The United States Department of Veterans Affairs operates one of the country’s largest telemedicine programs, with some 700,000 veterans receiving medical care and advice via their computers and mobile devices last year alone. Now, the VA is announcing a drastic expansion of that program with the launch of a new tool called VA Video Connect, which it intends to expand to every VA hospital across the country.
The new tool, a collaboration between the VA and the White House’s American Office of Innovation run by senior adviser Jared Kushner, will offer veterans access to doctors from more than 50 specialties, from dermatology to dentistry, with a special focus on providing mental health services to veterans, particularly in rural areas where such services aren’t readily accessible in-person. Starting today, VA video will be offered by 300 medical providers at 67 VA hospitals and clinics across the country, with plans to expand the tool after that.
“As all of us begin to feel more comfortable with technology and incorporating it … into how we get healthcare, I think, is just a natural extension of that,” said VA Secretary David Shulkin on a press call previewing the announcement.
Under the Obama administration, the federal government began a push to modernize the VA which has sustained scandal after scandal for its inefficiency in treating patients and dangerously long backlogs of patients. The United States Digital Service, a sort of tech startup within the White House, built tools that help veterans formally appeal decisions made about their healthcare benefits and created a portal called Vets.gov where veterans can apply for healthcare and check the status of their claims. And in June of this year, Shulkin announced the VA would adopt the same electronic health records the Department of Defense uses to eliminate confusion once active duty service people transition to the veteran health system.
The expansion of the telehealth program is in line with a recent boom in telemedicine, as patients, both veteran and non-veteran, become more comfortable with communicating with their doctors digitally, and as technology itself advances to enable the private transfer of medical records and test results. This growth has been particularly pronounced in the field of mental health and in rural areas. According to a recent study by Harvard Medical School and the RAND Corporation, between 2004 and 2014, the number of telemedicine visits for mental health services grew 45.1 percent annually.
“Our results highlight the growing importance of telemedicine in the treatment of mental health disorders in rural settings where access to mental health care is often problematic,” Ateev Mehrotra, associate professor at Harvard Medical School, said in an interview for the school.
Shulkin says he expects the number of people seeking telehealth services to get “much, much higher” as VA Video rolls out. And yet, questions remain about how a program like this will perform among the people who arguably need this tool most: older veterans in rural areas. These patients may not be as familiar with mobile technology or have access to the broadband capabilities that make telehealth feasible.
“Rural connectivity is something that’s of critical priority and importance to the Trump administration and to Congressional leadership as well,” Reed Cordish, assistant to the President for intragovernmental and technology initiatives, said on Thursday. “To help address that we’re making it a priority item within our infrastructure package that will be transmitted to Congress later this year.” That theoretical infrastructure agenda, however, has been long-promised yet so far is devoid of details. And it will likely take a backseat to the more pressing duty Congress has to pass a budget and raise the debt ceiling, or risk running out of money by September.
Another open question is how the VA will manage the expected growth in veterans seeking medical care through telemedicine. In addition to the VA Video tool, the VA is rolling out an app called the Veteran’s Appointment Request, which allows veterans to schedule appointments with VA providers on their smartphones. But Shulkin warns, “This does not put them at the front of the queue.”
That queue, of course, is notoriously and dangerously long. Just this week, the Senate approved a $3.9 billion emergency spending package to help the department whittle down its monstrous backlog. Shulkin acknowledged that some VA hospitals and clinics are “still struggling” in terms of long wait times. But he predicts that the VA Video tool could allow doctors working in hospitals with ample capacity to treat patients in places with fewer medical providers. Time will tell whether that prediction holds up. In a department rife with internal crises, there is only so much that even the most sophisticated technology can do.