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Providence VA Medical Center, Rhode Island

 

Telehealth Offers Convenience, Reduced Waiting

Valerie Machado, left, a telehealth clinical technician at the Providence VA Medical Center uses Clinical Video Telehealth, or CVT, equipment to meet with Shelly Greene, a licensed practical nurse in the Clinical Telehealth Department Dec. 14, 2016. (Providence VAMC photo by Allen Andersen)

Valerie Machado, left, a telehealth clinical technician at the Providence VA Medical Center uses Clinical Video Telehealth, or CVT, equipment to meet with Shelly Greene, a licensed practical nurse in the Clinical Telehealth Department Dec. 14, 2016. (Providence VA Medical Center photo by Allen Andersen)

By Nisa Koo, telehealth clinical technician, VA Springfield Outpatient Clinic
Wednesday, December 28, 2016

December is National Telehealth Month. Clinical telehealth offers a real-time method of delivering value-added, high-quality and time-saving medical care to Veterans. Telehealth provides care in their local clinic or medical facility, improving access by reducing the amount of time spent waiting for a specialty appointment; reducing the time spent commuting to a specialty provider, who may be located many miles away from their home; and reducing the time spent waiting for a diagnosis and treatment plan.

Clinical telehealth touches many branches of specialty care, including dermatology, endocrinology, mental health, audiology, allergy, psycho-pharmacology, pharmacy, surgical, neurology and cardiology, just to name a few.

Clinical Video Telehealth, or CVT, uses video-conferencing technology and special equipment to provide care for Veterans. For example, in CVT dermatology clinics, a hand-held high-definition camera is used to take close-up photographs of a skin lesion or mole. The dermatologist is then able to speak directly with the patient, obtain their medical history, make a diagnosis and prescribe any necessary medications. Another example is CVT endocrine clinics. In addition to video-conferencing technology, telehealth clinical technicians are trained to perform simple neurological tests. These visits often last only 30-minutes and are completed with a dermatologist or endocrinologist who can be located many miles away.

Store-and-Forward Telehealth, or SFT, which is not is not real-time, has two categories: SFT Tele-Dermatology and SFT Tele-Retinal Imaging. SFT Tele-Dermatology is a same-day visit with a telehealth clinical technician. No appointment is necessary.  A Veteran may be seen by their primary care provider, in urgent care or in an inpatient ward. The Veterans' primary provider receives the information about the skin condition that may need to be further assessed. The Veteran does not need to wait for an appointment to be seen. The telehealth clinical technician will use a high-definition camera to take images of their skin condition, upload them to the Veteran's medical record, and have the images available for the dermatologist to read and diagnose. The Veteran may receive their results within three days from the date the images were taken. The telehealth clinical technicians then follow up with patients to review the next steps as needed. If the patient needs a face-to-face visit with a dermatologist, the consult is promptly created, so an appointment can be scheduled quickly.

Both Veterans who are newly diagnosed diabetics and existing diabetics who have not previously had their eyes checked are eligible for SFT Tele-Retinal Imaging. There is normally little to no wait time for this appointment. The telehealth clinical technician reviews the Veteran's medical record, schedules their appointment and takes eight images of their eyes. One of the best features of this type of imaging is that the Veteran's eyes are not chemically dilated, because it takes advantage of the eye’s natural ability to dilate in response to darkness.

Clinical telehealth helps provide Veterans with improved access to care, one of the Veteran Health Administration’s strategic priorities, and there are many opportunities to expand into additional specialty services in the future, such as labs, intensive care, emergency care and more. For more information on clinical telehealth, ask your doctor, visit your local Clinical Telehealth Department, or visit http://www.telehealth.va.gov.

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