Page 9 CaseStudiesinTelehealthAdoptionTheVATakingHomeTelehealthServicestoScaleNationally

The VeTerAns heAlTh AdminisTrATion: TAking home TeleheAlTh serVices To scAle nATionAlly 9

role and with individuals encouraged to take on greater CONCLUSION
responsibility for their own health management. Because the Department of Veterans Affairs operates a
Adapting to continuous technological large integrated delivery system financed primarily by
change. The VHA is looking at new and emerging public money, drawing lessons from the VHA’s experi-
technologies, such a social media and mobile devices, ence may be easiest for other integrated delivery net-
to aid in delivering care remotely. There are profes- works or government-sponsored systems. The lessons
sional, ethical, technological, regulatory, legal, organi- of the VHA may be most applicable to the population
zational, and risk management issues that apply to how that most resemble veterans targeted for CCHT: dual-
these new technologies will be implemented, and the eligibles who tend to receive care services through a
VHA is addressing these. The VHA also has launched fee-for-service model. Telehealth-based care coordina-
numerous technology initiatives to transform itself tion and management will have an impact on the qual-
into a 21st century organization that is people-centric, ity of life and care, as well as costs associated with this
results-driven, and forward-looking. Through a new population. But implementation of programs will likely
program called the Innovation Initiative, the VA has need to be accompanied by the ability to reproduce the
committed to being on the cutting edge of health care VHA’s underlying systemness to comprehensively sup-
delivery and laying the foundation for safe, secure, and port the patient population.
authentic health record interoperability. By tapping into Organizations can learn from the VHA’s home
the talent and expertise of individuals both inside and telehealth experience on a number of levels. In particu-
outside the organization, the VA seeks to identify new, lar, by using the core principles that have guided the
innovative solutions that will increase veterans’ access implementation at scale: a recognized responsibility
to VHA services, improve the quality of services, for the care and case management of patients across
enhance the performance of VA operations, and reduce the continuum; a systematic approach to the introduc-
or control the cost of delivering those services that vet- tion of a quality performance improvement and man-
erans and their families receive. agement infrastructure; contracting with technology
vendors on a national scale; and implementation that is
driven at the local clinical level. In addition, the VHA
has a tremendous capacity for change that is instilled in
the organizational culture from the national leadership
and is embodied in all areas of practice.

how This cAse sTudy wAs conducTed

This case study was developed through interviews with staff from the VHA’s Care Coordination/Home Telehealth
(CCHT) program and an examination of peer-reviewed journals, articles, and websites of the Department of
Veterans Affairs. In particular, the authors would like to acknowledge Dr. Adam Darkins, who oversees the VHA’s
CCHT, and his staff.

The other organizations profiled in our Case Studies in Telehealth Adoption series are Partners HealthCare’s
Connected Cardiac Care Program and Centura Health’s Centura Health at Home program. To read them, along
with a synthesis of findings from all three case studies, visit our website at http://www.commonwealthfund.org/
Publications/Case-Studies/2013/Jan/Telehealth-Synthesis.aspx.