Describe how the organization responded to those issues with technology and leadership in terms of successes, failures, or unforeseen results.

Case Studies in Telehealth Adoption

The mission of The Commonwealth Fund is to promote a high performance health care system. The Fund carries out this mandate by supporting independent research on health care issues and making grants to improve health care practice and policy. Support for this research was provided by The Commonwealth Fund. The views presented here are those of the author and not necessarily those of The Commonwealth Fund or its directors, officers, or staff.

For more information about this study, please contact:

Andrew Broderick, M.A., M.B.A. Codirector, Center for Innovation and Technology in Public Health Public Health Institute abroderick@phi.org

The Veterans Health Administration: Taking Home Telehealth Services to Scale Nationally

Andrew Broderick

ABSTRACT: Since the 1990s, the Veterans Health Administration (VHA) has used infor- mation and communications technologies to provide high-quality, coordinated, and com- prehensive primary and specialist care services to its veteran population. Within the VHA, the Office of Telehealth Services offers veterans a program called Care Coordination/ Home Telehealth (CCHT) to provide routine noninstitutional care and targeted care man- agement and case management services to veterans with diabetes, congestive heart fail- ure, hypertension, post-traumatic stress disorder, and other conditions. The program uses remote monitoring devices in veterans’ homes to communicate health status and to cap- ture and transmit biometric data that are monitored remotely by care coordinators. CCHT has shown promising results: fewer bed days of care, reduced hospital admissions, and high rates of patient satisfaction. This issue brief highlights factors critical to the VHA’s success—like the organization’s leadership, culture, and existing information technology infrastructure—as well as opportunities and challenges.

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OVERVIEW Since the 1990s, information and communications technologies—including tele- health—have been at the core of the Veterans Health Administration’s (VHA’s) successful system-level transformation toward providing continuous, coordinated, and comprehensive primary and specialist care services. The VHA’s leadership and culture; underlying health information technology infrastructure; and strong commitment to standardized work processes, policies, and training have all con- tributed to the home telehealth program’s success in meeting the chronic care needs of a population of aging veterans and reducing their use of institutional care and its associated costs. The home teleheath model also encourages patient activation, self-management, and helps in the early detection of complications.

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Commonwealth Fund pub. 1657 Vol. 4