Mobile healthcare, telemedicine, telehealth, BYOD

Policy News

Audit of VA Telehealth Shows Shortfalls

By Ryan Mcaskill

The Department of Veteran Affairs (VA) is one of the major organizations that is embracing telehealth solutions. Over the last few months, there has been several news releases from the VA that show the expanded use of the technology to help treat patients and lower costs.

- In March, the VA submitted its budget for fiscal year 2016. It features an increase in funding for telehealth support from $986 million in 2014 to $1.472 billion by 2017. This is needed as the number of veterans using telehealth services is expected to increase from 717,000 in 2014 to 1.1 million in 2016.

This is all part of making telemedicine a key component to its strategic goals moving forward through the formation of the Connected Health Initiative. This will feature $50.1 million in financial support that will be used for a number of different projects including the creation of My HealtheVet, an online portal where veterans can access and download their medical records at any point.

All of this expansion is needed because of the growing demand from patients. However, it also seems that the program could be missing a number of patients that really need it. In March, the Office of the Inspector General released an audit of the VA’s 12-year-old Home Telehealth Program. The report examined the program in 2012 and 2013 and found that the number of non-institutional care (NIC) veterans enrolled in the telehealth program increased by 13 percent in 2012 but dropped 4 percent in 2013. However, in 2013 the number of veterans enrolled in chronic care management guidelines increased 51 percent and patients admitted under health promotion/disease prevention (HPDP) guidelines increased 37 percent.

In all, the report determined that the VA missed opportunities to serve additional NIC patients that could have benefits by the telehealth program. As many as 59,000 veterans could have had their need for long-term institutional care delayed. The reason these patients were missed was not money, but rather a change in performance methodology.

In 2011, the agency switched from measuring specific performance goals for the three categories to looking at the total number of patients enrolled. This encouraged the VA to enroll more HPDP participants that would need less intervention from Primary Care physicians because their health care needs would be less complex. While the VA was able to meet its new metrics, it did not result in the patients that needed the most care always receiving it.

The OIG recommended that the program be tweaked to include a mechanism to identify demand for NIC patients and develop specific performance measures to promote enrollment of NIC patients. The VA agreed with the recommendation and is working to correct the problem.

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