VA Connected Health Evans and Sus… · Veteran Mobile Apps 2013 Field testing & Initial...

VA Connected Health Neil C. Evans, MD – Co-Director, Connected Health Veterans Health Administration

June 2015

VETERANS HEALTH ADMINISTRATION

VHA’s Current Priorities

• Access

• Veterans Experience

Connected Health Care

Homelessness

Mental Health Care

Standardization

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VETERANS HEALTH ADMINISTRATION

VA Connected Health

Connected Health Technologies Year Started Veterans Served in 2014

Virtual Care Modality Totals (Telehealth, Secure Messaging, SCAN-ECHO only)

1,831,221 (32% VHA patients)

Veteran Point of Service Kiosks 2010 >4M transactions

My HealtheVet 2003 ~2,900,000

Blue Button 2010 ~1,100,000

Secure Messaging 2008 1,093,327

Store & Forward Telehealth 2000 379,010

eConsults 2010 351,239

Clinical Video Telehealth 2002 248,774

Home Telehealth 2003 156,826

SCAN-ECHO 2011 1,429

Veteran Mobile Apps 2013 Field testing & Initial Release

Staff Mobile Apps 2013 Field testing 2

VA has been a leader in Virtual Access

In FY 2014

• Transactions:

– 1 million+ prescriptions refilled online per month

• Communications:

– 1 million patients using VA secure email with providers

• Expert Care: – More than 2 million Telehealth visits

• 150,000 patients case-managed by home telehealth (HT)

• 250,000 patients used clinical video telehealth (CVT) between VA clinics; 4,000+ received CVT visits directly into their homes

• 380,000 used store and forward telehealth (SFT) technology

– 350,000 eConsults

• Information Sharing:

– 1 million patients using Blue Button to download EHR data

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VETERANS HEALTH ADMINISTRATION

VA Connected Health

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VETERANS HEALTH ADMINISTRATION

VA Connected Health

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VETERANS HEALTH ADMINISTRATION

Healthcare’s Next Transition

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VETERANS HEALTH ADMINISTRATION

My HealtheVet: VA Personal Health Portal

• My HealtheVet has 10+ years of

award-winning and proven success – Transactions (example: Rx Refill)

– HealtheLiving Assessment (Calculate your health age)

– Secure Messaging (Secure e-mail exchange your health

care providers)

– Blue Button (Download and share your health data)

– Open Notes (View your own medical chart, including

progress notes)

As of September 30, 2014, nearly 45 percent of VA

patients have registered for My HealtheVet

142 million+ visits

3.1 million+ registered users

1.1 million+ opted-in to use

Secure Messaging 7

VETERANS HEALTH ADMINISTRATION

VA Mobile Health

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VETERANS HEALTH ADMINISTRATION

VA Launchpad – Mobile One-Stop Patient Entry

• Groups Apps with secure login • Access multiple Apps without individual login • Can access Apps without Launchpad

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VETERANS HEALTH ADMINISTRATION

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PTSD Coach Pain Coach Concussion Coach Mindfulness Coach Mood Coach Moving Forward Parenting2Go Care4Caregiver

ACT Coach CBT Insomnia Stay Quit Vet Change CPT Coach PE Coach Mission Health* VetLink*

*Peer-to-Peer Community

VETERANS HEALTH ADMINISTRATION

Appointment Scheduling/Request (VAR)

Prescription Refills Annie App FitHeart (Cardiac Rehab) GDx (Genetic Testing) Summary of Care Mobile Blue Button

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Secure Messaging Teledermatology MyVAHealth VA Moms (Maternity

Care) eKidney App Wellness Check MOVE! Coach Burn Pit Registry VA Launchpad

VETERANS HEALTH ADMINISTRATION

VA / NHS Partnership

- VHA and NHS England

3 year partnership

initiated in early 2013.

- A transatlantic

exchange to support

the adoption of digital

health between the US

VHA and England’s

NHS

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VETERANS HEALTH ADMINISTRATION

Text Messaging and Its Impact (cont.)

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VETERANS HEALTH ADMINISTRATION

0%

20%

40%

60%

80%

100%

18-29 30-49 50-64 65+ <30K 30-49K 50-75K

Age Annual Income Pew Research Internet Project

http://www.pewinternet.org/fact-sheets/mobile-technology-fact-sheet

U.S. Adults and Cell Phone Use (January 2014)

Smartphone Cell Phone

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Messaging Enabled Self-Care

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Background helping your patients to help themselves

2009

2009

2010

April 14th 16:21

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COPD, CHF, new hypertension, hypotension, diabetes type

1, retinopathy, medication compliance, diabetes type 2,

medication titration, orthopaedic, smoking cessation,

speech therapy, carers wellbeing, mental health

behaviour, long term hypertension, adult asthma, alcohol

support, weight management, early hospital discharge,

outpatient therapy, acute specialist follow up, long term

monitoring, anti-coagulation, oximetery review, asthma, depot injections, pregnancy, child asthma, pain management,

physiotherapy, palliative care, gestational diabetes, learning

disability, oncology, nephrology, rheumatology, asthma,

obstetrics, interstitial lung disease, dietetics, depression,

CKD, urology, obesity + many more

The exciting thing…. helping your patients to help themselves

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Background helping your patients to help themselves

2009

2009

2010

April 14th 16:21

2013

2015

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Annie, VA Text Messaging System Susan S. Woods, MD, MPH Connected Health, Veterans Health Administration

June 2015

VA’s Automated Text Messaging System

Annie G. Fox

Chief Nurse at Pearl Harbor, first woman to receive Purple Heart

How’s your blood pressure today? Thanks, Annie.

BP 120 78

Thanks, I’ve got it. Looks good. I’ll stay in touch.

Annie

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VETERANS HEALTH ADMINISTRATION

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Annie Success Factors

1. Team view - value supplementing care

2. Clinician communication - benefit, limitations

3. Ease of use – access, enrollment

4. Protocols – match to clinical need

5. Workflow (Team) – fit, message review

6. Workflow/Lifeflow (Patient) – fit, relevance

7. Messaging – content, tailoring, frequency, duration

8. Part of a menu of care?

9. Device?

VETERANS HEALTH ADMINISTRATION

Contact Information

Neil C. Evans, MD Co-Director, Connected Health Office Veterans Health Administration Neil.Evans@va.gov @neilcevans Susan S. Woods, MD, MPH Director, Patient Experience, Connected Health Office Veterans Health Administration Susan.Woods@va.gov @SueWoods

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