VA Secretaries may come and go (or never get there), but their initiatives stay. With much fanfare last year, then-Secretary David Shulkin announced the ‘Anywhere to Anywhere’ telehealth and telemedicine program [TTA 3 Aug]. This program will use VA practitioners to provide virtual patient care across state lines when a veteran cannot make it to a VA hospital or clinic. The Department of Veterans Affairs published the proposed rule last October [TTA 3 Oct 17] with the Final Rule published in the Federal Register on 11 May.
Technically, it preempts state and local regulations around telehealth. “VA is exercising Federal preemption of conflicting State laws relating to the practice of healthcare providers; laws, rules, regulations, or other requirements are preempted to the extent such State laws conflict with the ability of VA health care providers to engage in the practice of telehealth while acting within the scope of their VA employment.”
It was widely supported by ATA, the American Association of Family Physicians, American Medical Informatics Association, Federal Trade Commission, the College of Healthcare Information Management Executives (CHIME), and many other industry organizations. It also enjoys wide Congressional support.
There is plenty of room for growth. Only 1 percent of VA’s veterans used Home Telehealth, while 12 percent used other forms of telehealth. They will be doing so with few suppliers: Medtronic, 1Vision/AMC Health, and Care Innovations. Iron Bow/Vivify Health was found to not have tablets which met the US production qualification. This Editor wonders how the current three suppliers will fare.
This telehealth program will be located in the apparently newly named Veterans Health Administration Office of Connected Care. mHealthIntelligence.com
Breaking News, Updated The Department of Veterans Affairs (VA) on 1 Feb issued over $1 billion in awards to four companies to provide Home Telehealth vital signs monitoring technologies to veterans in home care and monitoring. The four companies are Medtronic, Care Innovations, Iron Bow Technologies, and 1Vision LLC. The $1 billion is split evenly between the four ($258 million for each company over the five-year duration). The contracts are for an initial year (31 Jan 2018 end date listed on GovTribe.com), renewable annually for five years total. The bid process started in 2015 and the award had originally been scheduled for early-to-mid 2016.
On the suppliers:
- Medtronic is the incumbent as a supplier since 2011, dating back to Cardiocom’s 2011 award for its home monitoring units (Cardiocom was acquired in August 2013). Medtronic is a Dublin, Ireland HQ’d company with a US headquarters in Minnesota.
- Care Innovations is well known to our Readers as the developer of Health Harmony and the acquirer of the QuietCare telecare/behavioral monitoring used in senior housing. Their parent is Intel.
- Iron Bow Technologies is a supplier to VA in other healthcare areas (telemedicine and store-and-forward) and is a large, privately held IT company with multiple Federal contracts and deep Federal contractor roots. Their revenue has been reported at over $462 million (Washington Technology Top 100 2016).
- 1Vision LLC is a new company formed as a joint venture between HMS Technologies, Inc. and MBL Technologies, Inc. Neither are previously engaged as home telehealth providers, but both are Federal contractors. According to their individual websites, HMS is an IT systems integrator and MBL is engaged primarily in cybersecurity.
The question for this Editor is how Iron Bow and 1Vision, which are not telehealth (vital signs) monitoring companies but telemedicine and IT service providers respectively, will execute Home Telehealth with the VA. Have they partnered with yet-to-be disclosed providers in providing home telehealth services to the VA? (Watch this space)
While the award is the largest in US telehealth, the VA is, by this Editor’s experience in her last position with Viterion Corporation, extremely demanding on its service providers and will be even more so in the future. The future reasons are clear: 1) President Trump has put a Klieg light on the VA and 2) he’s named a new VA secretary, Dr David Shulkin, who is currently VA Undersecretary for Health (confirmation hearing notes courtesy of POLITICO, nomination approved by the Senate committee Tuesday, and easily confirmed Monday night 13 Feb), who has been highly engaged with HIT issues, including both the VistA EHR modernization/replacement and initiatives such as the recently unveiled Digital Health Platform [TTA 12 Jan]. (more…)
Further to our report in October on the introduction of the Veterans E-Health & Telemedicine [grow_thumb image=”http://telecareaware.com/wp-content/uploads/2015/10/Dept-of-VA-logo.jpg” thumb_width=”150″ /]Support Act (“Veterans eHealth & Telemedicine”, 10 October 2015), Sen. Joni Ernst’s website reports that Sen. Ernst was the first witness to testify in front of the Senate Veterans Affairs Committee on Wednesday (19 November 2015) about the proposed legislation.
“The VA has been practicing telemedicine since 2001, and they are largely cited as leaders and innovators in the field. Their efforts in telemedicine have saved money and veterans’ time by eliminating often an hour or more long drives to the VA, and reducing bed days at the VA” Ernst is reported to have said.
“For example: According to the VA, in Fiscal Year 2014, telehealth reduced bed days of care by 54%, reduced hospital admissions by 32%, and saved $34 in travel savings per consultation. (more…)
[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/07/Big-T-thumb-480×294-55535.gif” thumb_width=”150″ /]Tunstall
has been quiet on the newsfront lately, so these two items from Australia and the US are to be noted. In Australia, the Department of Veterans Affairs (DVA) rehabilitation appliances program (RAP), which provides subsidized personal response systems to veterans, now includes Tunstall’s PERS, iVi fall detector pendant, PIR movement sensor and GPS watch. The program requires that veterans be evaluated for need by a qualified health provider. Tunstall has participated in the RAP program since 2002. Pulse+IT (Australasia)
In the US, a significant part of Tunstall’s purchase of AMAC were medical answering service operations in Long Island City, NY, Pawtucket, RI, and Newington, CT. A $10 million upgrade of their 24/7 service includes CRM for healthcare providers for after-hours, overflow support, appointment reminders, insurance verification and help desk services. Release
The US Department of Veterans Affairs (VA) has some good news (for a change)–that during the just-closed Federal FY 2014, 690,000 veterans, or 12 percent, used telehealth services. This was a 13.3 percent increase over FY 2013 (608,900). While this report is preliminary (beware!), we see a slowing of growth in the number of veterans accessing telehealth and a concentration–not dispersal–of telehealth services in rural areas (+ 10 points). This chart compares the numbers:
[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/10/VA-2014-vs-2013.jpg” thumb_width=”350″ /]
Chart: EIC Donna. Please note that percentage of telehealth users add up to over 100 percent due to usage (one patient could access two or three forms of telehealth. FY14 telehealth user breakout is estimate based on FY13 percentage, to be eventually compared to official figures.)
Telehealth as defined by VA: (more…)
The King’s Fund has posted video highlights from last month’s International Digital Health and Care Congress. Talks include those from futurist Ray Hammond, Kathleen Hammond (US Department of Veterans Affairs), Dr Ali Parsa (Babylon), Paul Rice (NHS England) and Sian Jones (NHS Bristol). Click on the tabs at top for presentation decks and posters. TTA was a media partner of the Congress. Hat tip to Mike Clark via Twitter (@clarkmike).