Health care for rural vets getting easier every day

The VA is increasing care access with the Virtual Living Room

Jonathan Kaupanger
January 29, 2018 - 2:30 pm

(Photo by PA Images/Sipa USA)


The lives of rural vets just got easier.  Well, the medical side of their lives did.  It’s a new program VA is trying out and it has a very relaxing name too, the Virtual Living Room.

“We’re removing geography as a barrier so that we can speed up access to veterans and really honor our commitment to them,” said VA Secretary Dr. David J. Shulkin in the latest edition of ORH’s newsletter, “The Rural Connection.”  The Virtual Living Room (VLR) is great example of how VA is doing this too

Vets in McKee, Kentucky have to travel more than 60 miles to get to the closest VAMC in Lexington.  Another roadblock is that 36 percent of rural vets don’t have access to the internet, so that cuts out using telemedicine.  Instead, vets in McKee have a private room in the Jackson County Public Library they can use for medical appointment, cutting out the need for the long drive.

 “What I see is a better future for our veterans” said Dr. Tuyen Tran of the Lexington VAMC.  “If we do this well, we can mimic this model in out places.”  This is the first program of its kind in the country.  ORH found the local telephone line provider, worked with them to connect things with the medical center and did the same with the library.  Currently the Jackson County vets can only use the VLR for mental health appointments. 

Getting good healthcare for vets living in rural areas has always been an issue.  High poverty rates, hospitals closing due to financial instability and geographic and distance barriers are all contributing factors.   Veterans Affairs is trying to fix this problem with cold, hard cash.  32 percent of VA’s health care budget is used to help rural vets.

For this specific issue, it’s done differently though.  Through the Office of Rural Health (ORH) the VA looks for existing program that are strong and then helps to build and connect them to the existing VA healthcare network. 

Originally, ORH would provide three years of funding for local pilot programs.  The programs would be run out of local VA medical centers or Community Based Outpatient Clinics.   But starting in 2016, with more than 1,700 small local pilot programs to pull from, the Agency moved everything into two categories Enterprise-Wide Initiatives and Rural Promising Practices.

Enterprise-Wide Initiatives (EWI) takes VA existing programs and expands them to sites that serve rural veterans.  You can find the list of these programs here, and there are some that may surprise you, like the program to train rural healthcare providers on the special needs of transgender veterans.  The majority of these programs are run through telemedicine, so there’s even a program that makes sure vets have computer tablets so they can access care, and not have to drive all day to do it.

The other part of rural care comes from VA's rural Promising Practice program.  These types of programs go through a trough review process before they can be pushed out for veterans.  The criteria is pretty straight forward, does it increase access for veterans, is the partnership used strong, is the clinical impact for rural veterans a positive one and there needs to be a good return on investment.  Operational feasibility and of course customer satisfaction round out how programs are selected.

You can watch the launch of the VLR here.  The intent is to open this up to other practices as soon as possible.