Progress continues on a major effort to increase telehealth at the Department of Veterans Affairs (VA), which is good news for home care providers that serve this client population. However, even if the VA’s telehealth initiatives prove to be successful, they might not change the game for expanding telehealth more broadly.
In early 2017, as part of a years-long telehealth push, VA announced that it had chosen four companies to provide vital signs telehealth monitoring to veterans in their homes, awarding contracts with the potential to exceed $1 billion. This month, one of those companies, 1Vision, announced that it has partnered with AMC Health, which will offer its CareConsole virtual care and remote monitoring solution to vets. The maximum value of the contract is nearly $260 million, which includes one base year and four one-year option periods.
The sizable contract is good news and in keeping with the VA’s approach, according to one senior care tech expert.
“The VA has been traditionally one of the most forward-thinking health systems in terms of using telehealth and telemedicine,” Majd Alwan, senior vice president of technology at LeadingAge and executive director of LeadingAge Center for Aging Services Technologies (CAST), told Home Health Care News.
The VA has established the Care Coordination/Home Telehealth (CCHT) program, aimed at coordinating care for veteran patients with chronic conditions, and findings published in Telemedicine and e-Health indicated the program reduced admissions and bed days of care. Specifically, the VA found in comparative studies on 17,025 patients enrolled in the VA CCHT program in 2006 and 2007 that there was a 25% reduction in bed days of care and a 20% decrease in the numbers of admissions.
As of 2017, VA was providing telehealth services to more than 677,000 vets, according to HealthcareDIVE. That is only a fraction of the 5.6 million vets receiving VA health care.
While telehealth has the potential for a wider impact outside the VA population, the Centers for Medicare & Medicaid Services (CMS) has traditionally pushed back on relaxing many of the restrictions on telemedicine and telehealth, Alwan noted. And because the VA is a unique case where the payer is also a care provider, the contract is less likely to have an impact on the acceptance of telehealth as a whole, even if it produces good results, he added.
More tools for care
Ramon Rodriguez, the owner of Home Helpers of Amsterdam, New York, and an Army veteran of 20 years, is more optimistic about the contract, at least in terms of its potential to help veterans stay home. His Home Helpers franchise currently serves about 150 clients, and works with the VA closely as a VA-approved provider.
“If somebody has telehealth and we’re providing home care, the [Home Helpers] nurse will have all the tools they need to provide a better quality service,” he told HHCN.
The telehealth offerings from AMC Health will let veterans automatically transmit such information as vital signs measurements, including blood pressure and blood glucose levels, and condition-specific information to the main telehealth platform via Bluetooth-enabled devices.
That data could be particularly useful to those who provide home care services and their clients, Rodriguez told HHCN.
“All the glucose monitoring, telehealth monitoring, that data can also be shared with our nurses that are doing the home health assessment and monitoring the care plan to make sure that we have support for the medical condition,” he said. “That would help a veteran stay home longer than they normally would.”
The 1Vision telehealth platform uses an analytics engine that can notify a veteran’s care coordinator to concerning trends or emerging health issues, which can ensure prioritized outreach, 1Vision told HealthCare IT News.
Rodriguez explained this in more depth. For example, a person who needs to be encouraged to drink more fluids might have data reflecting the need for hydration sent to their care coordinator at the VA through telehealth. The care coordinator can communicate this information to the home care nurse, who can then integrate it into the client’s care plan for the personal care aide to use.
Supplement, not replacement
The well-known workforce difficulties in home care, as well as scarcity of transportation in rural areas such as Amsterdam, New York, justify the use of telehealth whenever it can be used, Rodriguez said.
But telehealth cannot be regarded as “a solution to everything,” he stressed. It can complement and support the people being served in their homes, but the human element remains crucial.
“Technology is a good supplement to human power, human resources,” he said.
