Telehealth, ran its own pilot program between 2000 and 2004.
Store-and-Forward Telehealth involves the acquisition and storing of clinical information (e.g., data, image, sound, video) that is then forwarded to (or retrieved by) another site for clinical evaluation.
“The biggest program we have involves taking images of the retina of the eye,” Darkins noted. “That allows screening people with diabetes to see if they have diabetic eye disease – a sudden cause of blindness. But we can also take images for dermatology – for skin lesions, for wound care – and also acquire and store information on respiratory function tests or EKGs.
“The biggest program we have involves taking images of the retina of the eye,” Darkins noted. “That allows screening people with diabetes to see if they have diabetic eye disease – a sudden cause of blindness. But we can also take images for dermatology – for skin lesions, for wound care – and also acquire and store information on respiratory function tests or EKGs.
“The principle is that you take clinical information, whether it’s a digital image or data like an EKG, you upload it to a data system where it’s stored temporarily,” he said. “Then you send it to an expert who may be thousands of miles away and they review it at a ‘later date.’ By ‘later date’ that is usually within 12 to 72 hours, in some cases less than that. And they then send the report back to the referring center where the patient was.”
A VA employee conducts an eye exam using Store-and-Forward Telehealth. Store-and-Forward involves storing clinical information and then forwarding it to another site for clinical evaluation. It has proven to be particularly valuable during eye exams. U.S. Department of Veterans Affairs photo
Offering a tele-retinal imaging scenario, Darkins said, “Some 20 percent of the 6.3 million veterans that VA provides care for are diabetic. One of the complications of diabetes is sudden blindness, unless you screen for it, because diabetic eye disease can really creep up unnoticed. So we have placed the retinal cameras that take these images in over 300 sites now. And those sites send information in for the eyecare clinician – the ophthalmologist or optometrist – to review. They can then communicate back to primary care, telling them if VA needs to see a particular patient in the eye clinic to receive treatment and stop the progression of diabetic eye disease.”
From approximately 1,000 patients in the pilot program in 2004, the national retinal imagery effort has grown to encompass more than 260,000 veterans.
Clinical Video Telehealth, the third key element of VA Telehealth Services, links video teleconferencing equipment with end items like blood pressure cuffs or a variety of exam scopes to replicate what would be a face-to-face clinic visit.
The subsequent dermatology expansion program grew from a 2011 pilot effort to more than 27,000 patients in 2012.
Clinical Video Telehealth, the third key element of VA Telehealth Services, links video teleconferencing equipment with end items like blood pressure cuffs or a variety of exam scopes to replicate what would be a face-to-face clinic visit.
On July 30, 2013, the Veterans Health Administration held the Connected Health Showcase at the National Press Club in Washington, D.C. Members of the press were invited to experience VA’s Connected Health Technologies firsthand. These innovations virtually connect patients with services, allowing the delivery of veteran-centric healthcare, when and where veterans need it. Sen. Bernie Sanders and Under Secretary for Health Dr. Robert Petzel connect with veteran Robert Shuey, who lives in Roseberg, Ore. Shuey receives care using VA’s Virtual Prosthetics Clinic, connecting to the Portland VA Medical Center and avoiding a very long trip to see his specialist. U.S. Department of Veterans Affairs photo by Robert Turtil
Last year the technology supported the care of 148,385 people in 44 clinical specialties.
“Instead of having to travel hundreds of miles to a clinic, you would see them remotely,” Darkins noted. “As an example, we have the capabilities in a clinic in Caribou, in the north of Maine, which saves some veterans the eight-hour roundtrip journey to the VA hospital in Togus, Maine. And in the winter, there may be snow on that eight-hour trip. The same can be said for Colorado, Wyoming, Montana, Minnesota, the Dakotas, and elsewhere. There are large areas where we are keeping people from having to travel long distances.”
“Taking all three programs together, last year VA Telehealth supported just under half a million patients – 497,000 – who received 1.4 million episodes of care.”
“Taking all three programs together, last year VA Telehealth supported just under half a million patients – 497,000 – who received 1.4 million episodes of care,” Darkins summarized.
Looking toward the future, he added, “We are on the verge of doing some very exciting things. The various technologies are converging. There are all sorts of exciting things happening in consumer devices. For example, we have started doing work where video goes directly into the home, and have provided that platform to over 800 patients.”