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From Fantasyland to Tomorrowland: Wireless Health for Rural Vets

Cheryl Clark, for HealthLeaders Media, June 30, 2010

Committee Chairman, Rep. Michael F. Michaud, D-Maine urged the VA to do more to implement wireless healthcare technologies. “The VA is certainly a recognized leader in using electronic health records, telehealth and telemedicine. However, wireless health technology also includes mobile health, which is truly a new frontier in health innovations,” he said. “For the 3 million veterans living in rural areas, access to healthcare remains a key barrier as they simply live too far away from the nearest VA medical facility.

“Unfortunately, this means that rural veterans cannot see a doctor or healthcare caseworker to receive the care they need when they need it given these barriers. It’s no surprise that our rural veterans have worse healthcare outcomes than the general population.”

The speakers, many from companies hoping to develop and sell more products, chimed in. What better population to explore the balance of costs versus benefits of wireless health technology, they proclaimed. The Veterans Health Administration is already way ahead on telehealth implementation, with more than 263,000 vets receiving telehealth services in 2009 alone. It’s not much more of a reach to expand its wireless capabilities too, they said.

For example, the VA’s Care Coordination/Home Telehealth (CCHT) program—the largest telehealth program in the world—has documented a 25% decline in bed days, a 50% decline for patients in rural areas, and a 19% reduction in hospital admissions from using telehealth technologies.

Joseph Smith, MD, chief medical and science officer for the West Wireless Health Institute in San Diego, attributes this to “linking chronically ill veterans with healthcare providers and care managers through video-conferencing, messaging and biometric devices and other telemonitoring equipment.”

But the VA should take it one step further, Smith suggested. Wireless biometric sensors can track disease activity continuously, transmitting information to the patient’s providers without requiring that the patient make a long-trip for an in-person visit.

Perhaps, Smith says, the VA should think about the $1.8 billion it intends to spend building two new hospitals. “Imagine how many veterans in remote areas across the country could be reached through wireless technologies with a similar expenditure of those precious resources: The CCHT’s program cost is $1,600 per patient per year, meaning an additional 225,000 veterans in remote areas could be reached for a comparable cost over a five-year period.”

Certainly the VA has done a lot, said Gail Graham, the VA’s deputy chief officer for Health Information Management, who points out in an interview that $1,600 per patient cost used to be $13,121 per patient for primary care and $77,745 per patient for nursing home care. The VA is also partnering with the Department of Defense, which is spending research money to equip newly returning service members with different sophisticated wireless devices to monitor their health.

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