Telemedicine / E-visits Enable Physicians to Practice Anywhere, and Save Lives

The VA and its network is using a tool that is helping many patients who live in rural areas, and this practice idea could be applied by any medical practice that services rural areas with little access to health care professionals. The Veterans Administration Hospital is putting telemedicine to work, enabling health care professionals to reach out to those veterans who live in rural areas far from the VA network.

Other health care providers call this an e-visit. E-visits are now an allowed medical billing service when services follow the required regulations and use a HIPAA-compliant Internet connection.

In an article written by Quil Lawrence for NPR (5/29/2013), “For Ailing Vets in Rural Areas, Telemedicine can be the Cure,” he speaks of one particular individual who lives in White Mountain, Alaska. The nearest VA hospital is hundreds of miles away. The means to reach the VA is either by two plane rides, or one day by snowmobile or dog sled to Nome, Alaska.

E-visits are performed using a secure connection between the larger VA hospitals to multiple clinics across Alaska. At each clinic is a cart, with an older desktop computer that has multiple retractable cables. These cables can be connected to just about everything the doctor might carry in that “little black bag,” including the stethoscope, otoscope, a high-resolution camera, as well as an ultrasound.

One prime example given was an image taken of a lesion on one veteran's head. The image was immediately sent to the head of dermatology at the VA in Seattle, located thousands of miles away. Result: after a prompt biopsy was done, the lesion was diagnosed as melanoma. If the visit had been done the traditional route by the patient traveling to visit the doctor in person, it would have taken weeks.

Quick action like that can save lives — and lots of money on travel. The VA estimates it has saved more than 800,000 miles of travel that patients didn't have to make since the program was set up.

Veterans who are linking up to telemedicine appear to take better care of themselves. They are able to take their blood pressure, which is beamed, straight to the VA. It seems that the vets from both the Korean and Vietnam eras make up the largest group who are seeking care at this time as they are in the years when health complaints are more common.

Another good use of telemedicine is the video group therapy sessions that are available for veterans who suffer from post-traumatic stress disorder. It is private session and meets the needs of the individuals involved.

The VA stated that e-visits have saved not only miles of travel for veterans, it is saving both patients and physicians time and money, helping both sides. Most importantly, e-visits allow physicians to give immediate attention to lifesaving situations.

The examples in this story can be replicated in any rural area that has the required electronic setup. It can be called the electronic version of the doctor's home visit.

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