VA healthcare: at home, in a library and soon, to a VSO near you

Jonathan Kaupanger
July 27, 2018 - 4:11 pm



Providing healthcare to veterans living in rural areas means VA has to be creative. Telehealth is the obvious choice, but what the agency is doing with it is changing everything.

VA is unique because it enrolls veterans for care in areas where there aren’t medical facilities. VA Video Connect app mitigates this problem and lets veterans connect with their healthcare team through any mobile or web-based device.  In some areas, broadband internet access is either too expensive or just unavailable. The solution is to find a centrally located place and build a virtual living room. The first of these is in Appalachia, Kentucky.   

The virtual living room is located in a public library. It consists of two rooms: a living room which acts like a waiting room and then an office where the veteran meets with a physician through a TV monitor. It’s very convenient for veterans but it took a $50 million infrastructure investment between two counties to make it happen. 

“We’re lucky that rural broadband providers are so committed to partnering with us,” said Dr. Leonie Heyworth, VA’s National Synchronous Lead, Telehealth Services. The library’s virtual living room is working out so well, VA already has plans to expand the initiative.

“We have a partnership with veteran service organizations,” Heyworth said. “Specifically, with VFW and American Legion to identify sites within their posts around the country where we can build a telehealth access station so veterans can be connected and get care in their community.”

In some areas, telehealth is used to match clinical supply and demand. This only recently became possible due to legislation in the VA Mission Act which passed in June. VA is now able to hire clinicians in states or cities where it’s easy to do so and then provide those clinical services to veterans in very rural locations where the agency is having difficulty finding staff.

VA has about 10 mental health and 10 tele-primary care hubs in different locations throughout the country. Medical providers associated with these hubs fill vacancies across the VA without having to move locations.

There are several apps in VA’s Mobile App Store that work in conjunction with telehealth, too. Heyworth’s favorite is the ANNIE app. It is an automated texting app uniquely configured to a veteran’s needs. 

“If we’re talking about managing a veterans blood pressure better, we would put in the limits of where we want ANNIE to alert the veterans,” said Heyworth. “What blood pressure is too high, too low and how often do we want ANNIE to text the veteran. So, what you essentially have is veterans taking healthcare into their own hand at home and providing us this information by text message.” 

VA created its' telehealth emergency management initiative in response to hurricanes' Harvey and Maria. Volunteer providers from across the country supported patients in Houston and after Maria hit, outreach teams made phone calls to high-risk, mental health veterans in both English and Spanish.

In 2017, more than 720,000 veterans were treated in over 50 specialty areas, which turns out to be over 2.18 million episodes of care, many happening in the comfort of the veteran’s own living room.

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