Store-and-Forward Telehealth
You have probably heard the expression that a picture can save thousand words? In some areas of health care pictures can save thousands of clinic visits. Three areas of health care where this is becoming commonplace in VA are: radiology, dermatology and checking for the effects of diabetes on the retina in the back of the eye.
Care coordination involving store-and-forward telehealth technologies acquire and store clinical information (e.g. data, image, sound, video) that is then forwarded to (or retrieved by) another site for clinical evaluation. For many years, local and regional Store-and-Forward programs have been providing consultation to VHA sites in need of specialty expertise. VHA's first national Store-and-Forward program is a primary care-based model that will screen veterans with diabetes for retinopathy using teleretinal imaging that expedite referral for treatment and provide health information.
Teledermatology: Dermatology (skin) problems are common and often a source of discomfort and concern to patients. The diagnosis of a skin problem can often be made from a digital picture if it is sent to a skin specialist (dermatologist) to see. A report with recommendations for treatment can then be sent back to a patient's primary care, or other, physician. The recommendation may be for treatment in the form of a medication or may be a referral to a dermatology clinic for more detailed assessment. VA is using teledermatology to improve access to skin care for veteran patients who live in remote and other areas to save having to travel to a dermatology clinic. (more)
Teleretinal Imaging: Diabetes can cause problems with the blood vessels in the back of the eye (retina), especially if the diabetes is poorly controlled. A special camera is now available that can take pictures of the retina of the eye without needing to put drops in the eye to widen the pupil of the eye. The picture that is taken is then sent to an eye care specialist to review and a report is sent back to the patient's primary care physician who then follows-up if treatment to prevent blindness is required. This investigation does not replace a full eye exam and is not suitable for people who already have complications of diabetes but makes it does mean that those at risk of eye problems from diabetes can be assessed easily and conveniently in a local clinic. (more)
Teleradiology: X-ray images can be sent over telecommunications lines to be read by a radiologist (x-ray doctor) at another site. This makes it possible to get expert opinions, if they are needed and speed-up the process of getting x-ray reports. VA, like many other organizations, is now routinely using teleradiology in many hospitals in the routine delivery of care.
The ability to acquire, store and then forwards digital images for reporting is a crucial area of care coordination development within VHA. VA's computerized patient record called VistA has a component called VistA Imaging. VistA Imaging. VistA Imaging enables the communication of clinical images throughout VA. Using VistA Imaging VA is able to undertake.