According the April newsletter “The Rural Connection”, published by the Veterans Health Administration’s Office of Rural Health (ORH), the elderly rural veteran population is rapidly growing. The reality is that rural veterans are on average older than their urban counterparts and have trouble finding primary care physicians with the training or experience to manage complex older adults with multiple chronic diseases.
“ORH is taking a multi-pronged approach to home health care, telehealth, chronic disease management, transportation, and care giving initiatives”, according to Dr. Mary Beth Skupien ORH Director.
To meet the veterans’ needs, ORH is rapidly expanding home telehealth into rural areas. The VA’s Home Based Primary Care (HBPC) program is now available at 140 VA Medical Centers and 53 Community-Based Outpatient Clinics. The VA Office of Geriatrics and Extended Care in partnership with ORH started HBPC to provide comprehensive, longitudinal primary care by interdisciplinary provider teams for veterans at home with complex and chronic disabling conditions.
HBPC provides medication management, wound care, pain management, collection of specimens for laboratory analysis, monitoring of symptoms through telehealth, and provides care coordination between the VA and community providers.
ORH is providing nearly $43 million to support the HPBC effort in an additional 50 rural areas and in FY 2013, ORH will continue to support rural HBPC expansion. ORH is also funding demonstration projects and equipment purchases to help expand home telehealth initiatives to help more homebound veterans with chronic conditions.
One of the major medical issues affecting veterans is dementia since the VA has to treat the elderly veteran population. ORH supports the VA Proactive Dementia Care Pilot program taking place in rural areas. The program combines educating the rural Community-Based Outpatient Clinics (CBOC) staff on screening for memory disorders, providing telehealth technology to help veterans receive specialty care from neuropsychologists, and coordinating care with providers to form a comprehensive management plan.
Telehealth is not only helping rural veterans but also helping the total veteran population in new ways. Today, the VA is using telehealth to meet specific medical concerns in managing pain. The “Resilient Coping with “Chronic Pain” program is offered both in-person and via telehealth to veterans. By using videoconferencing, veterans not only receive education and support but are also able to learn practical techniques to help improve their ability to cope with pain on a daily basis as well as how to manage flare-ups.
The VA is helping veterans with spinal cord injuries by enabling spinal cord telehealth visits to take place. Telehealth is used to link veterans to specialists that can help them consult with physicians, consult with physical and occupational therapists, receive post-operative follow-up care, and address complex psychosocial concerns.