Jim Doray was visiting relatives in New Mexico this year, hundreds of miles from his home in Southern California, when he noticed that something was wrong with his blood pressure. This was no small problem for the 61-year-old Navy veteran, who has coped with multiple serious health issues since a spinal cord injury five years ago left him with permanent spinal inflammation and no feeling below his knees.
But Doray, who spent 24 years in the Navy, didn’t need to rush to an emergency room where he would have had to try to patiently explain his long, complicated medical history to strangers. He didn’t even have to cancel plans to travel with his wife the next day to the Texas Panhandle.
Instead, thanks to Doray’s participation in the Department of Veterans Affairs’ VA Telehealth Services program, he was able to go to a website that afternoon and use a secure messaging system to make an appointment for a video visit with his doctor’s office in California. The next morning, sitting on the sofa in his RV, with his wife driving east on Interstate 40, Doray used a tablet to call up his medical practice and soon was greeted by the reassuring face of his doctor’s head nurse. The result of this video visit was a decrease in one medication and an increase in another.
It was exactly the sort of experience that has made Doray, who needs frequent medical attention and lives quite a distance from the nearest VA Medical Center, an enthusiastic user of VA telehealth services.
“It’s priceless to be able to hook up with my medical team, which is familiar with my condition,” says Doray, who credits telehealth with making it possible for him and his wife to move from Poway—about 20 miles from the VA Medical Center in La Jolla—to their home in Julian in eastern San Diego County, more than three times as far from the facility.
Doray’s experience is becoming increasingly common as the VA, under pressure to improve access to care for veterans, expands its efforts to provide care remotely, especially to those in rural areas. In fiscal year 2018, which ended Sept. 30, the VA surpassed 1 million video health visits for the first time, an increase of about 20 percent over the previous year.
This month, the VA announced its newest effort to increase the use of telehealth – partnerships with Walmart, Philips Healthcare, the VFW and the American Legion. The initiative, known as Advancing Telehealth through Local Access Stations (ATLAS), is designed to enable veterans who lack the necessary technology in their home and live far from a VA facility to receive remote health care at a convenient location.
Walmart will provide private examination rooms and telehealth equipment at five of its stores in a 12-month pilot program with VA Telehealth. Philips will donate telehealth equipment to a total of 10 VFW and/or American Legion posts, where vets will be able to use private spaces set up for telehealth visits.
The VA also announced a new agreement with T-Mobile to help expand access to telehealth. Customers of T-Mobile and Metro by T-Mobile will be able to use VA’s telehealth application, VA Video Connect, without their data plans being charged for use of the service.
VA officials, who emphasize that use of telehealth services is optional for veterans, say there are multiple benefits. For one, patients can have a consultation with specialists in rare conditions who practice far away. Also, relatives and friends who might not be able to accompany a patient to a visit at a medical facility often can participate in a video visit at home.
Seeing a patient’s home setting also can offer physicians insights that they might not get from a visit at a medical office, says Neil Evans, M.D., Veterans Health Administration chief officer for the Office of Connected Care.
“When I see a person at home, I get a better sense of their situation,’’ says Evans. “It shows the challenges they’re facing in the home environment.’’
One of the greatest benefits of telehealth, Evans says, is the flexibility it provides for veterans with mobility challenges. For example, Evans says, one recent morning he was supposed to see an elderly patient who needs someone to drive him to appointments, but the ride fell through.
The patient’s family, he says, “called my nurse. She immediately said, ‘Dr. Evans can meet with you at 5 p.m. by video.’” The appointment was arranged with plans to use the patient’s son’s cellphone for the video connection.
Telehealth also allows patients to be monitored remotely between visits.
John Whalen, 88, of Lanham, Md., an Army veteran who served in the Korean War, uses a device attached to his phone that allows him to easily send readings of his blood pressure, blood sugar, weight and oxygen to his medical team. The readings, he says, go right to his doctor’s desk at a local VA clinic.
“It’s part of my daily routine,’’ says Whalen.
Whalen suffers from hypertension, diabetes and edema, and struggles sometimes with his breathing and managing his weight because he isn’t able to exercise enough. Using the technology, he says, he’s been able for about five years to continue going to the same physician at the nearby VA clinic instead of traveling every several months to a larger VA facility farther away, where there is more physician turnover. A nurse at the clinic, he says, checks in with him once a month.
“These people have extended my life,” he says.