Hostname: page-component-848d4c4894-5nwft Total loading time: 0 Render date: 2024-06-07T08:51:02.160Z Has data issue: false hasContentIssue false

Use of Telehealth to Improve Access to Care at the United States Department of Veterans Affairs During the 2017 Atlantic Hurricane Season

Published online by Cambridge University Press:  13 April 2020

Claudia Der-Martirosian*
Affiliation:
Veterans Emergency Management Evaluation Center (VEMEC), U.S. Department of Veterans Affairs, North Hills, California
Karen Chu
Affiliation:
Veterans Emergency Management Evaluation Center (VEMEC), U.S. Department of Veterans Affairs, North Hills, California
Aram Dobalian
Affiliation:
Veterans Emergency Management Evaluation Center (VEMEC), U.S. Department of Veterans Affairs, North Hills, California Division of Health Systems Management and Policy, University of Memphis School of Public Health, Memphis, Tennessee
*
Correspondence and reprint requests to Claudia Der-Martirosian, Veterans Emergency Management Evaluation Center (VEMEC), 16111 Plummer Street MS-152, North Hills, CA 91343; (e-mail: claudia.der-martirosian@va.gov).

Abstract

Objectives:

This brief report examines the shift from in-person care to US Department of Veterans Affairs (VA) telehealth services during 3 devastating hurricanes in 2017 (Harvey, Irma, and Maria).

Methods:

VA administrative data were used to analyze the number and percentage of telehealth services 30 d pre- and 30 d post- the 2017 hurricanes for 3 hurricane-impacted VA medical centers (VAMCs): Houston (Texas), Orlando (Florida), and San Juan (Puerto Rico).

Results:

All 3 VAMCs remained open during the hurricanes. For the Houston VAMC, during the first week post-Harvey, in-person patient visits decreased while telehealth visits increased substantially. Similarly, for the Orlando VAMC, during the 1-wk post-Irma, telehealth use increased substantially. For the San Juan VAMC, there were many interruptions in the use of telehealth due to many power outages, resulting in a modest increase in the use of telehealth post-Irma/Maria. The most commonly used telehealth services at Houston and Orlando VAMCs during the hurricanes were: primary care, triage, mental health, and home health.

Conclusions:

Telehealth has the potential to improve post-disaster access to and coordination of care. However, more information is needed to better understand how telehealth services can be used as a post-disaster health-care delivery tool, particularly for patients receiving care outside of systems such as VA.

Type
Brief Report
Copyright
© 2020 Society for Disaster Medicine and Public Health, Inc.

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

US Department of Veterans Affairs. VA Telehealth Services. https://www.telehealth.va.gov. Accessed July 9, 2019.Google Scholar
US Department of Veterans Affairs. VA Telehealth. https://www.va.gov/COMMUNITYCARE/docs/news/VA_Telehealth_Services.pdf. Accessed July 9, 2019.Google Scholar
US Department of Veterans Affairs. Health Services Research & Development. www.hsrd.research.va.gov/news/feature/telehealth2016.cfm. Accessed July 9, 2019.Google Scholar
Agha, Z, Lofgren, RP, VanRuiswyk, JV, et al. Are patients at Veterans Affairs Medical Centers sicker? A comparative analysis of health status and medical resource use. Arch Intern Med. 2000;160(21):3252-3257.CrossRefGoogle Scholar
Nelson, KM, Starkebaum, GA, Reiber, GE. Veterans using and uninsured Veterans not using Veterans Affairs (VA) health care. Public Health Rep. 2007;122(1):93-100.CrossRefGoogle Scholar
Randall, M, Kilpatrick, KE, Pendergast, JF, et al. Differences in patient characteristics between Veterans Administration and community hospitals. Implications for VA planning. Med Care. 1987;25(11):1099-1104.CrossRefGoogle ScholarPubMed
Xiong, W, Bair, A, Sandrock, C, et al. Implementing telemedicine in medical emergency response: concept of operation for a regional telemedicine hub. J Med Syst. 2012;36(3):1651-1660.CrossRefGoogle ScholarPubMed
Schultz, JH, Brooks, E, et al. A medical disaster response to reduce immediate mortality after an earthquake. N Engl J Med. 1996;224:438-444.CrossRefGoogle Scholar
Vo, AH, Brooks, GB, Bourdeau, M, et al. University of Texas medical telemedicine disaster response and recovery: lessons learned from Hurricane Ike. Telemed J E Health. 2010;16(5):627-633.CrossRefGoogle ScholarPubMed
Kim, TJ, Arrieta, MI, Eastburn, SL, et al. Post-disaster Gulf Coast recovery using telehealth. Telemed J E Health. 2013;19(3):201-201.CrossRefGoogle ScholarPubMed
Latifi, R, Tilley, EH. Telemedicine for disaster management: can it transform chaos into an organized, structured care from the distancer? Am J Disaster Med. 2014;9(1):25-37.CrossRefGoogle Scholar
Der-Martirosian, C, Griffin, AR, Chu, K, et al. Telehealth at the U.S. Department of Veterans Affairs after Hurricane Sandy. J Telemed Telecare. 2019;25(5):310-317.CrossRefGoogle ScholarPubMed
Office of the Texas Governor. Governor Abbott adds 7 Texas counties to presidential disaster declaration in response to Harvey. https://gov.texas.gov/news/post/governorabbott-adds-7-texas-counties-topresidential-disaster-declaration. Accessed July 9, 2019.Google Scholar
US Department of Veterans Affairs. About the Michael E. DeBakey VA Medical Center - Houston, Texas. https://www.houston.va.gov/about/index.asp. Accessed July 9, 2019.Google Scholar
2017 hurricane season FEMA after-action report. https://www.fema.gov/media-library-data/1531743865541-d16794d43d3082544435e1471da07880/2017FEMAHurricaneAAR.pdf. Published July 12, 2918. Accessed June 17, 2020.Google Scholar
US Department of Veterans Affairs. Orlando VA Healthcare System. https://www.orlando.va.gov/about/index.asp. Accessed May 22, 2020.Google Scholar
Zolnikov, TR. Humanitarian crisis: lessons learned from Hurricane Irma. Am J Public Health. 2018;108:27-28.CrossRefGoogle ScholarPubMed
US Department of Veterans Affairs. VA Caribbean Healthcare System. https://www.caribbean.va.gov/about/index.asp. Accessed May 22, 2020.Google Scholar
Sailors, RM, Duke, JH, Walls, JA, et al. Dreams. (Disaster Relief and Emergency Medical Services) and digital EMS. Proc AMIA Symp. 2000:1127.Google Scholar
Brown, SW, Griswold, WG, Demehak, B, et al. Middleware for reliable mobile medical workflow support in disaster settings. AMIA Annu Symp Proc. 2006:309-313.Google ScholarPubMed
Chipara, O, Plymoth, AN, Liu, F, et al. Achieving reliable communication in dynamic emergency responses. AMIA Annu Symp Proc. 2011:238-247.Google ScholarPubMed
Graschew, G, Roelofs, TA, Rakowsky, S, et al. Interactive video communication and medical telepresence and their role in trauma, emergencies, and disaster management. In: Latifi, R, ed. Telemedicine for Trauma, Emergencies and Disaster Management. Norwood, MA: Artech House Publisher; 2010:89-108.Google Scholar
Doarn, CR, Merrell, RC. Telemedicine and e-Health in disaster response (Editorial). Telemed J E Health. 2014;20(7):605-606.CrossRefGoogle Scholar
Alverson, DC, Edison, K, Flournoy, L, et al. Telehealth tools for public health, emergency, or disaster preparedness and response: a summary report. Telemed J E Health. 2010;16(1):112-114.CrossRefGoogle ScholarPubMed
Jury, SC, Kornberg, AJ. Integrating telehealth in to ‘business as usual’: is it really possible? J Telemed Telecare. 2016;22(8):499-503.CrossRefGoogle ScholarPubMed