Tender Alert: NHS England, London South Bank, Univ. of Leeds, NHS Digital, Halifax, Healthy New Towns

We have a specially wrapped and large present from Susanne Woodman, our Eye on Tenders. Some are high value, all have short deadlines, so read up!

  • NHS England: This is through the NHS South, Central and West Commissioning Support Unit and is for a Dynamic Purchasing System (DPS) for the procurement of online consultation systems. It is for a little over two years starting January 2018 and valued at £45 million. Closing is 29 December. Details at Gov.UK.
  • London South Bank University: This is for a Summative Assessment (Evaluation) of Simulation for Digital Health (SimDH). This would result in three reports to delivered electronically to be reviewed by the project team (LSBU) and project funders (GLA & ERDF). This is deadlined on Thursday 14 December, but an inquiry on this might invite further dialogue. Value is £13k. Gov.UK
  • University of Leeds: This is for an app specification and design, to engage participants in clinical trials, to thank and build relationships with these 600,000+ people in the UK. Again, an early close of 20 December, valued at £100k – £500k. Gov.UK
  • NHS Digital: The De-identification Project will implement a strategic approach to de-identifying data flowing into or out of NHS Digital or requiring linkage with NHS Digital data. Status is ‘open early engagement’ which means they are judging interest from potential suppliers. Another early closing of 18 December. Gov.UK
  • Borough of Calderdale, Halifax: Seeking provision of a community alarm and mobile response service; comprising of a community alarm – call monitoring centre, mobile response, and the installation of various pieces of assistive technology, carbon monoxide detectors and smoke detectors. The contract is for 36 months with extension up to 24 months. Value excluding VAT: £2,250, 000. Deadline is 10 January 2018. TED
  • NHS England–Healthy New Towns: This program is to support a vision of healthcare in a Healthy New Town. Responses should include: rationale for system transformation, key challenges and priorities for the healthcare sector, barriers to implementation and overcoming them, and the role of the Healthy New Towns programme in NHS England’s Five Year Forward View and Business Plan. This NHS England link may not work, so see attached PDF for requirements (thanks Susanne!). Deadline is 19 January 2018. Here’s more on it: 
    • As set out in the Specification of Requirements, the desired outcomes of the Healthy New Towns programme and the guidance are that: (A) Neighbourhoods, town and cities built in England after 2019 have:
      • populations with reduced levels of preventable disease;
      • communities with improved health and wellbeing; and
      • health and social care provision that is more effective and better for users
      (B) The guidance that this commission helps deliver has played a major role in achieving the above, because:
      • the guide and the process of developing it have built momentum and support; and
      • the guide collates good practice and shares it in a compelling, highly useable way.

      In a context of pressure on the NHS caused by preventable disease and changing demographics, how, in your role as New Care Models support partner for the Healthy New Towns programme, will you help us achieve these outcomes?

Babylon Health: correcting earlier NW London CCG report; other concerns raised by CQC report (updated)

Correcting and commenting on our earlier report. This Editor had earlier published on 11 Dec, as follow up to the extensive coverage on Babylon Health’s ‘GP at hand’ pilot activity in London, summarizing a report in Digital Health stating that the North West London Collaboration of Clinical Commissioning Groups (CCG) ended plans for expanding a test of the Babylon video consult/symptom checker app for GP practices in that area and that the app could be ‘manipulated’ to secure GP appointments faster and would not reduce demands on GPs. The original article was first corrected at an NHS England‘s representative’s request to reinforce that this was a local CCG project and that NHS England was not involved. The second request we received last Friday was from Babylon Health’s PR representative, Giles Kenningham, principal at Trafalgar Strategy. It was certainly strong and quoted here, edited as indicated to remove the link to the original article and Mr. Kenningham’s signature:

Your recent article on Babylon is factually wrong and misleading (link removed):
You claim the babylon app was dropped after being manipulated by patients. The term ‘manipualtion’ has been removed from the board papers and is wrong. Similarly the planned pilot had never begun so there so nothing to roll out.
This story is based on incorrect board papers which have now been corrected.

Please find a spokesman quote below. (closing signature removed)

A spokesperson for Babylon said:

“No pilot was ever carried out, nor any agreement signed with Babylon for such a pilot.

“Discussions were held after Babylon was selected in a competitive procurement exercise as the best technology to trial in GP practices across North West London. Subsequently, a decision was taken not to fund the pilot.”

This Editor then checked on the Digital Health article and found it had been removed without any follow-up or correction. Thus on Friday 8 Dec, this Editor removed the article, thanked Mr. Kenningham for bringing it to attention, and added that our report cited Digital Health as the source. I also requested a reference or third-party confirmation of his corrections. (This last request was not received as of the time of this writing.)

Wanting to get to the bottom of this for our Readers–and as a marketer who’s corrected more than a few inaccurate reports, your Editor has located the CCG’s report which is here published 22 November. It corresponds with Mr. Kenningham’s full note. The CCG report appears to have been revised (the URL indicates a v3), there never was a Babylon pilot, this version does not use the word ‘manipulation’, and the end result was that the CCG decided not to proceed to the pilot stage. In short, it appears to this Editor that the Digital Health report was based on an earlier and incorrect version of the report (perhaps as early as 25 Oct) and we are of course happy to correct. My fault and apology to our Readers and to Babylon in that I should have located the 22 Nov revised report prior to publishing the article and essentially provided a correction to Digital Health‘s report.

However, the CCG’s report on their Babylon evaluation contains two findings that were included in Digital Health‘s now-deleted article and give some pause. The CCG used focus groups of potential users, which surfaced that, in the CCG’s words, “The focus groups had also commented that there is a risk of some people gaming the symptom checker to achieve a GP appointment. The insights gathered therefore revealed that the symptom checker in particular was unlikely to reduce demand for GP services.”

Updated: Our Editor Chrys has pointed out the Pulse article which also comments on this and was corrected for the CCG’s revised report. The comments here by practicing GPs are worth reading. Scroll down and you’ll see that  ‘gaming the system’ has happened using direct triage in practices using personal phone consults–no app required. Can this even work?

Focus groups are highly subjective, but they are great ways of surfacing the flaws that developers and companies have gone blind to.

We hope that Babylon Health does take this feedback seriously. This Editor makes no secret of her advocacy of technology that can speed the obtaining of care, but based on her experience with early-stage companies, every critique, every hole kicked in a service, delivery, and logistics should be appreciated–and ruthlessly scrutinized for flaws that need solutions. This becomes harder to do when you’ve achieved Big Funding. Babylon is typically burning a hole through it (The Times, 1 Oct–hat tip to Chrys). The pressure on now to find The Road to Breakeven is stunning.

Speaking of finding solutions, Babylon should also note the findings of the Care Quality Commission (CQC), not to be confused with the CCG, in their report published on Friday 8 December. The CQC is the independent regulator of all health and social care services in England; the closest US equivalent would be the Joint Commission. The CQC uses a five-point evaluation measure (page 3) developed via staff, stakeholders, organizational documents, and sample medical records. Their extensive evaluation is published here.

In most aspects, it’s a highly favorable evaluation by the CQC, except in three care areas: prescribing decisions were not always made appropriately, that prescribing information wasn’t always shared with the patient’s GP to ensure safety, and there was no system in place to give assurance that patients’ conditions were being appropriately monitored. This means to the CQC that Babylon is not meeting Regulation 12 HSCA (RA) Regulations 2014 ‘Safe care and treatment’ in three aspects which are summarized on page 13 and detailed in the report.

What was distressing is that the HSJ (paid subscription only) reported that “Babylon Health Services has failed to stop the publication of a Care Quality Commission report that states it is not providing a safe service in some areas.” and that the CQC report was published after an injunction was lifted. It is one thing to differ with the findings, another thing to use legal action to stop a regulator’s report, but at this point we only have the HSJ article stating this. This Editor is standing by for further reports on this matter and Reader citations of further information. Hat tips to Roy Lilley, Editor Emeritus Steve Hards, and Editor Chrys.

CVS-Aetna: the canary says that DOJ likely to review merger–plus further analysis and developments

click to enlargeThe canary is still tweeting. News reports indicate that the US Department of Justice (DOJ) will be in the lead reviewing the CVS acquisition of Aetna. This should be no surprise to our Readers. This Editor’s first analysis noted regulatory necessity and earlier this week, more explicitly predicted either the Federal Trade Commission (FTC) or the DOJ would be reviewing.

The New York Post’s Beltway sources (for ex-US readers, it’s the mass market News Corp. paper/site) are talking up DOJ:

President Trump’s Department of Justice appears to be the agency that will review CVS Health’s $69 billion merger with Aetna, sources tell The Post. While the decision is not yet final, the move would not be good news for the merging parties, sources said. “I think they would prefer it to be at the Federal Trade Commission,” one Washington, DC, source said.

The article explains that it’s a tossup as to bailiwicks–FTC reviews retail and drugstore mergers, DOJ insurance mergers. A sound but (by CVS) unwelcome reason for DOJ to review the merger is their familiarity with Aetna after DOJ opposing its failed merger with Humana in Federal court less than a year in the past. Their expertise would be wasted and politically, a cup that FTC would wish to pass inasmuch they are also short on commissioners.

As the Third Century Greek philosopher Sextus Empiricus stated, ‘The mills of the gods grind slowly, but they grind small’ (or ‘exceeding fine’ in more modern citations), which means that justice, at least in the Federal definition, will be served eventually.

  • The Trump Administration has let DOJ question the AT&T/Time Warner merger on antitrust reasons up, down, and sideways, to the point where it is nearly derailed. Much the same can be expected here.
  • The businesses create a new type of healthcare system. Expect HHS to have a say.
  • Congress is already demanding hearings, which given the short time to Christmas break will likely be January. 
  • What may help Aetna’s cause is that the merger with Humana was a friendly one; the decision, at least in the press, was accepted with grace. 

But as wags have said for at least two centuries, you can always tell the pioneers by the arrows in their back. When you’re redesigning the Conestoga Wagons, it has to be expected–which is why the experts gathering here in NYC over the past week have had not much to say about it to date.

Certainly it has been a downer for investment pickers, though both companies had significant profitability challenges facing them in the future. We refer here to several articles in Seeking Alpha where it’s predicted that the acquisition will boost CVS’ growth, but saddle it with huge debt: $45B in new debt, $21B in new equity, plus using $4B in available cash. Are they overpaying? Will it reduce internal cost and boost profitability? Will it do what they say they’ll do, which is to bend the cost curve down by start-to-finish engagement with customers? What pieces are missing? And time is a critical factor–how long this will take to realize is not projected. If you like stock and value charts and graphs, here’s the place. Seeking Alpha (by author): Ciura, Arnold, Ward

Other retailers will have their say. We’ve noted earlier that the vast supermarkets like Publix, Wegmans, Shop Rite or Ahold (Stop & Shop, Giant) are likely looking at opportunities with logical alliances or buy-ins to insurers like Oscar, Clover, Bright Health, or the smaller Blues. Target is already allied with CVS for their in-store drugstores. And then there is retail/online giant Walmart. The Wal-Martians need plenty of healthcare and Humana, based on local Louisville-area reports, is in play after not merging with Aetna.

Looming over all this is Amazon. A little-noticed report in Becker’s from July indicated that their 1492 unit has set about extracting data from legacy EHRs and to build a telehealth platform on Amazon hardware such as Echo. Already noted has been their buying of pharmacy licenses in various states. None of which can make any of the usual healthcare suspects happy.

TTA’s week: CVS-Aetna’s implications, #MedMo17 report, Aussie Health Care Homes test

Is the CVS-Aetna merger heralding a new era, or an executional disaster in waiting? A lively #MedMo17 awards six startups. And Australia tries Health Care Homes for coordinated care.

Special to Alerts Readers: One free place at The King’s Fund Leeds meeting on 13 December. Last week! See offer below. And a reminder that you have one more week to 15 Dec to submit your project for the 2018 Digital Health Congress.


For our UK Readers: The King’s Fund has been kind enough to offer to our Readers one complimentary spot to their Wednesday 13 December ‘Sharing health and care records’ conference at the Horizon Leeds. If you would like to attend, email us by end of day Thursday 7 December at Extras@telecareaware.com with your name, title, and organization. Put in subject line of the email “KF-Leeds Ticket”. The winner will be chosen from best responses and notified by Friday 8 December.


Analysis of the CVS-Aetna merger: a new era, a canary in a mine–or both? (Are US healthcare execs in shock?)
#MedMo17: the conference, winning startups, Bayer, blockchain, and more (A lively conference report!)
Health Care Homes – treating chronic diseases in Australia (Coordinating care Down Under)

Does telemental care work?–the VA record. Secretary Shulkin moves forward on private care, Mayo’s Dr. Montori on care fitting into life. And HeyDoctor is Text 4 Doc.

OnePerspective: VA shows how technology can improve mental health care (Telemental health’s expansion chronicled in our new section)
VA’s Secretary Shulkin wants more private care options for veterans as part of reforms (Telehealth, private care coverage leading to better care)
Mayo Clinic’s Victor Montori MD calls for a ‘patient revolt’ for ‘careful and kind care’ (Expanding minimally disruptive medicine concept)
HeyDoctor! Come and get your diagnosis via text here! (Intriguing, but we see the downside)

Plenty of news before (US) Thanksgiving: NHS/Babylon Health’s London tests, Tunstall, Caribbean telemedicine. 

Rollout of second planned Babylon Health GP pilot for North West London scuttled (More unsettling news for Babylon’s model)
NHS, Public Health England testing multiple digital health devices for obesity, diabetes (Taking a year to do so with five suppliers)
NHS ‘GP at hand’ via Babylon Health tests in London–and generates controversy (Hits a GP brick wall)
Tunstall partners with voice AI in EU, home health in Canada, update on Ripple alerter in US (Changing their model, hopefully to profit)
A fistful of topical events (London Health Technology, NICE briefings, Planetary Health, RSM, DHACA, with a splash of Club Soda!)
Telemedicine comes to Saint Lucia–and the Caribbean (Seeking warmer climes doesn’t mean you leave telemedicine behind)

FDA’s approval of the first digital drug tracker. Reports on CES 2018, Aging 2.0. Looking forward to four conferences in NYC at end of November. Roundups on telehealth and companies. And Editor Charles cheerfully points out the difference between doers and advisors. 

Breaking: FDA approves the first drug with a digital ingestion tracking system (Proteus only took 16 years)
Telehealth roundups: Cuyahoga County (OH), BMJ systematic review, AAFP Forum (Telehealth results, PCP challenges)
Tender/Prior Information Alerts: North Yorkshire, North Ayrshire (Closing early 2018)
CES Unveiled’s preview of health tech at CES 2018 (5G, AI, VR, Extreme Tech, more)
BU CTE Center post-mortem presentation on Aaron Hernandez: stage 3 CTE (Can health tech even help?)
Some quick, cheerful updates from Welbeing, CarePredict, Tunstall, Tynetec, Hasbro, Fitbit
Themes and trends at Aging2.0 OPTIMIZE 2017 (Reinventing aging to thrive, not just survive)
A blogger’s lot is not a happy one (Editor Charles opines on the increasing disproportion between doers and advisers in the NHS) 


Having the ability to share health and care records digitally is essential to offering better, more co-ordinated care for local populations. But delivering the key benefits requires three things: the appropriate technology, the right governance structure and a culture of adoption. Learn about this at The King’s Fund’s 13 Dec full day conference at Horizon Leeds, where you will explore the different models that have been developed over the past few years and learn how local areas are overcoming these challenges. Click on the advert to register or here


Of continued interest….

Fall risk in older adults may be higher during warm weather–indoors (A counterintuitive surprise marks need for gait detection/analytics)
How does the NHS get funded and work? The King’s Fund pulls it together for you. (Graphics and video)
Public Health England: we’re hiring to expand digital initiatives (A hiring blitz of 9 openings, more to come)
A few short topical items: NHS Digital, DHACA, IET, more (Editor Charles’ update)

CareRooms: the perils of “Silicon Valley hype” when your customer is the NHS (Discretion is the better part of valor)
Tender Alert: advance notice for NHS England ACS-STP Innovation Framework (Another big part of this NHS initiative)
Will Japan’s hard lessons on an aging population include those with dementia? (Japan’s bellwether rings again)
CVS’ bid for Aetna–will it happen, and kick off a trend? (updated) (Where do payers, retailers go to expand?)


Have a job to fill? Seeking a position? Free listings available to match our Readers with the right opportunities. Email Editor Donna.


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Telehealth & Telecare Aware: covering the news on latest developments in telecare, telehealth, telemedicine and health tech, worldwide–thoughtfully and from the view of fellow professionals

Subscribe here to receive this Alert as an email on Wednesdays with occasional Weekend Updates. It’s free–and we don’t lend out or sell our list–no spam here!

Donna Cusano, Editor In Chief, donna.cusano@telecareaware.com, @deetelecare

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Analysis of the CVS-Aetna merger: a new era, a canary in a mine–or both?

click to enlargeThis Editor has been at two healthcare conferences in the last four business days (with tomorrow being a third). They should be abuzz about how the CVS-Aetna merger may transform healthcare delivery. To her surprise, there’s been a surprising lack of talk. There is a certain element of ‘old news’, as the initial reports date back five weeks but the sheer size of it ($240bn combined future value, $69bn purchase, an estimated $750 million in near-term synergies), being the largest health insurance deal in history, and the anticipated effects on the health delivery model normally would be a breaking news topic. To this Editor, it is a sign that no one truly knows what to make of it, and perhaps it’s too big–or threatening–to grasp for provider and payer executives especially.

For an overview of what we saw at the time as reasons why and possible competitor reaction, Readers should look back to our original article [TTA 28 Oct]. It’s being presented by both companies as a vertical merger of two complementary organizations, which already were moving towards this model, integrating their different services into “America’s front door to quality health care” (CVS CEO Larry Merlo)–a lower cost setting that saves premium dollars and brings integrated care to consumers’ doorsteps.

CVS brings to the table huge point of care assets: 9,700 pharmacy locations, 1,100 MinuteClinics, Omnicare’s senior pharmacy solutions, Coram’s infusion services, and the more than 4,000 CVS Health nursing professionals providing in-clinic and home-based care. Aetna has about 23.1 million medical members, 14.5 million dental members, and 15.2 million pharmacy benefit management (PBM) services members. Aetna also has a wealth of advanced data analytics capabilities through two subsidiaries, ActiveHealth Management and  Medicity’s health information exchange technology.

Seeking Alpha has an intriguing POV on this entry into a ‘new era’: that both CVS and Aetna consider this to be a long-term reshaping of their business model under the threat posed by Amazon, and are willing to do this despite little short-term financial benefit for either company. The problem as the writer sees it: execution. This is re-engineering care on a national scale, and its benefits are based upon combining intangibles, a murky area indeed especially in healthcare. Time is also a factor, as Amazon is getting pharmacy licenses in multiple states, and is rather an expert at combining intangibles.

Does it signal that the approach to a ‘new era’ in healthcare is accelerating? If this is a preview, 2018 will be extremely interesting. Our ‘canary in the coal mine’ may tweet–or fall over on its perch, asphyxiated.

Some additional points to consider: (more…)

#MedMo17: the conference, winning startups, Bayer, blockchain, and more

click to enlargeMedStartr Momentum‘s conference last week was extremely well attended, with 260 registrations over the two days at PricewaterhouseCooper’s NYC HQ. It jumped! (Disclaimers: your Editor is one of the hosts and co-organizers; TTA is a media partner) #MedMo17 had about 50-60 total speakers, presenters, and panelists in fast-moving sessions, most 10-15 minutes, with panels clocking under one hour.

What’s always unusual about MedStartr conferences is the mix of topics and people, and not just from NY. There were startups just getting going, successful startups sharing their stories, patient advocates, providers, and investors sharing what they want to see (and not see) before they fund. There was Deborah Estrin from Cornell Tech describing how they nurture graduate student tech entrepreneurs and Maria Gotsch from the Partnership Fund for NYC discussing how they accelerate, partner, pilot, and fund companies coming to market. One sponsor was nearby Newark NJIT’s NJ Innovation Institute–and one of the presenting companies was Uniphy Health (formerly PracticeUnite) that they’ve worked with and helped make successful over five years. Who would have expected a wild discussion about blockchain? Well, here, hosted by media personality/entrepreneur Ben Chodor (HealthTechTalk Live) with panelists ranging from a digital asset hedge fund founder to a patient advocate. For two panels, questions came from ‘the field’ via a Reddit ‘Ask Me Anything’.

Notably, Bayer G4A Generator, coordinated in the US by Aline Noizet, came on board as a sponsor. They came to the right place as they are seeking early-stage companies for Bayer Grants4Apps. In the US, they are seeking new companies developing self-care products: nutritionals/wellness, therapeutics (pain management, seasonal health), personal care (skin, sun, footcare), and self-care in general. Bayer also runs similar programs in Berlin (Accelerator and Dealmaker), Barcelona, Tokyo, Moscow, Singapore, Shanghai, and Italy.

Of the 18 Grand Challenge finalists competing for financing and guidance, the winners were: Population Health–Valisure (online pharmacy pre-screening meds); Wearables/Medical Devices–Alertgy (non-intrusive continuous blood glucose monitoring); Clinical Innovations–eCaring (at-home senior care monitoring), and in Killer Apps, a product that actually kills bad bacteria on the skin–Xycrobe (good recombinant bacteria for dermatological use). Special awards were given to Check with Ellie (breastfeeding questions answered, Momentum Award for growth) and MedAux (patient ed and HIPAA compliant messaging–Crowd Choice Award).

The full conference (Thursday and Friday) is up on video at Medstartr.tv. And in 2018, it will be 29-30 November, so put it in your calendar. Kudos to the MedStartr team, especially Alex Fair. Hat tip also to the NOLA (New Orleans) Health Innovation Challenge 

Health Care Homes – treating chronic diseases in Australia

The second tranche of the so called “Health Care Homes” (HCHs) trial started enrolling and providing services click to enlargeyesterday (1st December 2017) in Australia according to Australia’s Department of Health.

HCHs are existing General Practices (GPs) or Aboriginal Community Controlled Health Services providing a more systematic, coordinated care for people with chronic conditions such as diabetes, heart disease and respiratory problems. Patients who have been assessed as eligible can choose to enrol on the programme at a HCH and a care plan is then developed covering care to be received from their GP/ Aboriginal health worker and nurses at the GP practice as well as specialists and allied health workers.

Australia has seen a rise in chronic diseases with 50% of the population now having at least one chronic illness and 25% having at least two. The Australian Government believes that the GP led Primary Care system does not deal well with chronic diseases where patients often need services from multiple professionals working in different parts of the healthcare system. The HCH model is expected to reduce the confusion, delays and costs by using a team based coordinated delivery of care.

A key element of the HCH model is that the patient and all members of the care team (within the HCH and outside) have access to the care plan. A minimum requirement for software tools for creating and sharing the care plan have been defined and several companies have already produced software for this purpose. There has been some criticism of the way the software tools market has developed and the lack of independent guidance on choosing such software.

On the whole this trial is of interest not just to Australia but also to all other countries since chronic disease care is a key issue around the world. HCH model is considered consistent with the models used in the UK and New Zealand.

The stage one trial is due to run until November 2019 and has around 200 HCHs, of which the first tranche of 22 started in October 2017.

A brochure on the HCH produced by the Australian Dept of Health is available here.

OnePerspective: VA shows how technology can improve mental health care

Editor’s note: This inaugurates our new series of ‘OnePerspective’ articles. These are written by industry contributors on issues of importance to our Readers and are archived under ‘Perspectives’. For more information on contributing an article to our OnePerspective program, email Editor Donna.

click to enlargeBy: Gigi Sorenson

The shortage of mental health professionals in the U.S. is becoming more acute for two reasons: 1) more health professionals are encouraging their patients to seek treatment, and 2) more people now have health insurance due to the Affordable Care Act.  A December 2016 assessment showed that over 106 million Americans live in areas where there are not enough mental health providers to meet the need. Because of this provider shortage, as well as the stigma attached to behavioral health treatment, roughly half of mental illness cases go undiagnosed or unaddressed.

However, telehealth could fill much of this gap, and the beginnings of this trend are already evident. A growing number of psychiatrists and psychologists are using video and audio teleconferencing to treat patients remotely. Patients have access to this “telemental health” either in clinics and medical centers or, in some cases, through their Internet-connected personal devices. Studies of telemental health have found that it is effective for diagnosis and assessment in many care settings, that it improves access and outcomes, that it represents a portable, low-cost option, and that it is well-accepted by patients.

VA Program Sets the Pace

The Department of Veterans Affairs (VA) began to deploy telemental health in the early 2000s, and the VA now has the largest and most sophisticated such program in the U.S. In 2016, about 700,000 of American’s 22 million veterans used VA telehealth services. In 2013, 80,000 veterans used telemental health services, and over 650,000 veterans took advantage of those services in the previous decade.

The VA system has trained more than 4,000 mental health providers in evidence-based psychotherapies for post-traumatic stress disorder (PTSD) and other mental health conditions.  It has expanded the use of telemedicine at its 150 medical centers and its 800 outpatient clinics.  It is relying increasingly on telemental health to serve its beneficiaries, partly because nearly half of the veterans of Iraq and Afghanistan live in rural areas. Mental health professionals are often unavailable in these regions, and it can be difficult for these veterans to travel to metropolitan areas where VA clinics and medical centers are located.

Telemental health can address these issues.

(more…)