Sunday, July 19, 2009

Reaching Out to Rural Vets

The Craig VA Telehealth Outreach Clinic located in a rural area in Colorado has been in existence for two years. The facility has two full time nurses on staff and sometimes sees as many as 50 patients in a week with patients interacting with doctors at the Veterans Affairs Medical Center in Grand Junction 150 miles away.

The nurses report vital signs, draw blood, listen to patient’s heart and lungs, and make physical assessments. The clinic provides for teleconferencing, uses a high intensity camera with a magnified view, uses an otoscope to let the doctor look into the patient’s ears, and uses a smart stethoscope to listen to the patient’s heart and lungs.

The Craig Clinic is the only one using high technology on the Western Slope in Colorado but other clinics are due to be modeled after the Craig Clinic. Records show that nearly 45% of veterans live in rural areas where getting to a doctor or to a medical clinic may require hours of travel.

Congressmen Jim Matheson reported in June that there is now a $7.3 million federal grant to start new telehealth outreach clinics in the Mountain West including the Moab and Price Utah-areas with funding allocated by the VA’s Office of Rural Health.

The funding calls for two primary care offices to be opened and be staffed by two full time registered nurses and one telehealth medical technician. Matheson said they will use computers equipped with cameras to help the staff to communicate via the internet with a VA doctor at a medical center

In May 2009, the VA provided $215 million in competitive funding to improve services specifically designed for Veterans in rural and highly rural areas. VISNs, VA’s regional healthcare networks, and Veterans Health Administration program offices were allowed to submit up to eight proposed projects each. The Office of Rural Health then selected 74 programs many of which were either national in scope or in affected multiple states.

The new funding is geared to improve access and quality but there is also emphasis on the use of the latest technologies, but also the recruitment and retention of a well educated and trained healthcare workforce is high on the agenda.

On the legislative front, Representative Ann Kirkpatrick from Arizona recently introduced the “Rural Veterans Health Care Improvement Act of 2009” (H.R. 2879) in the House to make it easier for veterans living in rural areas to access quality healthcare options.

The bill calls for demonstration projects to look at expanding care for veterans in rural areas. The projects will develop a partnership between the VA and HHS to coordinate care for rural area veterans at community health centers. Funding of $350,000,000 will be available for the demonstration projects for fiscal years 2009 through 2011.

The legislation also calls for the integration of electronic health records with the Indian Health Service. In addition, the Secretary of Veterans Affairs and the Secretary of the Interior realize the importance of having a Memorandum of Understanding between the agencies to ensure that the health records of Indian veterans can and will be transferred electronically.