Telehealth program can deliver care to veterans
Telehealth is bridging the gap between health care providers at VA Butler Healthcare Healthcare and patients who may not be able to travel to their doctor.
The Veterans Affairs' motto for Telehealth is “The right care in the right place at the right time.”
For several years the VA has been utilizing more of these health delivery programs under the overarching name of Telehealth, according to Laurie Conti, VA Butler Telehealth coordinator.
Providers are finding these technological tools and virtual visits invaluable in treating patients who may be suffering from Post Traumatic Stress Disorder (PTSD) or other disabilities that prevent them from gaining access to proper care.
The VA has three programs within the Telehealth services, including Home Telehealth, Clinical Video Telehealth, and Store-and-Forward Telehealth.
Home Telehealth monitors veterans who have conditions such as chronic obstructive pulmonary disease, hypertension, diabetes or weight issues.
The veteran is provided with a monitoring device, such as a computer tablet or a laptop. The device will have various peripheral devices that can be linked to a computer to monitor symptoms.
For example, a patient may be provided with a blood pressure cuff and a weight scale to monitor congestive heart failure symptoms. For diabetes symptoms, a glucometer would be provided to manage symptoms.
A registered nurse located elsewhere checks these readings and sets parameters so that a nurse can respond if necessary.
“Through this program, we've learned we can manage these conditions better, handle symptoms more quickly, reduce hospitalization and keep veterans in their homes longer,” Conti said.
A program called, Clinical Video Telehealth (CVT) is a method of real-time video conferencing by which a patient can obtain remote access to specialists who are working from the VA's main campus in Butler through a community-based outpatient clinic (CBOC). There are five CBOCs in the region, including Lawrence, Mercer, Clarion and Armstrong counties, and Cranberry Township.
Registered nurses work with the patient by using a stethoscope or blood pressure cuff, which is linked to a computer workstation located atop a wheeled cart brought into the examination room. The computer can then send data to the doctor in another location through his device.The examination room computer also has a total exam camera so the nurse can hone in on an area.“Different methods like that allow for the person in the room to help be the hands of the physician,” Conti said.CVT also is being used to treat mental health disorders. Telehealth technology has been an asset to veterans suffering from PTSD symptoms, VA officials said.Dr. Mary Jane Niebauer, lead psychologist and PTSD team leader for VA Butler Healthcare, was one of the first specialists to provide mental health care through Telehealth starting in 2008.Niebauer said the VA provides both individual psychotherapy and medication management to veterans who either can't afford to travel to a therapist or find it challenging to go out in public.“There are some veterans who have a hard time coming into the therapy office because they find it to be too intense of an emotional experience,” Niebauer said. “So sometimes the CVT allows enough distance that it makes them more comfortable in beginning to engage in the therapy process.”Veteran Bernard Williams, who was an air traffic controller with the Army's 101st Airborne Division during the Vietnam War, said his experience with Telehealth in managing his PTSD symptoms has been invaluable.Because of living in an isolated area of Venango County, Williams said Telehealth has allowed him teleconference with Niebauer for therapy.“When PTSD is at its very worst for me, I really can't and don't leave my property. That is the time when I really need to be in touch with Dr. Niebauer. But I simply can't walk into the VA hospital,” he said.“In the past, I would have to cancel those appointments and that didn't help. By doing this, when the worst of it comes, such as anniversaries of things that happened, now I don't feel like I have to put myself at risk to go in for some help,” Williams said.Besides the trauma of war, Vietnam vets were not warmly welcomed back to the country, which didn't help with feelings of depression.Williams said he recalled getting off a plane in Seattle with other vets coming home and being spat at by war protesters. When the vets were rushed away onto a bus, protesters threw garbage.“It wasn't the world we had left,” he said. “The program (Telehealth) works and I like getting the word out to other vets who simply don't know about it.”Conti said CVT Telehealth is also being used to connect veterans with specialists working at the VA's Pittsburgh hub to eliminate the need to drive into the city.“Instead of our veterans having to drive to Pittsburgh with the stress of that travel, the expense, the parking, and all that goes into that, they can visit their neighborhood CBOC to connect with a specialist,” she said. “Some of them have a lot of pain issues, it's not a comfortable trip for them.”VA Butler Healthcare is starting a preoperative program with the Pittsburgh VA in which Butler County patients can have pre-op testing or counseling done with their Pittsburgh specialist by video conferencing at the CBOC before surgery in the city.Through CVT, specialists can treat patients with tobacco cessation, weight management, substance abuse, mental health or even palliative care.Veterans also have access to an asynchronous program called Store-and-Forward Telehealth (SFT), in which data can be downloaded, digital images, video, audio and clinical data can be captured, stored, and then forwarded to a medical specialist at a separate location to study and interpret.For example, a patient with a dermatology issue can have digital photographs taken of the skin condition. That data can then be uploaded to a dermatologist elsewhere, who can then make recommendations for treatment based on what was seen in the photographs.SFT has also been used for diabetic retinal screening, pulmonary function testing and sleep studies.Within the last year, VA Butler Healthcare also started utilizing mobile applications for veterans to use at home. The VA rolled out about 20 new mobile apps designed to help veterans with everything from PTSD to concussion treatment to parenting.“Anytime we see a need, we want to save our veterans that travel,” Conti said. “It's the way we're moving care to make things better and closer to home.”
