The Veterans Administration’s Office of Rural Health (ORH) has funded over 500 projects and programs across the VA healthcare system. ORH supports 273 individual projects across the country and some are in collaboration with other VA program offices. Some of the offices deal with mental health, geriatric extended care, and telehealth services.
One of ORH’s goals is to optimize the use of available and emerging technologies such as telemedicine, telehealth, web-based networking tools, and mobile devices to deliver care to rural and highly rural veterans. Telehealth makes up to 25 percent of the ORH portfolio and major telehealth projects have been implemented especially in the VISNs located in rural areas.
Telehealth projects in place include:
• Ten telehealth specialty clinics established in VISN 19
• ORH teledermatology services that reach over 2,400 veterans and diagnose over 3,700 conditions in VISN 15 and 20
• A Care Coordination Home Telehealth renal project treating 20 veterans with chronic kidney disease
• Implementing Northern Plains PTSD Telehealth services on rural reservations.
• Opening additional PTSD telemental health clinics in VISN 19 & 23
• Fourteen clinics serving over 11 tribes in Montana, Wyoming, Nevada, North and South Dakota and Utah with the help of the Denver VA Medical Center’s rural-funded psychiatrist
• Implementing a collaborative discharge planning model using teleconferencing serving rural veterans
• Establishing programs using telehealth technologies to help OEF/OIF veterans with mental health and substance abuse care
• Improving access to care via home telehealth by providing for home-based primary care and geriatric services
• Implementing the tele-audiology pilot program & teleMOVE program
ORH also supports telehealth sub-specialty pre- and post-operative services for their most rural medical centers. Services include surgery, endocrinology, cardiology, TBI, pain management, podiatry, PTSD, along with addressing mental and behavioral health issues.
The Veterans Health Resource Centers are very active in providing help to rural veterans and in FY 2011, were involved in many projects. According to an article appearing in the ORH newsletter “The Rural Connection”, the Veterans Rural Health Resource Center- Western Region based in Salt Lake City, provides support across the U.S. but also for veterans from the Great Plains to American Samoa and the Philippines. Much of the work focuses on two particular veteran populations that include Native Veterans and Aging Veterans.
The Center recently launched the “Rural Native Veterans Promising Programs Initiative”. The initiative is developing best models of care for the Native Veteran population by piloting and evaluating programs responsive to specific cultural and health challenges facing rural native veterans. One outcome from this program has helped to establish new telemental health clinics for rural native veterans.
Another program, “Native Domain” is in place to establish collaborations with other agencies and native communities to disseminate models of best care for rural native veterans and to support clinical demonstration projects. The “Native Domain” program has produced several publications on PTSD/TBI Service Utilization, Telehealth, Population Reports, plus information on traditional healing.
ORH finds there are challenges in providing for health care for rural veterans but is looking towards the future. The VA is studying and evaluating the programs impacting rural veterans in terms of the impact of available and emerging technologies, best ways to improve efficiency to deliver care, how to improve quality of care, and ways to provide for education and training. The program is looking to implement new ways to establish and improve partnerships to share services and to work together to coordinate veterans care more effectively.