Veterans Health Care: DoD and VA pursue PCMH model

The concept of a “medical home” puts the new approach in perspective. Proponents believe that by giving the patient a portal to access his or her medical records and the ability to see tests results in real-time, schedule visits and ask questions of the medical team electronically, the PCMH will go a long way toward making the patient an active participant in his or her healthcare, rather than a passive observer.

But the idea has another side, too: It’s where the medical providers live. It becomes a central location, whether physical or digital, with the primary care physician as captain of the ship and a crew that can include physician specialists, nurse practitioners, nurses, pharmacists, nutritionists and social workers coordinated to deliver not just better medical care but to change the course of healthcare from sick care to preventative care.

A team approach to healthcare has been proven to significantly reduce emergency room visits and hospital readmissions, which usually occur when there are gaps in care or a breakdown of communications, Grundy said.

The DoD and VA mission is to eliminate those holes.

What lies ahead? According to Grundy, the goal will be the use of even more sophisticated technologies like predictive analytics, which analyze and interpret patient data to catch negative health outcomes before they occur. IBM’s Watson, the Big Blue computer that beat human competitors in Jeopardy, is targeting healthcare in its ultimate deployment as just such a predictive analytics tool, Grundy said.

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Veterans Health Care: Teleheatlh - Health-care communication, telemedicine empowers patients

"The advantage of telemedicine is that it allows the veteran, or civilian for that matter, to access care in their location," said Nick Ross, assistant director of outpatient clinics and planning at the VA of North Florida and South Georgia.

Patients with chronic diseases such as diabetes can now use a device to send medical data to the doctor's office from their homes. Then doctors can provide targeted advice over the telephone when necessary.

No more drives to the doctor's office or long waits in the waiting room.

Doctors can monitor patients remotely to detect changes in their vital signs and send messages to patients through the interactive television sets.

The 64-year-old veteran said being in a different room than the doctor has helped him speak candidly about disturbing memories.

"I used to have to patch the guys up when they got shot and get them in the helicopter immediately, and it was a lot of things you want to forget," he said. "This new videoconferencing, it's a way to release … it's a person, but you don't have to worry about being in the same room with them. It's a lot easier to say what you want to say."

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Veterans Heatlh Care: Teleheatlh - VA assists rural Vets with Telehealth clinics

"Not everyone has a cardiologist nearby," she added. "With Telehealth, they do."

"With Telehealth, our Veterans can connect with VA specialists in mental health, cardiology, dermatology, gastroenterology, rheumatology and urology," Ryan said. "This is important, because a large percentage of our rural Veterans are advancing in age. They have chronic health conditions that require constant monitoring. If it wasn't for Telehealth, we'd be hard pressed to deliver the kind of day-to-day observation they require.

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