The Veterans Affairs Department is exploring a number of applications of wireless technologies to improve the health outcomes of veterans, especially those in rural areas that may be hundreds of miles from the closest VA clinic or hospital.
Wireless technologies can link veterans with their providers through personal cell phones and enable them to manage their health, said Gail Graham, deputy chief officer in health information management in the Veterans Health Administration.
For many veterans, "geographical distance from VA's physical healthcare assets often presents a challenge to receiving care," she said at a hearing of the House Veterans Affairs Committee health subcommittee June 24.
Among its projects, VA is building a prototype of a mobile version of MyHealtheVet, VA's online personal health record, to deploy on mobile phones and test for usability and functionality. Through MyHealtheVet, veterans can receive patient education, wellness reminders and refill prescriptions.
VA sought the suggestions of veterans in five rural communities about the features they desired in a mobile version of MyHealtheVet, Graham said.
It's already installed very small aperture terminals (VSATs) on its 50 mobile vet centers to provide satellite communications. The agency uses the centers to provide readjustment counseling services.
VA's wireless efforts are also part of changes it is making in the way it delivers care, by designing its systems around the needs of patients and to improve care coordination and online access through secure messaging, social networking tools and telehealth, Graham said.
VA will use these capabilities, among other things, to support a home-care model to help veterans manage their chronic diseases, and for a preventative care program for telephone-based health counseling to reduce risky behaviors, such as smoking and physical inactivity.
VA has demonstrated that it can realize cost savings and improve care with its deployment of promising technologies, said Dr. Joseph Smith, chief medical and science office at West Wireless Health Institute.
For example, through the use of its care coordination and home telehealth program VA reported a 25 percent reduction in bed days of care, and a 19 percent reduction in hospital admissions by linking chronically ill veterans with healthcare providers and care managers through videoconferencing, messaging and biometric devices and other tele-monitoring equipment, he said.
Through the program, which involved 43,000 veterans, one nurse could "touch" 150 patients remotely on a daily basis.
VA's program "offers substantive proof that wireless health technology can dramatically increase the efficiency of already overstretched health professionals to help patients no matter where they are or when they need care," Smith said.
The U.S. Army also is also using mobile phone technology for patients with mild traumatic brain injury, said Col. Ronald Poropatich, deputy director of the telemedicine and advanced technology research center, U.S. Army Medical Research and Materiel Command.
These patients, who are receiving outpatient care in their home communities, receive health tips, appointment reminders and general announcements from a secure central Web site where healthcare providers can enter and control message content and review delivery confirmations, he said.
The mobile messages provide additional communications between face-to-face office visits. Currently, the service is available to soldiers in five selected sites in Alabama, Florida, Illinois, Massachusetts and Virginia.
Similarly, VA will also test the use of videoconferencing with a mobile device for a small number of recently diagnosed patients with post traumatic stress disorder (PTSD) in San Diego, according to Smith, whose health institute is working with VA on the project.
