Indiana Providers, VA Eye 3 New Telehealth Programs for Veterans

Two Indiana institutions are working with the Department of Veterans Affairs to develop three new telehealth services for veterans in the state.

The Indiana University School of Medicine and the Regenstrief Institute are partnering with the VA’s Quality Enhance Research Initiative (QUERI) on a program to evaluate and launch connected health platforms for stroke (TeleNeurology), chronic pain (TelePain) and geriatric (TeleGRACE) care.

The three models of care are part of QUERI’s EXTEND (Expertise Through E-health Network Development) program, which is being funded by a $5.1 million federal grant. It’s one of 10 QUERI programs scattered across the country.

"The VA has been heavily investing and innovating the design and delivery of telehealth services over the past decade," Teresa Damush, PhD, a research scientist at the VA and the Regenstrief Institute, senior research professor of medicine at the IU School of Medicine and co-leader of the EXTEND QUERI, said in a press release.

"Our primary goal is to collaborate with our clinical stakeholders and utilize implementation strategies to facilitate the uptake and sustainment of telehealth services within three targeted contexts of VHA specialty care services to increase veteran access to high quality, evidence-based programs,” she said. “Second, we plan to evaluate best practices for optimal communications and shared care between telehealth, primary and specialty care services and veteran patients."

"The COVID-19 pandemic has led to a greater utilization of telehealth by providers in many health systems,” added Linda Williams, MD, a VA core investigator, co-leader of EXTEND QUERI, Regenstrief research scientist and IU School of Medicine neurology professor. “The VA has paved the way for clinical providers to practice across state lines to increase patient access to specialty care services like the national, virtual acute TeleStroke services for rural emergency departments.  We hope to build on that momentum, implementing programs that will maximize the potential of telehealth and allow the VA to provide more accessible care to more veterans."

The TeleNeurology program will focus on two separate tracks for stroke care and rehabilitation. One centers on standard virtual consults, while the other, called “Teleneurology to Local,” uses an eConsult telemedicine platform to train and support local primary care providers on initial consults.

The TelePain program targets the use of telehealth to help veterans manage chronic pain.

"We are building from these models to implement them nationally into the recently formed VHA telehealth hubs," Alan McGuire, PhD, a VA research scientist, associate research professor at IUPUI and leader of the TelePain project, said in the press release. "Chronic pain is a serious problem faced by many veterans. We hope the TelePain program makes pain treatment accessible to a greater number of patients served by the VA."

The TeleGRACE (Geriatric Resources for Assessment Care of Elders) program will focus on using telehealth to extend the reach of the GRACE program, a VA-based multidisciplinary care model using geriatricians, social workers, nurses and primary care providers to deliver care in the veteran’s home.

"These projects were identified by drawing upon our partners' shared agendas," project co-leader Dawn Bravata, MD, a Regenstrief research scientist, VA core investigator and a professor of clinical medicine at IU School of Medicine, said in the release. "We are excited to implement these evidence-based interventions in routine clinical care settings and hope to learn how to optimize them for the benefit of veterans and the providers who serve them."