Veteran Engagement with eHealth Technologies
•Descargar como PPTX, PDF•
2 recomendaciones•1,661 vistas
The document discusses Veteran engagement with electronic health technologies at the Veterans Health Administration (VHA). It provides an overview of VHA's use of connected health technologies like telehealth, My HealtheVet, and mobile apps to improve care delivery and patient engagement. It outlines VHA's goals of expanding the use of these technologies through new mobile and web-based tools that allow real-time access to health information and communication with providers.
Recomendados
Recomendados
Más contenido relacionado
La actualidad más candente
La actualidad más candente (20)
Similar a Veteran Engagement with eHealth Technologies
Similar a Veteran Engagement with eHealth Technologies (20)
Más de Johns Hopkins
Último
Último (20)
Veteran Engagement with eHealth Technologies
- 1. Veteran Engagement with Electronic Health Technologies MARCH 12, 2014 Neil C. Evans, MD Co-Director, Connected Health Office of Informatics and Analytics, Veterans Health Administration
- 2. 2
- 3. 3
- 4. 4
- 5. 5
- 7. VETERANS HEALTH ADMINISTRATION 8.93 Million VA Health Care System Enrollees*** 6.84 Million VA Supervised & Administered Life Insurance Policies* * 3.66 Million Veterans Receiving VA Disability Compensation * * 3.31 Million VA Maintained Gravesites * ** 1.87 Million Active VA Home Loan Participants * * 950,000 VA Education Beneficiaries * * 300,000 Veterans Receiving VA Pension * * 300,000 VA Vital Statistics 7 131 VA National Cemeteries 56 VBA Regional Offices 1,600+ VA Health Care Sites *As of FY 2012 **As of 6/30/13 ***As of FY 2013 Veteran family members receiving care through VA health care programs***
- 8. VETERANS HEALTH ADMINISTRATION Hospital System to Health System In 1996, VA began the creation of Veterans Integrated Service Networks (VISNs) to transform VA Health Care from a “Hospital System” to a “Health System.” VHA currently has 21 VISNs. •135 Community Living Centers •300 Vet Centers •151 Medical Centers •985 Outpatient Clinics 820 Community-Based 151 Hospital-Based 8 Mobile 6 Independent •103 Domiciliary Residential Rehabilitation Programs 8 •70 Mobile Vet Centers Source: FY 2012-2013 End-of-Year Pocket Card
- 9. VETERANS HEALTH ADMINISTRATION Vision: VHA will continue to be the benchmark of excellence and value in health care and benefits by providing exemplary services that are both patient-centered and evidence-based. This care will be delivered by engaged, collaborative teams in an integrated environment that supports learning, discovery and continuous improvement. It will emphasize prevention and population health and contribute to the Nation’s well-being through education, research and service in national emergencies. VHA’s Mission and Vision 9 Mission: Honor America’s Veterans by providing exceptional health care that improves their health and well-being.
- 10. VETERANS HEALTH ADMINISTRATION VHA Principles 10 VHA’s principles are the philosophical pillars that are embedded in VHA’s vision. They are embodied in our goals, objectives, and every initiative undertaken. Data-Driven/Evidence Based Patient Centered Providing Value Continuously Improving Team Based Prevention/Population Health
- 11. VETERANS HEALTH ADMINISTRATION VHA’s Current Priorities • Patient Aligned Care Teams (PACT) • Connected Health Care • Access • Homelessness • Mental Health Care • Standardization 11
- 13. VETERANS HEALTH ADMINISTRATION Connected Health • VA: Connected Health is defined as extending the reach of healthcare, empowering patients, and supporting healthcare teams through virtual systems of care • Connected Health is powered by consumer health technologies that engage patients and connect them to their health care teams, enabling the extension of the health care relationship beyond the traditional in-person synchronous encounters that for so long have been the centerpiece of patient/provider interactions. • Wikipedia: Connected health is a model for healthcare delivery that uses technology to provide healthcare remotely. Connected health aims to maximize healthcare resources and provide increased, flexible opportunities for consumers to engage with clinicians and better self-manage their care. It uses technology – often leveraging readily available consumer technologies – to deliver patient care outside of the hospital or doctor's office. Connected health encompasses programs in telehealth, remote care (such as home care) and disease and lifestyle management, often leverages existing technologies such as connected devices using existing cellular networks and is associated with efforts to improve chronic care.
- 14. 14
- 15. VETERANS HEALTH ADMINISTRATION VA Connected Health VA is aligning virtual care technologies to create a seamless, unified experience for Veterans. VA’s virtual care technologies include: • Clinical Video Telehealth • Home Telehealth • Store and Forward Telehealth • Telemental Health • Mobile Health • My HealtheVet • Secure Messaging • SCAN-ECHO • Mobile Apps • VA Point of Service Kiosks
- 16. VETERANS HEALTH ADMINISTRATION VA Connected Health (Virtual Care) 3
- 17. VETERANS HEALTH ADMINISTRATION Connected Health Technologies Year Started Estimated Veterans Served in 2013 Home Telehealth 2003 144,250 Clinical Video Telehealth 2002 202,823 Store & Forward Telehealth 2000 311,369 eConsults 2010 257,949 SCAN-ECHO 2011 1,632 My HealtheVet 2003 2,487,000 Blue Button 2010 881,000 Secure Messaging 2008 795,000 Veteran Mobile Apps 2013 Field testing Staff Mobile Apps 2013 Field testing Veteran Point of Service Kiosks 2010 >4M transactions VA Connected Health
- 19. VETERANS HEALTH ADMINISTRATION Scope of VA Telehealth Services 19 Clinical Video Telehealth (CVT) Real-time video consultation that covers 44 clinical specialties including: Tele- Intensive Care, TeleMental Health, TeleCardiology, TeleNeurology, TeleSurgery, Women’s Telehealth, Tele-Primary Care, TeleSCI care, TeleAmputation Care, TeleAudiology, Remote Nursing Home Consultation, TelePathology, etc. Home Telehealth (HT) Care and case management of chronic conditions and provision of non-institutional care support to patients. Uses in-home and mobile technologies to manage diabetes, chronic heart failure, hypertension, obesity , head injury, depression, etc. Store and Forward Telehealth (SFT) TeleRetinal Imaging, TeleDermatology, TeleWound Care, TeleSpirometry, Tele-Sleep Studies TeleCardiology.
- 20. VETERANS HEALTH ADMINISTRATION VHA Telehealth Services: Outcomes 20 Reductions in Utilization FY 2012 Home Telehealth - reduces bed days of care – 58% Home Telehealth – reduces hospital admissions – 38% Clinical Video Telehealth – reduces bed days of care 56% for mental health care Patient Satisfaction Home Telehealth - 85% mean score Store-and-Forward Telehealth –96% mean score Clinical Video Telehealth - 93% mean score Travel Reduction Savings Clinical Video Telehealth – $34.45 per consultation Store and Forward Telehealth - $38.81 per consultation Home Telehealth Savings $1,999 per annum per patient
- 22. VETERANS HEALTH ADMINISTRATION My HealtheVet A personal My HealtheVet account provides Veterans with 24/7 online access to a variety of tools to manage their health care. Communicate with Participating Patient Aligned Care Team Members View Appointments and Health Information Refill Prescriptions Download and Share Personal Health Record 22 www.myhealth.va.gov
- 23. VETERANS HEALTH ADMINISTRATION 23 www.myhealth.va.gov • More than 107 million visits • Over 2.5 million registered users • More than 1.3 million users have a Premium (authenticated) account • Over 47.3 million VA prescription refills since August 2005 • More than 918,000 unique VA Blue Button users since August 2010 • More than 5.2 million VA Blue Button file downloads • More than 843,000 VA patients opted in to use Secure Messaging My HealtheVet Statistics (as of November 2013)
- 24. VETERANS HEALTH ADMINISTRATION • VA Prescription Refill(s) • VA Prescription Refill History • Self-entered medication(s), herbal(s), over-the-counters (OTCs) and supplement(s) • VA Medication(s) List* • My Complete Medications List (VA and self-entered)* More than 47.3 million VA prescription refill requests since launched in August 2005 Encouraging VA patients to play an active role in the medication reconciliation process *Requires Advanced account. My HealtheVet: Pharmacy Veterans’ Top Request for Online Services 24
- 26. VETERANS HEALTH ADMINISTRATION VA Blue Button ® : Download Results 26
- 27. SecureMessaging Patients and providers are able to communicate securely online through VA’s Secure Messaging accessible through My HealtheVet.
- 31. VETERANS HEALTH ADMINISTRATION 2 VA Connected Health (Virtual Care) Where is VA Going?
- 32. VETERANS HEALTH ADMINISTRATION VA Mobile / mHealth 32
- 33. VETERANS HEALTH ADMINISTRATION Is there interest in mHealth?
- 34. 34
- 35. 6.8 BILLION MOBILE-CELLULAR SUBSCRIPTIONS
- 36. VETERANS HEALTH ADMINISTRATION Goals of VA Mobile Health • Focus on health by engaging patients and Caregivers outside of traditional health care visits • Improve data sharing to increase the value of communication • Increase health care provider efficiency and satisfaction 36
- 37. VETERANS HEALTH ADMINISTRATION 37 PTSD* Coach *Post-Traumatic Stress Disorder More 80,000 downloads in 70 countries VA’s Office of Mental Health began VA Mobile App development with “stand alone” apps VA’s Mobile Health Program Office focuses on Mobile Apps that connect into VA data systems
- 38. VETERANS HEALTH ADMINISTRATION VA Mental Health Apps 38 VA Mental Health Apps 38 Available on iTunes Apps are native and do not connect to VA
- 39. VETERANS HEALTH ADMINISTRATION Washington, DC VA Medical Center Pilot Summary of Care App – Lab Results • Significant desire for access to a robust set of clinical data • High levels of enthusiasm for mobile tools • Usability/security issues • No lack of ideas for customized workflow-focused Apps 39
- 40. VETERANS HEALTH ADMINISTRATION VA Mobile Strategy Timeline 2011 2012 2013 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 PROVIDER/STAFF MOBILE CAPABILITIES VETERAN FACING MOBILE APPLICATIONS CENTRAL MOBILE DEVICE MANAGEMENT AND CLOUD HOSTING New Cloud MDM Begin VA Mobile - Interim MDM - Initial Cap 1500 Mobile Devices Mobile Validation Field Enterprise App Library Dedicated Cloud Environment Hosting – FISMA High Impact Certified Mobile App Development Environment Security Test and Certification Authority to Operate (ATO) Certification and Governance Veteran Mobile Credentialing Services Delegation Authorization Family Caregiver Pilot Caregiver Evaluation Study More Apps Provider Mobile Pilot Mobile Display of Patient Data Mobile Imaging Nursing Apps Mobile Browser Pilot Scheduling App 40
- 41. VETERANS HEALTH ADMINISTRATION VA Mobile Framework 41
- 42. VETERANS HEALTH ADMINISTRATION Mobile Application Environment • Standardizing Apps and their development; Reducing Costs • Common Dev Tools • Common Services & Software Library • Dev Knowledge Base • Development & Production Environments 42
- 43. VETERANS HEALTH ADMINISTRATION VA Mobile App Certification Process Requirements Business Ownership Commitment Aligned with VA Business Objectives Sustainment Plan Usability Testing VA Branding Data and Terminology Standards Compliance Security Privacy System Performance Impact Assessment Patient Safety Assessment & Functional Testing 508 Accessibility Clinical Review for Medical Apps Help Screens Software Quality Assurance ALL VA Apps must be certified before posting on App stores 43
- 44. VETERANS HEALTH ADMINISTRATION Mobile Health Development Strategy 44 Build Apps at HTML5 so they will work on mobile browsers across platforms and on desktop browsers
- 45. VETERANS HEALTH ADMINISTRATION VA Mobile Health Staff Apps 45
- 46. VETERANS HEALTH ADMINISTRATION Clinicians Interested in Using Mobile Apps • 89 percent of primary care and internal medicine physicians use smartphones to communicate with other hospital staff • 51 percent of clinicians use smartphones to reference health information • 83 percent of clinicians would immediately utilize mobile EHR Apps to update patient charts, check labs and order medications if their current EHR vendor made those features available for mobile – Only eight percent currently use a mobile device for these functionalities 46 Source: Black Book Rankings, May 2013 Source: HIT Consultant
- 47. 47
- 48. VETERANS HEALTH ADMINISTRATION VA Health Care-Team Facing Apps in Development • Patient Viewer App (Data review, Note Entry, Order Entry) • Immunization App • Warfarin Monitoring • VA Mobile Imaging • Caring for Women Vets • Pre-Conception Care • Pregnancy • Chronic Kidney Disease App • Safe Women Prescribing • Maternity Care Coordinator • Scheduling Calendar View • Secure Messaging • Joint VA-DOD Patient Viewer • Launchpad • Mobile ECG Viewer 48
- 49. VETERANS HEALTH ADMINISTRATION VA Mobile Health Provider Program 49 Photographs from Washington, DC VAMC Distribution
- 50. VETERANS HEALTH ADMINISTRATION VA Mobile Health Veteran Apps 50
- 51. VETERANS HEALTH ADMINISTRATION Does someone in your family have a working cell phone? Do you use the Internet? Do you access the Internet through a Cellular Network? Have you downloaded Health-related information to your phone? 0 10 20 30 40 50 60 70 80 90 100 91 65 21 10 92 73 30 12 92 76 40 11 Veterans enrolled in VA Veterans not enrolled in VA Non-Veterans Veteran Mobile Device Access 51 2012 Health Information National Trends Survey
- 53. Expert Care and Self Care Information Sharing Transactions Communications
- 54. VETERANS HEALTH ADMINISTRATION Veteran-Facing VA Mobile Apps In Pilot Testing • Family Caregiver Suite of Apps • Veteran Appointment Request App • My Story • Mobile Blue Button Soon-to-be Released • Summary of Care • Mobile Blue Button • LaunchPad 54
- 55. VETERANS HEALTH ADMINISTRATION Family Caregiver Mobile Health Pilot • Cohort: Seriously Injured post-9/11 Veterans and their Family Caregivers in the VA’s Family Caregiver Program • Suite of Apps designed based on needs of Caregivers and Veterans • iPads loaded with Apps loaned to Caregivers for one year August 2012 Mailing to Notify of Selection, Request Loaner Agreement, Invite into Study 1,200 Caregivers Responded “Yes” Distribute 800+ iPads Mailing to 4,000+ Caregivers September 2012 November 2012 May 2013 Timeline 55
- 56. VETERANS HEALTH ADMINISTRATION Family Caregiver Apps 56 1) Pain Coach – Supports Pain Management 2) Care4Caregiver – Supports Caregiver Stress 3) Journal – Record Vitals/Exercise/Food/Contacts 4) RxRefill – Refill Prescriptions 5) Summary of Care – Display Data from HER 6) PTSD Coach – Supports PTSD management 7) Health Advocate – Allows Veteran to Designate a Health Advocate 8) Notifications and Reminders – Sets Medication Reminders and Receive Notifications from Health Care Team
- 57. VETERANS HEALTH ADMINISTRATION Login • Uses Department of Defense LogOn (DS LogOn) credentials. • Delegation App will allow Veterans to authorize sharing of their VA clinical data with Family Caregivers using DS LogOn credentials. 57
- 58. VETERANS HEALTH ADMINISTRATION VA Mobile Launchpad (iOS Version) 58
- 59. VETERANS HEALTH ADMINISTRATION • Medications • Labs • Problem List • Radiology Reports • Progress Notes • Demographics • Vitals Summary of Care App Displays EHR Data 59
- 60. VETERANS HEALTH ADMINISTRATION • Vitals • Exercise • Diet • Mood • Communications Journal App 60
- 61. VETERANS HEALTH ADMINISTRATION RxRefill App 61 • Allows Veterans to request prescription refills
- 62. VETERANS HEALTH ADMINISTRATION How Caregivers are Supported • Training –Quick Start Guide –Videos • Help Desk • Newsletter 62
- 63. VETERANS HEALTH ADMINISTRATION Family Caregiver Mobile Health Evaluation Study Primary Quasi-Experimental Study • Caregiver burden levels and Veterans Health Care utilization Longitudinal Cohort Study • How does exposure to apps relate to outcomes • Statistical model to predict utilization of apps Qualitative Study • Phone interview with high and low app users 63
- 64. VETERANS HEALTH ADMINISTRATION VA Family Caregiver Pilot Characteristics of iPad Recipients • 879 iPads distributed • Average age (of both Caregivers and Veterans) – 40 years old • 95% of caregivers are female • 90% are spouses of the Veterans • Majority of Veterans are rated with a service-connected disability of 80% or greater – PTSD – Nerve/Fracture related injuries – TBI • 60% Urban, 40% Rural 64
- 65. VETERANS HEALTH ADMINISTRATION VA Family Caregiver Pilot – Baseline Caregiver Strain 65 Average: 5.54 STD: 3.68 Median: 5
- 66. VETERANS HEALTH ADMINISTRATION Unique Users by Month by App 66 0 200 400 600 800 1000 1200 1400 1600 630 Caregiver/Veteran diads (72%) have used at least one of the ten apps in the suite.
- 67. VETERANS HEALTH ADMINISTRATION Family Caregiver Pilot App Utilization 67 0 100 200 300 400 500 600 700 Jun Jul Aug Sep Number of Unique Users per Month
- 68. VETERANS HEALTH ADMINISTRATION Percentage of Reported Reasons for Non-Use of Family Caregiver Apps 68 DS Login Issues App Issues Usability 219 Non-Users
- 69. VETERANS HEALTH ADMINISTRATION VA Family Caregiver Pilot – Preliminary analysis Significant Predictors of Mobile Health App use include the following • Veteran Age – Mobile Health App use decreases with increases in the age of the Veteran. • Caregiver-Veteran relationship – Odds of use increase if caregiver is a spouse of the Veteran. • Urban/Rural – Odds of use increase if the Veteran lives in a rural location. • Mental Health Diagnosis – Odds of use increase of if the Veteran has a mental health diagnosis. 69
- 70. VETERANS HEALTH ADMINISTRATION Veteran Appointment Request App • Allows Veterans to request appointments for primary care and mental health care using a Mobile App – Includes Mobile App- specific to both the Veterans and Appointment Clerk’s needs – Mobile Web App can be used on multiple mobile devices or from desktop – Pilot includes more than 600 Veterans at Washington, DC and Palo Alto VAMCs 70
- 71. VETERANS HEALTH ADMINISTRATION 71 MyStory App (Personal Health Inventory) • Allows Veterans to identify what is most important to them in terms of life and wellness goals to achieve those goals – Provides ability for Veterans to share information with their support teams (e.g., VA health care team, family and friends, life coach, support group, personal trainer, etc.) – Three-month pilot includes 30 Veterans at North Chicago, East Orange, Fayetteville (NC), Denver, West Los Angeles, Salisbury and Columbia VAMCs
- 72. VETERANS HEALTH ADMINISTRATION Mobile Blue Button 72
- 73. VETERANS HEALTH ADMINISTRATION New Veteran-Facing Mobile Apps in Development • Text Messaging Program (Annie) • Patient Personal Health Plan • Women’s Health • Mission Health (Gaming App) • Wellness Check (Bio-surveillance Reporting) • Pre-visit Agenda and Post-Visit Plan • Cardiac Rehabilitation • Chronic Kidney Disease • VA Benefits App 73For more information, visit http://mobilehealth.va.gov
- 74. VETERANS HEALTH ADMINISTRATION What we have Learned • Barriers to Use –Low computer literacy –Access problems with credentials • Facilitators to Use – Availability of support – Easy to use interface – Knowledge that Healthcare Team is involved – Trusted Invitation to Participate 74
- 75. VETERANS HEALTH ADMINISTRATION Critical Factors for Success • Senior leadership commitment to “care at a distance” • Intelligent design and implementation – User-centered development and design – Ease of use!!! – Integration with core IT systems and data – Accounts for provider and patient workflows – Informed by pilots, with rapid-cycle corrections – Adequately resourced implementation • Effective Communication to patients about the value of these technologies – Extension of the relationship – Personal invitation to participate • Accessible user support and low barrier to entry 75
- 76. VETERANS HEALTH ADMINISTRATION Contact Information 76 Neil C. Evans, MD Co-Director, Connected Health (Clinical Director) Department of Veterans Affairs Washington, D.C., USA Neil.Evans@va.gov VA Mobile Health Website http://mobilehealth.va.gov
- 77. 77
Notas del editor
- As the nation braced itself for the final throes of the Civil War, thousands of spectators gathered on a muddy Pennsylvania Avenue near the U.S. Capitol to hear President Lincoln’s second inaugural address. It was March 4, 1865, a time of great uneasiness. In just over one month, the war would end and the president would be assassinated. President Lincoln framed his speech on the moral and religious implications of the war; rhetorically questioning how a just God could unleash such a terrible war upon the nation. “If we shall suppose that American slavery is one of those offenses in the providence of God, ... and that He gives to both North and South this terrible war as the woe due to those by whom the offenses came.” With its deep philosophical insights, critics have hailed the speech as one of Lincoln’s best. As the speech progressed, President Lincoln turned from the divisive bitterness at the war’s roots to the unifying task of reconciliation and reconstruction. In the speech’s final paragraph, the president delivered his prescription for the nation’s recovery: “With malice toward none, with charity for all, with firmness in the right as God gives us to see the right, let us strive on to finish the work we are in, to bind up the nation’s wounds, to care for him who shall have borne the battle and for his widow, and his orphan, to do all which may achieve and cherish a just and lasting peace among ourselves and with all nations.” With the words, “To care for him who shall have borne the battle and for his widow, and his orphan,”President Lincoln affirmed the government’s obligation to care for those injured during the war and to provide for the families of those who perished on the battlefield. Today, a pair of metal plaques bearing those words flank the entrance to the Washington, D.C. headquarters of the Department of Veterans Affairs (VA). VA is the federal agency responsible for serving the needs of veterans by providing health care, disability compensation and rehabilitation, education assistance, home loans, burial in a national cemetery, and other benefits and services. Lincoln’s immortal words became the VA motto in 1959, when the plaques were installed, and can be traced to Sumner G. Whittier, administrator of what was then called the Veterans Administration. A document on VA medical history prepared for the congressional Committee on Veterans’ Affairs and titled, “To care for him who shall have borne the battle,” details how the words became VA’s motto. “He (Whittier) worked no employee longer or harder than himself to make his personal credo the mission of the agency. What was that credo? Simply the words of Abraham Lincoln, to care for him who shall have borne the battle and for his widow, and his orphan. To indicate the mission of his agency’s employees, Mr. Whittier had plaques installed on either side of the main entrance.” President Lincoln’s words have stood the test of time, and stand today as a solemn reminder of VA’s commitment to care for those injured in our nation’s defense and the families of those killed in its service.
- ID:04Created 11/4/13Source: http://www.va.gov/vetdata/docs/Quickfacts/Stats_at_a_glance_06_30_13.pdf http://www.va.gov/vetdata/docs/Quickfacts/Summer_13_sharepoint.pdfAdded Veteran family members on 12/19/13 with info from 10NA Updated Enrollees on 1/9/14 to reflect FY 2013 4th Quarter pocket card: http://vaww.va.gov/VHAOPP/vast3.asp
- ID:07Created for VHA Overview Version 1.6/13/2011Updated 1/9/2013 to reflect FY 2013 4th Quarter pocket card: http://vaww.va.gov/VHAOPP/vast3.asp(rounded to nearest tenths place)Approximately 3.1 million Veterans enrolled in VA health care live in rural areas.
- ID:24Created 11/4/13
- ID:25Created for VHA Overview Version 2.7/18/2011Edited 1/10/2013 Modified 11/4/13
- ID:27Created by LGaegler on 9/30/13
- VA: Connected Health is defined as extending the reach of healthcare and empowering patients and supporting healthcare teams through virtual systems of careAlternate: Consumer health technologies that empower patients and connect them to their health care teams, enabling the extension of the health care relationship beyond the traditional in-person synchronous encounters that for so long have been the centerpiece of patient/provider interactions.Wikipedia: Connected health is a model for healthcare delivery that uses technology to provide healthcare remotely. Connected health aims to maximize healthcare resources and provide increased, flexible opportunities for consumers to engage with clinicians and better self-manage their care. It uses technology – often leveraging readily available consumer technologies – to deliver patient care outside of the hospital or doctor's office. Connected health encompasses programs in telehealth, remote care (such as home care) and disease and lifestyle management, often leverages existing technologies such as connected devices using existing cellular networks and is associated with efforts to improve chronic care.
- The collection of technologies that enable the extension of the health care relationship beyond the traditional in-person synchronous encounters that for so long have been the centerpiece of patient/provider interactions.Connected Health technologies include telehealth, telemedicine, patient portals, mobile health applications (mHealth), wearable monitoring devices and other technologies that connect patients to their health care team or health resources.
- William Osler – ““To know what has to be done, then do it, comprises the whole philosophy of practical life.”Some Future Planned CapabilitiesUniversal easy access to patient-facing applications for Veterans and CaregiversAllow Veterans to request appointments over the InternetEnable video visit capabilitiesImprove VA’s secure messaging capabilityCreate text messaging capability for disease management supportContinue development of patient-facing disease management support appsSupport Veteran self-care through data collection and sharing from monitoring devicesDevelop a pre-visit agenda and post-visit plan applicationDevelop a personal health profile and plan Establish a standardized process for collecting and storing patient-entered dataEstablish a standardized process for sharing patient-generated dataCreate a virtual health portal for staffDevelop staff-facing web/mobile apps Establish an infrastructure to support distributed app development Foster the development of innovation with internal and external stakeholdersCreate an outreach and communications strategy for partnering with internal and external communities and stakeholders
- Forty-five percent of these patients lived in rural areas, and may otherwise have had limited access to VA health care; the number of Veterans receiving care via VA’s telehealthservices is growing approximately 22% annually.In FY2013, 144,520 Veterans enrolled for VA home telehealth services, 41,430 of those patients were supported by Home Telehealth to live independently in their own homes, patients who otherwise would have needed long-term institutional care.
- Reductions and Satisfaction data from FY12 Telehealth Services’ Report Card in FY12, for 1,439 TMH patients, There was a 30% reduction in admissions in home telemental health in their first six months of care when reviewed to a comparative period of time before enrollment. This resulted in a 56% reduction (-3,026 days) bed days of care (BDOC). Source routine VA HT outcome data. Travel reductions savings and HT savings calculated by ARC
- 82 million+ visits2 million+ registered users686,000 Veterans have downloaded data569,000 Veterans use Secure Messaging36 million prescription refills
- ID:34Created for VHA Overview Version 1.6/13/2011Updated with url on 12/27/13
- Veterans served in FY2013: 801,849In FY 2013, VA expanded its use of Secure Messaging in:Primary CareSpecialty CareSurgical CareIn FY 2013, VA launched Secure Messaging in:Mental HealthDentistryRehabilitationProsthetic Services
- VA Mobile aims to improve the health of Veterans by expanding care beyond traditional settings. VA mobile applications (Apps) deliver evidence-based tools and connections to health data and VA care teams while on-the-go. Patient-Centered Care: Providing Veterans with additional opportunities to become active partners in their health care. Data Mobility: Providing opportunities for VA’s health care teams to more easily engage with and empower Veterans and Caregivers in the management of their health and well-being. Pilot programs are used to evaluate how Apps increase convenient access to health care, improve patient engagement and strengthen communication among Veterans, Caregivers and VA clinicians. The Apps support a range of health care management tools, facilitate day-to-day administrative tasks and expand education and communication. Pilot programs allow VA to gather user feedback, allowing for corrections and enhancements. For more information, visit mobilehealth.va.gov.
- Empower Veterans to have more control over their personal and medical information and gives them the capability to ensure their information is current and accurate.Allow Veterans to view upcoming appointments, update personal information, review insurance information and check their account balances.Increase convenience and improve the check-in process.
- Scan-Echo: Specialty Care Access Networks-Extension for Community Healthcare OutcomesIn many rural and remote areas, Veterans and their primary care providers do not have easy access to specialty care services and expertise. VA is using video teleconferencing to increase access to specialty care for Veterans in rural and medically underserved areas. SCAN-ECHO links several primary care providers, many of whom are in different rural communities, simultaneously enabling rural primary care clinicians to gain the knowledge needed to provide care that was not previously available in their communities. It also enables Veterans with chronic conditions requiring complex care to get the medical care they need. In FY 2013, SCAN-ECHO served more than 1,600 Veterans.
- Inform Me (Inform and Attract) Engage Me (Retain and Interact) Empower Me (Partner Efficiently) Partner with Me (Create Synergy and Extend Reach) Support my e-Community.William Osler – ““The search for static security – in the law and elsewhere – is misguided. The fact is security can only be achieved through constant change, adapting old ideas that have outlived their usefulness to current facts.”William Osler – ““The good physician treats the disease; the great physician treats the patient who has the disease.”New Blue Button Features in 2013More timely access to information (reduced ‘hold periods’ for several VA data classes from 7 calendar days to 3 calendar days). These changes were also made to the VA CCD in the My HealtheVet 12.5.1 Release on July 2, 2013Expansion of the types of self-reported information that all registered users can include in their VA Blue Button: My Goals (Current Goals/Completed Goals)Improved performance for the Blue Button data refresh processEnhanced data refresh status message with link to a user friendly description to enhance understandingEnhanced user interface which includes information about business rules for VA data classesImproved user message when no records match selection criteriaMinor formatting improvements for Blue Button output(See the release notes and sample files posted on our Resources page)
- External organizations are deploying Connected Health technologies of varying maturities across four different categories
- Mobile Apps will be using the DOD DS Log On credentials.
- Primary Quasi-Experimental Study:Changes in Caregiver burden Levels extracted from chart reviewsVA collects Caregiver burden levels quarterly during home visits using Zarit Burden InventoryChanges in Veteran Healthcare Utilization VA Hospital Admission RatesVA Emergency Department Visit RatesVA Provider Visit RatesOutpatient Appointment No-show RatesLongitudinal Cohort Study:How does exposure to apps relate to changes in Caregiver Preparedness & Burden LevelsCaregiver and Veteran Factors predicting App Frequency of UseQualitative Study:Phone interviews with High and Low App Users to find out why use variedWhy is this important? The pilot evaluations inform next steps in VA’s roll out of a suite of Mobile Health resources and ensures that all technologies developed best meet the needs of Veterans, Caregivers and clinicians.
- Characteristics of iPad Recipients The VA distributed 879 iPads to Caregivers in the VA’s Family Caregiver Program. The average age of both the Caregivers and Veteran recipients is 40 years old. The majority of the Caregivers are female (95%) and spouses of the Veterans (90%). The majority of the Veterans are rated with a service-connected disability of 80% or greater and the most common conditions are PTSD, Nerve/Fracture related injuries and TBI. The recipients are split pretty evenly between urban locations (60%) and Rural locations (40%). VA Mobile App Use The VA created a suite of ten apps for the Family Caregiver mobile health pilot. Seven of these apps were designed to support patients and Caregivers in the self-management of their health. 630 Caregiver/Veteran diads (72%) have used at least one of the ten apps in the suite. The most commonly used app is the Summary of Care app, which displays information from the VA’s electronic medical record. Preliminary analysis shows that significant predictors of Mobile Health App use include: Veteran Age, Caregiver-Veteran relationship, Urban/Rural living location and a Veteran Mental Health diagnosis. Specifically …The odds of using a Mobile Health App increases if the Caregiver is a spouse of the Veteran, if the Veteran lives in a rural location and if the Veteran has a mental health diagnosis. Mobile Health App use decreases with increases in the age of the Veteran.More analysis will be forthcoming on the impact of the suite of VA mobile health apps on Caregiver burden and Veteran healthcare utilization.
- 630 Caregiver/Veteran diads (72%) have used at least one of the ten apps in the suite.