Telehealth, a service encompassing the range of virtual and technological resources patients can access in place of in-person appointments, is gaining popularity in a world that has gone remote. Medical practitioners and healthcare providers alike have turned to telehealth initiatives, to meet patient needs in a sustainable way. The COVID-19 pandemic is making telehealth a more appealing option for individuals who are at-risk or have limited access to healthcare resources. However, these resources have been available to veterans long before it became a demand resulting from the virus outbreak. Telehealth may have been established by the VA, but it is being transformed for COVID-19.
In the 2016 fiscal year (FY16), the U.S. Department of Veterans Affairs (VA) reported over 700,000 patients received care through telehealth. When these numbers came out, the VA was expecting a 4% growth within the coming year. Recently, FY18 indicated over “2.29 million episodes of care to more than 782,000 patients via the three telehealth modalities.” As veterans began using telehealth before COVID-19, these statistics show that veterans sought telehealth services for reasons beyond social distancing and federal legislation. There was, and still exists, pressing interest in the opportune advantage of remote healthcare.
The VA is one of the nation’s “largest integrated health care system[s]…providing care at 1,255 health care facilities, including 170 VA Medical Centers and 1,074 outpatient sites of care of varying complexity (VHA outpatient clinics) to over 9 million Veterans enrolled in the VA health care program.” Accordingly, telehealth has emerged as a central feature of the VA health care program, one that veterans depend on.
For these veterans, time and accommodation play largely into the decision to enroll in telehealth. The VA found that for FY18, nearly half (45%) of veterans were in rural areas, a circumstantial obstacle to receiving healthcare that was not local, but hours or states away. Telehealth lets patients live in isolated areas, independent of the nearest or best hospital according to their health needs. Not only does telehealth ensure accessibility, but the VA strives to implement “national telehealth quality and training resources…in over 50 specialty areas of care.”
Adding to this, the United States Census Bureau recorded that in 2017, over 50% of veterans were over the age of 65, another demographic with increased health complications. Senior citizens residing in assisted living facilities or relying on geriatric care may also look to telehealth. Reduced expenses including time travel and transfer cost, as well as chronic care, where a 2008 study observed how telehealth shortened “the number of bed days of care by 25% and the number of hospital admissions by 19%,” meaning that telehealth is being optimized for both patients and practitioners. Further, this impact was not limited to routine checkups or chronic care but also aided surgical and ICU costs. There was “a 10% reduction in length of ICU stay, and a 20% reduction in floor stay,” from a 2007 study, pointing to telehealth’s efficiency.
Critical care patients and senior citizens are not the only types of veterans receiving telehealth. It is equally benefitting for veterans with mild to severe respiratory issues or who are dealing with chronic diseases to access.
One disease veterans are disproportionately affected by is mesothelioma. Almost a third of all mesothelioma diagnoses are of veterans, because of the lingering asbestos-containing products from ships, bases, and equipment. An airborne carcinogen, asbestos can become trapped in the lungs. Although this cancer has four types, developing in potentially four organs, it is most prevalent as a cancer of the lungs due to inhalation. While all cancer patients can receive telehealth services, now is an essential time. As telemedicine is proving to be a vital tool for veterans and cancer patients, it is also becoming a comprehensive service. Mesothelioma patients are encouraged to check with healthcare providers for services like non-essential doctor visits, routine check-ups, and refilling prescriptions.
Such services may not be unfamiliar to veterans dealing with this cancer and utilizing the VA’s program, which boasts of a range of telehealth:
- TeleBipolar Disorder
- TeleIntensive Care
- TeleOccupational Therapy
- TeleSurgery (Pre – & Post- Care)
- TeleWound Care
All are developing or developed services and are grouped into three categories.
Many imagine real-time, interactive videos for treating and providing medical help, better known as Synchronous telehealth. This can facilitate “video connectivity between a provider and a patient who is at home or other non-VA location.” The next type of telehealth is Asynchronous, “defined as the use of technologies to acquire and store clinical information” to process elsewhere. The VA utilizes Asynchronous telehealth for retinopathy screening and dermatology. Lastly is Remote Patient Monitoring for patients “with chronic conditions (e.g., hypertension or diabetes)” and involves “care and case management principles to coordinate care through health informatics, disease management and technologies, such as in-home mobile monitoring, messaging and video technologies.” Remote Patient Monitoring aims “to improve clinical outcomes and access to care while reducing” unnecessary visits.
Polls suggest that there is still patient satisfaction, compared to in-office appointments, with an average of 88.75% for the three types (though this was out of four, as Synchronous was split into two–Synchronous scores and Synchronous home/mobile scores–both at the time of appointment). The highest satisfaction was the Synchronous scores (at time of appointment) with 90%.
At this time the study came out, telehealth was promising. Now, the Trump Administration has expanded telehealth benefits for Medicare beneficiaries as a result of the COVID-19 crisis. States are also following this overwhelming push, greenlighting telehealth services to keep social distancing orders enforced.
Patients and doctors can see the improvement of telehealth in a time that demands this essential service. Telehealth meets healthcare necessities, without infringing on state legislation surrounding COVID-19 legislation. If telehealth and telemedicine were already developing resources for veterans, the COVID-19 era introduces a wave of populations and individuals exploring these services too.
The VA’s telehealth program, though designed for veterans, reaches far to cover all symptoms, diseases, and illnesses. It may not be all-inclusive yet, but it expresses how telehealth can become a successful industry, a more well-known and accepted type of healthcare.
As mentioned, the Trump Administration’s announcement to cover more telehealth benefits will spark more interest in telehealth. This comes through the Centers for Medicare & Medicaid Services (CMS) and opens healthcare for more than 140 million people. At-risk populations such as those with disabilities, senior citizens, and even marginalized individuals with poor healthcare are turning to the technological advantage of telehealth.
COVID-19 proves how a virus can flip the economy and society. Telehealth is another effect of this pandemic and one that can initiate improved advancements. It is an essential service now and it can exist as an ongoing part of the healthcare system. For veterans, cancer patients, and anyone struggling or concerned about their health during this time, telehealth is meeting this need.
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