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VA Launches Telehealth Program to Treat Rural Veterans With PTSD

The Department of Veterans Affairs says the Telemedicine Outreach for PTSD (TOP) pilot program will connect veterans in rural areas with psychologists and psychiatrists for online treatment.

Source: ThinkStock

By Eric Wicklund

- The U.S. Department of Veterans Affairs is launching a nationwide telehealth program to help rural veterans dealing with post-traumatic stress disorder (PTSD).

The pilot program, coordinated by the VA’s Office of Rural Health and its Quality Enhancement Research Initiative, will connect 12 community-based outpatient clinics (CBOCs) across the nation with veterans in need of treatment for PTSD. Care managers will first contact veterans by phone, then set up therapy sessions with available psychologists and psychiatrists through an interactive video platform.

“Long travel distances to urban areas can be a major barrier to care for rural Veterans,” Dr. John Fortney, a research health scientist with the VA Puget Sound Health System and the pilot program’s coordinator, said in a press release. “In a prior trial, we were able to use telehealth technologies successfully to engage Veterans in evidence-based, trauma-focused therapy without their having to travel to a distant VA medical center.”

The Telemedicine Outreach for PTSC (TOP) program, which has already enrolled 500 veterans living in rural locations, is the latest effort by VA Secretary David Shulkin to expand and improve treatment for veterans through telemedicine and telehealth.

“Our researchers have worked diligently in recent years to establish the safety and efficacy of PTSD psychotherapy delivered remotely, ensuring Veterans will get the same quality of PTSD care as if they were in a doctor’s office at a VA medical center,” Shulkin said in the press release. “We are excited to see this program help greater numbers of Veterans living in rural areas and pleased that it will save them time and effort to get to a VA facility that is far from their homes.”

Shulkin, who’s faced criticism and calls for his ouster in recent months, scored an important victory earlier this year with Congressional passage of the Veterans E-Health & Telemedicine Support (VETS) Act, which gives VA-affiliated healthcare providers the ability to treat veterans via telemedicine or telehealth wherever they live, bypassing state licensing laws.

The VA Secretary included that proposal in his ‘Anywhere to Anywhere Health Care Initiative,’ which he unveiled last year to meet increased demands for healthcare access for the nation’s more than 22 million veterans.

According to the VA, some 702,000 veterans, or 12 percent of the country’s veteran population, used telehealth or telemedicine in FY 2016, accounting for 2.17 million telehealth episodes. Of that group, 45 percent were living in rural communities.

Those encounters led to a 31 percent decrease in hospitalizations for veterans over the previous year, as well as a 39 percent reduction in acute psychiatric VA bed days, Shulkin pointed out in his order.

“What we’re really doing is, we’re removing regulations that have prevented us from doing this,” he said when unveiling the program last year. “We’re removing geography as a barrier so that we can speed up access to Veterans and really honor our commitment to them.”

Shulkin has taken a particular interest in expanding telemental health services for veterans. At the American Telemedicine Association’s 2016 conference and exposition in Minneapolis, he announced the expansion of the VA’s Mental Health Telehealth Resource Centers program, along with other measures designed to improve access to mental health services.

“We are in the midst of the largest transformation in the history of VA with MyVA, which means we are reorienting what we do around the needs of our veterans and providing care when, how and where they want to receive that care,” Shulkin, then the VA’s Undersecretary for Health, said.

PTSD rates are estimated to be as high as 40 percent among veterans, and as much as 81.5 percent of post-9/11 veterans suffer from acute or chronic pain. Among the mHealth services available to veterans are a self-guided mHealth training program introduced in 2016 and, more recently, the online PTSD Treatment Decision Aid.

The TOP program will make use of CBOCs located in Charleston, S.C., Iowa City, Iowa, Little Rock, Denver, San Diego and Seattle. Participants in the program will be able to choose between two trauma-based psychotherapy programs, cognitive processing therapy and prolonged exposure therapy.

VA officials expect to have results from the TOP program in two years, at which time they’ll make plans to expand the program further.


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