The Gateway

Telebehavioral health (TBH) has demonstrated to be a valuable tool in overcoming the terrain challenges in Afghanistan that severely limit in-person meetings between far-forward deployed Soldiers and behavioral health care providers. TBH is a low cost solution that increases a Soldier’s access to health care in the combat zone.

As of mid-September 2011, 47 far-forward sites in Afghanistan are operational with TBH, enabling health care providers to conduct more than 500 sessions with 200 patients.

The preliminary results of these sites are encouraging. Soldier satisfaction with the program is high and a majority of providers report that TBH encounters save them travel time and enhance their ability to provide timely care. Expansion of these sites is underway and will ultimately include a total of 81 sites.

While the audio and video quality is adequate for consultations, patient privacy remains a concern among Soldiers. The TBH program utilizes a hub and spoke concept, with a primary hub located at the behavioral health provider's area of operation and "spokes" located at far-forward sites. Presently, MC4 laptops with commercial software and a web-cam are being used on a secure Internet network for virtual face-to-face consultations.

By the end of November 2011, 81 sites throughout Afghanistan will be using MC4 hardware and COTS software to provide private, real-time audio and video via military networks. A recent pilot testing this new setup was well received by Soldiers, health care providers and commanders.

This has been an exciting year for telehealth and in particular telebehavioral health. TBH has become very successful in extending the clinical outreach of specialty providers to Soldiers in Afghanistan. Similar, smaller projects have been deployed to both Iraq and Kuwait, where they too have been well received by patients and medical staff.

Fielding the future telehealth suite could become part of every expeditionary medical experience. Deploying medical units with AHLTA-T will routinely provide safe, timely, early intervention from any geographic area.

Telehealth is a technology that stands ready to connect remote forward operating bases to deployed hospitals via military networks during future natural disasters or armed conflicts.

Col. Ron Poropatich, Deputy Director, Telemedicine and Advanced Technology Research Center, Fort Detrick, Md.