Telemedicine THEN: More on Telemedicine and the VA

The year is 2003 and Brian*, a cancer patient, is having a miserable day, after an even more miserable night. The day before started out alright, but by late morning he was having difficulties breathing and he was unable to hold down any food. On top of that (even though he had remarkably high tolerance) he was beginning to feel real pain. Having had no sleep or rest he was physically exhausted and felt completely unable to cope with the stress brought on by a usual day.

Brian lived 45 miles away from his VA medical center. Because of his medications, he was unable to drive, even if he did have a car. Finances were too tight to call for a taxi and his closest friend, who stayed with him on the weekends, would not arrive until the wee hours the following morning. He just wasn’t sure he would be able to hold on.

He called his oncologist , who told him, “Listen Brian, there’s a shuttle available to your area today so just come on in to the office. You missed your last appointment so, even though it sounds like all you need is a med adjustment, today would be a good day to play ‘catch up’.” Then he added, “Besides, I think have a solution to the problem of scheduling visits.”

Enter “Telemedicine”.

Cancer patients who are either trying to deal with their ‘end of life’ issues or are at a stage where they require chemotherapy have always been an underserved demographic. They’re subject to a type of stress that most people cannot understand. Perhaps they’re unable to get transportation when they need it because they are living within a strictly fixed income. Maybe their discomfort or pain level has led them to the point where they ‘just don’t care anymore’. Constant travel back and forth to the doctor, which may only be inconvenient to some, can evolve into severe stress for patients with life threatening conditions like cancer. Either way, care during chemotherapy and end of life has suffered. Some solution has been needed.

Healthcare Innovation by Design

Healthcare Innovation by Design – one of many sources of telemedical devices

Because of collaboration that developed between the National Cancer Institute (NCI) and the Department of Veterans Affairs (VA) from the mid to late 1990’s to the early 2000’s **, the problem was tackled and initial solutions found. Cancer patients were given the option of electronic monitoring of their symptoms so that the unique health problems they encountered could be addressed quickly and effectively. One such solution was a device called the “Health Buddy”, which could be connected to a telephone, giving them immediate access to their care coordinators.

Daily calls to a central terminal would enable the patients to report concerns and issues they may be experiencing, such as pain, breathing problems, depression, nausea or any other symptoms. This would be done through responses to detailed, multiple choice, voice-prompt questions relating to a dozen symptoms, entered on the phone handset numeral buttons. These responses would then be analyzed by the patient’s oncology team provider, whether the oncologist him/herself or the oncology nurse. If responses appeared to indicate complications requiring face-to-face consultation or that intervention such as a change in medications or dosages were needed, such action(s) could be affected immediately rather than having to wait for a consultation appointment.

Getting back to Brian, his visit with his oncologist resulted in the needed change of medication to ease his pain and discomfort but, more importantly, his physician introduced him to the “Health Buddy” system. Brian was soon provided the device to use at home and his stress level, hence other health issues, improved immensely.

The subject of Telemedicine and Telehealth has progressed far beyond this technology since then. It is destined to see increased efficiency, collaboration between facilities in not only cancer care but all other branches of medicine and home health care and accelerated research on a multitude of diseases and genetic conditions.

Thanks to the VA’s decision to pursue this technology, telemedicine has already helped veterans from all walks of life gain more immediate care for their medical conditions. From telephone consultations to web based teleconferencing “doctor visits”, Telemedicine has proven its worth to the health care issues of the day.

 *Not his real name.
**Sources consulted did not provide exact dates.
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Jon Bon Jovi, VA and Project REACH

(On this Memorial Day, 2013: God Bless Those Who Gave Much and the Families of Those Who Gave All…Heroes, Every One)

Catch your attention? Hope so!

So, what do Jon Bon Jovi, the VA (Veterans Administration) and also HUD (Housing and Urban Development) have in common… and just what is Project REACH?

Jon Bon Jovi, HUD and Health and Human Services collaborated with the VA Center for Innovation when it sponsored a mobile application competition called, you guessed it: “Project REACH”. The competition was created in March, 2012 to help those veterans, as well as others, who have found themselves in a homeless situation and in need of services available to them through various organizations via mobile and information technology.

The challenge to the community of software developers was to develop a way for our homeless vets to have access to assistance through local resources in order to get the support and physical care they need. The five finalists of the competition, selected in June of 2012, were allotted a certain amount of time to perfect their applications and last month, April 2013, the winner was announced.

“Qbase”, which is based in Reston, Virginia, won the $25,000 prize for the app, “Homeless REACH”, (Real-time Electronic Access for Caregivers and Homeless) which is a great tool for caregivers, social and other workers who are helping homeless veterans, according to Eric Shinseki, Secretary of Veterans Affairs in Washington.

reachLogo

The app will be able to access Veterans Administration open data, as well as open data from other agencies, both government and private, strictly for locating resources for the homeless anywhere in the country.

To quote Secretary of Housing and Urban Development, Shaun Donovan, “We’ve come to rely on smart phones and tablets to access information and now we can apply this same technology to help people find a place to sleep or direct them to medical and other vital services.” (1)

Veterans Administration Medical Centers all over the country have been using telemedicine and telehealth technology in greater or lesser degrees for decades, starting with the simplest form of anytime teleconsultations with a charge nurse. More recently, remote monitoring for certain conditions have been gaining attention as possible additions to the health care arsenal – again, in some locations more than others, depending on need and acceptance.

Imagine the benefits to be had by combining all medical care technologies together!

As for Jon Bon Jovi…I can certainly remember “back in the day” when I used to love to sit and listen to that band’s music. To know that he has combined forces with the VA, HUD and HHS to assist Project REACH attain its goals though…

                             Well now. Wow.

Just. Wow.

In Loving Memory of All Our Military From All Wars Who Made the Ultimate Sacrifice. We Thank You.

In Loving Memory of All Our Military From All Wars Who Made the Ultimate Sacrifice. We Thank You.


Reference(s) and Citation(s):

U.S. Department of Veterans' Affairs. (April 15, 2013). VA, HUD and 
Jon Bon Jovi Announce “Project REACH” Grand Prize Winner. In Office 
of Public and Intergovernmental Affairs. Retrieved May 25, 2013, 
from http://www.va.gov/opa/pressrel/pressrelease.cfm?id=2434.