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Access - VISN 4 Results

Connected Care

Jane Johnson (left), with Iron Bow Solutions, shows Erie VA Medical Center staff new telehealth technology available to connect patients with the right care, at the right time, in the right place.

VA's Connected Care programs extend access to care beyond the traditional office visit. Through virtual technology, VA is able to deliver care to patients where and when they need it.

The programs are divided into Telehealth, My HealtheVet, VA Mobile, and VHA Innovations. The goal of these programs is to keep Veterans from traveling (although Veterans can still report to the VA in person, if they prefer). VISN 4 is continually increasing the types of clinical activities and types of services that can be provided via Connected Care modalities.

Telehealth is broken down into three categories:

• Clinical Video Telehealth – This is live. The Veteran is at one endpoint; the provider at another. (VISN 4 is working hard to expand those endpoints: Vet Centers, outpatient clinics, and more.)
• Store & Forward – This is delayed. An image and/or information is captured and transmitted to an expert provider, who interprets it and responds within 48 hours.
• Home Telehealth – This requires equipment to be installed in a Veteran's home, and is followed carefully by a care coordinator (who is a registered nurse).

Elizabeth DeFeo (left), telehealth program manager at Coatesville VA Medical Center, speaks with Veterans outside T.E.D. about telehealth opportunities available to Veterans at outpatient clinics and in rural areas.

T.E.D. (Telehealth Education Delivered), a vehicle that provides education and demonstrations on a wide range of telehealth and patient care solutions stopped by each VISN 4 facility this year.

To learn more about telehealth in VISN 4, and to watch an informative video, please visit www.visn4.va.gov/services/telehealth.asp.

Secure messaging through My HealtheVet allows Veterans to communicate securely online with their VA health care team and other VA staff about non-emergency information or questions. Similar to email, Veterans can write a message, save drafts, review sent messages, and maintain a record of conversations. Veterans should receive a response within 3 business days.

Another Connected Care tool is E-consults – these are electronic consults between physicians (often a provider and a specialist).

New Nurse Triage Call Center

The new VISN 4 Centralized RN Triage Call Center is staffed with registered nurses at VA Butler Healthcare to enhance same-day services for Veterans.

Since Oct. 12, 2016, all facilities in VISN 4 have been utilizing a new, centralized nurse triage call center based at VA Butler Healthcare. Veterans (or family members) can speak to a registered nurse regarding health care concerns, or to report a symptom they are having, anytime by calling their local VA medical center and pressing the number 3.

During weekday administrative hours, they are connected to this new call center. After hours, on weekends, and on holidays, they are connected to a call center in New York. The call center has improved access to timely (even same-day services!) for Veterans and has greatly improved patient satisfaction. This is a great resource for Veterans to receive symptom management and medical advice anytime.

Audiology and Optometry Direct Scheduling

Veterans receiving care throughout VA are now able to schedule routine appointments for optometry and audiology without a primary care referral – a move that eliminates multiple steps and gets Veterans into appointments more quickly.

Same-Day Services

All VISN 4 facilities implemented Same-Day Services in primary and mental health care. This means that a Veteran with a need for care right away will have it addressed the same day. If the need arises after hours, it will be addressed the very next day.

The need may be addressed by providing a face-to-face visit, returning a phone call, arranging a telehealth or video care visit, or scheduling a future appointment. The care is provided by an appropriate clinical staff member.

Additionally, if a Veteran is in crisis or has an urgent need for mental health care, he or she will receive immediate attention from a health care professional. Any Veteran new to mental health with a non-urgent need will receive an initial screening evaluation by the next calendar day.

By the Numbers

Mental health staff reduced the number of Level 1 urgent appointments pending VISN-wide in more than 30 days of the Veteran's preferred date or clinically indicated date by 28% between June and December 2016.