Trump Touts New VA Telehealth Service

Ken Terry

August 04, 2017

President Trump today announced that the Department of Veterans Affairs (VA) will soon roll out a new virtual visit service called VA Video Connect along with a new smartphone app for appointment scheduling. VA Video Connect will allow any VA physician to conduct a telehealth visit with any veteran anywhere in the country, either on a mobile device or on a computer.

President Donald Trump listens to a presentation by VA Secretary David Shulkin, MD, yesterday during a VA telehealth event. Evan Vucci/AP

"This will significantly expand access to care to our veterans, especially for those who need help in the area of mental health, which is a bigger and bigger request, and also in suicide prevention," Trump said in a press conference at VA headquarters. "It will make a tremendous difference for the veterans in rural locations in particular."

VA Video Connect is already being used by more than 300 providers at 67 hospitals and clinics across the country, noted Secretary of Veterans Affairs David Shulkin, MD.

"We're removing geography as a barrier so that we can speed access to veterans and honor our commitment to them," he said. "That means we'll be able to use VA providers in cities where there are a lot of doctors, and be able to use those doctors to help our veterans in rural areas where there aren't many healthcare professionals."

Dr Shulkin noted that the VA has long been a leader in telehealth and that its telehealth program is the largest in the country. Last year, he said, 700,000 veterans used telehealth services, which are now available for more than 50 medical and dental specialties.

Although President Trump and Dr Shulkin talked about the great strides that the VA had made in the past 6 months, VA Video Connect has been in development for well over a year. In the past, video telehealth technology has been typically used to link a patient at a VA clinic with a provider in a VA medical center at a different location. VA Video Connect is designed to provide fast, easy access to care from a veteran's smartphone, tablet, or computer. Moreover, it allows the patient to seek care from wherever they happen to be.

State vs Federal Telehealth Laws

Dr Shulkin noted that a new federal regulation was required to allow VA doctors to treat patients remotely across state lines. "By working with the Office of American Innovation and the Department of Justice," he said, "we're going to be issuing a regulation that allows our VA providers to provide telehealth services from anywhere in the country to veterans anywhere in the country, whether it's in the home or any location."

The Office of American Innovation is led by Jared Kushner, the President's son-in-law. Its purpose is to encourage technological innovation and to infuse the best tech ideas into the government.

Allowing physicians to conduct telehealth encounters with patients in states where they are not licensed, however, runs counter to medical licensing laws in every state. The Interstate Medical Licensure Compact — which now includes 22 states — was devised to help doctors get licenses in multiple states, partly for the purpose of telehealth, but through the compact, states retain the authority to license and regulate physicians.

The Federation of State Medical Boards (FSMB), which spearheaded the compact, was circumspect in its response to yesterday's announcement. "The FSMB values the important work being done to improve the quality and delivery of healthcare to our nation's veterans," said Humayun Chaudhry, DO, president and CEO of FSMB, in a statement. "We look forward to reviewing the proposed regulation once issued by the VA, in consultation with our member state medical boards."

The American Telemedicine Association (ATA), which has fought for doctors to be allowed to conduct virtual visits anywhere in the country, also had little to say about this announcement. "VA has been a federal, and national, leader in the use of telehealth and advancing its clinical applications," Gary Capistrant, ATA's senior director of public policy, told Medscape Medical News. "Dr Shulkin has been a strong supporter [of telehealth] specifically and will be the keynote speaker for our fall meeting."

The VA's new scheduling app is already available in all 18 VA regions, and veterans have used it to book more than 4000 appointments, Dr Shulkin said. Now it is being rolled out nationally. Veterans can download the app at mobile.va.gov/appstore.

Dr Shulkin also showed a trunk filled with diagnostic equipment and a notebook computer, which he called "the doctor bag of the future." Noting that this is the same setup that travels with President Trump on Air Force One, he said, "We can now bring this doctor's bag into the homes of our veterans. Our nurse practitioners and our technicians are able to use this type of technology."

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