VA Will Use Telemedicine to Train Primary Care Docs

July 14, 2012
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I’m always looking for signs that we are putting the necessary infrastructure in place to make quality healthcare more accessible.

Case in point, the Department of Veteran Affairs plan to test the idea of using telemedicine to train rural primary care providers in 14 specialties. The name of the pilot is SCAN-ECHO, which stands for Specialty Care Access Network-Extension for Community Healthcare Outcomes.

I’m always looking for signs that we are putting the necessary infrastructure in place to make quality healthcare more accessible.

Case in point, the Department of Veteran Affairs plan to test the idea of using telemedicine to train rural primary care providers in 14 specialties. The name of the pilot is SCAN-ECHO, which stands for Specialty Care Access Network-Extension for Community Healthcare Outcomes.

Over the next three years, a panel of medical experts will conduct 90-minute weekly training sessions via videoconference. This won’t be just one-way communication because the primary care physicians will give the specialists specific cases which they want the specialists to analyze and suggest solutions.  The test will involve 11 VA sites across the country.

What the VA hopes to accomplish is to get specialty care to our valued veterans without having them drive long distances to the distant VA medical centers or participating academic medical centers (Harvard University, University of Utah, University of Nebraska and the University of South Florida). Plus the VA hopes to leverage this corps of specialists in taking care of more patients in close collaboration with the patients’ primary care physicians.

Dr. Sanjeev Arora came up with the concept of Project Echo in New Mexico. On a regular basis, the New Mexico program holds virtual “clinics” for rural communities and prisons.  A study published in the New England Journal of Medicine last year showed how Project ECHO managed to achieve comparable outcomes treating hepatitis C as those at the medical center in Albuquerque.  Charles Caleb Colton would be proud, because he was the first to say “imitation is the sincerest form of flattery.”  The University of Washington was the first to replicate the model which is now being deployed in a five-state region: Washington, Wyoming, Alaska, Montana and Idaho.  The University of Chicago has also jumped on board.  Ireland and Northern Ireland may soon join Brazil and India with ECHO programs

The pilot will cost the VA (and us taxpayers) $15 million over three years, a relative drop in the bucket for a program that could eventually be used throughout the VA system.  The return on that money could be huge balanced against veterans’ transportation and lodging costs. The VA is managing to do this so inexpensively because most of their clinics and medical centers began the largest telemedicine rollout in history in 2009.  Over the past three years, the VA has purchased nearly 2,000 GlobalMed solutions in what is truly a telemedicine success story.  The savings resulting from veterans seeing their physicians telemedically was so cost-effective that the VA stopped charging co-pays for the virtual visits earlier this year.  In fact, one Veterans Integrated Service Network reported it saved $742,000 in 2011, thanks to telemedicine.

More success can only lead to more imitation which will be good news to the thousands of primary care doctors in rural communities around the country who don’t yet have the support of an ECHO program.