Long troubled by inefficiency, waste and scandal, nobody has expected much from Veterans Administration healthcare of late. But clearly, they've done some great work as well, as the following demonstrates. Over the last decade, the VA has been quietly working on a telehealth platform that is starting to look like the ideal model for telemedicine moving into 2015.
Last October, the VA announced some statistics regarding the success of its investment in telehealth that astounded pretty much everyone. The first time I saw a link to their announcement, I thought it was a satire piece on The Onion. Really—the VA has been synonymous with inefficiency, corruption, waiting rooms filled to capacity and claims that take two years to process.
But, after years of being the butt of every joke about government ineptitude, the VA may have come up with something that works, and works well. Its telehealth program has become one of the most convincing success stories in the organization's history, and according to some experts could establish the VA as a leader in the discipline.
It's tough to argue with the figures the department shared in October:
"The Department of Veterans Affairs (VA) national telehealth programs served more than 690,000 veterans during fiscal year 2014. That total represents approximately 12% of the overall veteran population enrolled for VA healthcare, and accounted for more than 2 million telehealth visits. Of that number, approximately 55% were veterans living in rural areas with limited access to VA healthcare."
More recent data makes it clear that telehealth is having concrete results. As we recently reported, the results of VA telehealth programs include a 34% reduction in readmissions for home telehealth participants and a 42% reduction in bed days for telehealth participants in FY 2014.
Patients were happy with the results as well. The VA's clinical video telehealth program received a 94% satisfaction rating in a FY 2014 survey of roughly 10,000 veterans, and store-and-forward tele-dermatology received a 92% patient satisfaction rating. Meanwhile, tele-retinology racked up a 94% patient satisfaction rating, with an additional survey of 200,000 home telehealth participants boasting an 85% patient satisfaction rate.
Improving mental health
As impressive as those numbers are, they don't tell the whole story.This technology is also offering vets some relief from PTSD via tele-counseling and tele-psychiatry.
Last November, the Journal of the American Medical Association Psychiatry published the results of a study funded by the VA to see how effective telehealth could be in treating PTSD. The results were very promising. From JAMA:
"During the 12-month follow-up, 73 of 133 patients (54.9%) in the TOP [telehealth] intervention received cognitive processing therapy compared with 16 of 132 patients (12.1%) in usual care. Patients in the TOP intervention also had larger decreases in scores on a posttraumatic diagnostic scale, which measures PTSD severity, at six and 12 months compared with usual care patients... The authors found that attending eight or more sessions of cognitive processing therapy predicted improvement in posttraumatic diagnostic scale scores."
It would have been one thing to report that telehealth performed as well as usual care, but to demonstrate that it performed better than usual care by such a dramatic percentage—54 % to 12 %—is a discovery that reveals the amazing potential of telehealth under the VA model.
The bottom line here is that the VA is definitely on to something, and thanks to the new appropriations bill and planned telehealth expansion, the agency will get to further develop these services to meet the needs of a new generation of war veterans. The consumer marketplace would be wise to follow the VA's lead.