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VA Reaching Out to Rural Veterans With Telehealth

Woman speaking to a man on her computer screen

Some One on One — Veteran Ken Winn of Crescent City, Calif., enjoys a private conversation with Cassandra Donlon, a Psychiatric Mental Health Nurse Practitioner with the Roseburg VA Healthcare System.

Kenneth Winn, 48, suffered a head injury while deployed in Operation Desert Storm. Since then, he’s experienced his fair share of challenges in life. He’s been looking for a job now for two years.

“I want to work,” he said. “But if I tell them (a potential employer) I have a head injury, they don’t hire me. It’s been hell trying to find a job. I enjoyed being a helicopter mechanic when I was in the Army…I knew that job backwards and forwards.”

Winn said he finds it comforting to share his thoughts and feelings with his mental health provider at the Roseburg VA Health Care System. Fortunately, in order to see her, he doesn’t have to drive over 150 miles (three hours) from his home in Crescent City, in northern California, to Roseburg, Ore. Because of a technological marvel known as Telehealth, all he needs to do is drive to his VA clinic in town, where he’s quickly connected with his counselor at VA Roseburg.

“We want to keep people at home where they’re comfortable, where they have a support system, instead of at a hospital far away from where they live.”

— Dr. Tracy Weistreich, Associate Director for VA Patient Care Services

“Crescent City is No Man’s Land,” Winn said. “With Telehealth, it makes it where I can talk to my doctor without having to travel very far. It helps to talk to her when I’m down. She’s keeping tabs on my medications and stuff like that. She makes sure I receive what I need to receive”

“Not Everyone Has a Cardiologist Nearby”

Patricia Ryan, Associate Chief Consultant for the VA Office of Telehealth, said over 200,000 Veterans — like Kenneth Winn — have now used its clinic-based Telehealth services. She said another 51,000 patients nationwide are enrolled in VA’s Home Telehealth program.

“With Telehealth, our Veterans can connect with VA specialists in mental health, cardiology, dermatology, gastroenterology, rheumatology and urology,” Ryan said. “This is important, because a large percentage of our rural Veterans are advancing in age. They have chronic health conditions that require constant monitoring. If it wasn’t for Telehealth, we’d be hard pressed to deliver the kind of day-to-day observation they require.

“Not everyone has a cardiologist nearby,” she added. “With Telehealth, they do.”

“It’s Like I’m in the Same Room With You”

Cassandra Donlon, a Psychiatric Mental Health Nurse Practitioner at VA Roseburg, described what happens when Veterans like Kenneth Winn arrive at the clinic.

“A staff member escorts you to a private office, makes sure you’re comfortable, and ensures the (Telehealth) equipment is working,” Donlon explained “Once you and I are ‘connected,’ the staff member leaves the room and shuts the door. You’re in Crescent City; I’m 150 miles away in Roseburg, but we’re now engaged in a private, confidential, mental health appointment.

“It’s like I’m in the same room with you,” she continued. “We see and hear each other over our computer monitors and speakers. I can assess, evaluate, diagnose, and prescribe medications for you, or provide supportive counseling. I can order or review your lab work results.”

“We Can Bring the Doctor Right into Your Home”

Dr. Tracy Weistreich, Associate Director for Patient Care Services at VA Roseburg, said Telehealth is rapidly becoming an indispensible tool for meeting the health care needs of hundreds of rural Veterans served by the Roseburg VA Healthcare System.

“We live in God’s Country here,” Weistreich said. “Some people call it No Man’s Land, but I like to call it God’s Country. You can travel for miles and miles and not come to a town or a community. It’s remote, and getting to your nearest VA Medical Center can take hours. But with Telehealth, we can bring the doctor right into your home. You and your health care provider can discuss symptoms early and make appropriate adjustments to your treatment to help you avoid hospitalization.

“You really don’t want to go to the hospital if you can help it,” she added.

And there’s another big benefit as well. “Our Telehealth program here at Roseburg saves Veterans an estimated 62,000 miles of driving each year,” Weistreich said.

In addition to Crescent City, Calif., VA Roseburg has three clinics in Oregon with Telehealth capability — in North Bend, Brookings, and Eugene.

“My Goal is to Keep You Out of the Hospital”

Kathy Andersen, RN Care Coordinator for Roseburg’s Home Telehealth Department, manages patients with chronic diseases such as diabetes, congestive heart failure, chronic lung disease, and hypertension. There are 303 patients in Roseburg’s Home Telehealth Program; Andersen personally manages 81 of them.

“I have patients who live 150 miles away,” she said. “I even have patients who live 175 miles away, on the Oregon coast. If we didn’t have Telehealth, it would be impossible to monitor them as closely as we do.”

Andersen said VA issues each Telehealth patient a computer that allows them to send in their data every day…things like their weight, blood pressure, blood sugar (if they’re diabetic), or oxygen saturation level.

“I look at their data, and if their readings are off I call them and ask them some questions,” she explained. “For example, if you’re my heart failure patient and you’ve gained two or three pounds overnight, I’ll ask you what you’ve been eating, or whether you’re taking all your medications. By monitoring you every day, I can catch little things early, before they develop into big things. I can tell you if you’re eating something that’s not good for you, or I can have you adjust one of your medications.

“My goal is to keep you out of the hospital…keep you home, and keep you healthy,” she added.

“I Couldn’t Do Without It”

Jerry McDaniel, 80, served in the Navy during the Korean Conflict. A host of chronic health issues makes it exceptionally difficult for him to leave his house in Sutherlin, Ore., so Telehealth for him is not just a convenience, but a necessity.

“I can’t hardly get in the car…my wife does all the driving,” he said. “I can’t get out of bed without my wife’s assistance…I can’t do anything without her help. I wouldn’t be able to get to the VA to save my life, so the Telehealth program is wonderful. I couldn’t do without it. They monitor my blood pressure, my heart, my diabetes, my oxygen content.”

“I have a lot of pain,” he continued. “Sometimes you get to a place where you’re just about ready to give up. Most of the time I feel I’m at the end of my road. But as long as I’m breathing, I’m still fighting, and the VA is helping me with that fight. They’ve taken good care of me.”