A win for housebound Veterans
Housebound Veterans from the Coatesville VA are learning everyone can be a winner when they combine virtual and in-person health care visits.
Susan Gallagher is a Veteran of the U.S. Navy, who served from 1977 until 1983 in Virginia and Pennsylvania and has been receiving hybrid care, both virtual and in-person care, since coming to the Coatesville VA through Home Based Primary Care (HBPC) more than five years ago.
While working at the Wilmington VA in 1990, Gallagher was diagnosed with Multiple sclerosis (MS). MS is a potentially disabling disease of the brain and central nervous system for which there is no cure. Some people, like Gallagher, develop paralysis. She continued working until 2004 and medically retired in 2005.
Hybrid Home Based Primary Care
The HBPC team at the Coatesville VA delivers in-home care to Veterans who are unable to travel to VA health care facilities because of complex medical conditions or mobility restrictions.
Gallagher does not have the ability to move independently and uses transportation services anytime she needs to travel.
Nearly all her medical appointments with the Department of Veterans Affairs (VA) are conducted virtually except for an in-home visit scheduled every three weeks to deliver medications, record her vital signs and see how Gallagher is doing.
"I haven't been out to the medical center in Coatesville in the last five years except to receive my COVID vaccines and boosters," said Gallagher. "Virtual appointments achieve the same result with much less inconvenience. It's a win-win situation."
The virtual appointments she attends thru HBPC each month may include primary care, physical therapy, mental health, nutrition, recreation therapy and any other needs that may arise. Virtual appointments save Gallagher the time and hassle of arranging a driver and vehicle to transport her and a medical aide to attend an in-person appointment at the Coatesville campus.
"Every time I go out, it's an hour and a half there, then the appointment, and then an hour and a half back. That just blows my whole day," explains Gallagher. "But if I do it virtually, it's an hour."
Unable to work the iPad herself, Gallagher relies on her state-provided caregivers to set it up and navigate to the link in her email to start each appointment.
Helping Veterans figure out virtual care
Under the guidance of Dr. Christy Rothermel, VA Geriatric Scholar and psychologist, the HBPC team has worked hard since before the start of the COVID-19 pandemic to identify and remove the barriers for Veterans who agree to use virtual care like VA Video Connect.
"The largest barrier was that there were Veterans who were unable to use the device," explained Dr. Rothermel. Common barriers for people are tremors and involuntary muscle movements or a cognitive disorder where they are unable to learn new information, like how to connect to their virtual appointments.
HBPC connects Veterans to care by providing iPads, listening devices, and adaptive visual technology if they need it. Veterans like Gallagher, need a caregiver to assist them.
Finding the right balance with the hybrid care model
By far the most enjoyable appointments are the group sessions with Gallagher's recreation therapist, Ellen Barnes, who hosts virtual recreation therapy for housebound Veterans.
"Ellen usually has a whole agenda prepared. A lot of trivia games that I really like." But it's more than just games. "You get to know all the other guys. You know their pets and their family." Gallagher goes on to explain how Barnes is good at drawing people out and getting them to connect with each other.
In-home visits dropped off during the COVID-19 pandemic as health care facilities implemented safety protocols. There were 346 in-home visits in February 2020, the month before the restrictions were applied and only 43 VVC appointments. Four months later, virtual appointments exceeded 100 visits every month until March 2021.
Today, 71% of Veterans enrolled with HBPC at Coatesville VA can use virtual appointments and are choosing between virtual and in-home care. Although the number of virtual appointments has leveled off, they have not dropped below 63 in a single month again.
To say Gallagher is happy with the virtual and in-home care she receives through Home Based Primary Care is an understatement.
"It really has been exceptional for me," said Gallagher. "I mean, everything that could possibly be done to make my life easier has been done. I couldn't be any more appreciative."
If you know a Veteran who might benefit from Home Based Primary Care through the VA, encourage them to talk to their Primary Care Team, or call 610-384-7711 then dial extension 3381.