Background: A challenge confronting the United States is delivery of quality specialty healthcare to citizens living in rural areas.
Introduction: The Veterans Administration (VA) developed a large national telehealth network to address 5.2 million rural veterans. New Mexico's Albuquerque VA Neurology Service developed a teleneurology program for their rural veterans. This article analyzes our first 1,100 teleneurology patient visits.
Materials And Methods: Veterans living in remote areas of New Mexico, southern Colorado, eastern Arizona, and western Texas were offered follow-up teleneurology care at 16 rural VA community-based outpatient clinics (CBOCs) following an initial evaluation at the Albuquerque VA neurology outpatient clinic. Surveys were sent after all teleneurology visits focused on quality of care, ease of communication, satisfaction, and staff's ability to deliver same quality care as in person. Problems encountered, differences between face-to-face clinics and teleneurology, and cost savings were examined.
Results: Regarding the 701 (64%) returned surveys, we found 90% perceived they received good care, 91% felt there was good communication, 88% liked the convenience, and 87% reported they desired to continue teleneurology care. Ninety-six percent reported saving time, money, or both through CBOC visits instead of driving to Albuquerque.
Discussion: All providers felt that they could deliver excellent care through teleneurology. We found emergency room visits for neurologic problems was similar for both groups.
Conclusions: Our rural veteran patients and neurology staff overwhelmingly found high quality patient care can be delivered via teleneurology for a variety of chronic neurologic problems and was comparable to care delivered in neurology face-to-face clinics.
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http://dx.doi.org/10.1089/tmj.2018.0067 | DOI Listing |
J Med Internet Res
January 2025
Vibrent Health, Inc, Fairfax, VA, United States.
Background: Longitudinal cohort studies have traditionally relied on clinic-based recruitment models, which limit cohort diversity and the generalizability of research outcomes. Digital research platforms can be used to increase participant access, improve study engagement, streamline data collection, and increase data quality; however, the efficacy and sustainability of digitally enabled studies rely heavily on the design, implementation, and management of the digital platform being used.
Objective: We sought to design and build a secure, privacy-preserving, validated, participant-centric digital health research platform (DHRP) to recruit and enroll participants, collect multimodal data, and engage participants from diverse backgrounds in the National Institutes of Health's (NIH) All of Us Research Program (AOU).
Aging Ment Health
January 2025
Integrative Health Service, San Francisco VA Health Care System, San Francisco, California, USA.
Objectives: Loneliness and social isolation are associated with a range of deleterious health outcomes. Yoga is a mind-body physical activity that is used in health care settings and increasingly in a telehealth group format. This trial aimed to determine the effect of a brief course of telehealth yoga on loneliness among rural older adults.
View Article and Find Full Text PDFJAMA Netw Open
January 2025
Center for Veteran-Centered and Value-Driven Care, Puget Sound VA Healthcare System, Seattle, Washington.
Importance: The Veterans Health Administration (VHA) launched the Clinical Resource Hub (CRH), a national telehealth contingency staffing program, to address primary care staffing shortages and improve veteran access to primary care. How this large-scale telehealth intervention affects quality of care is unknown.
Objective: To assess the quality of care for chronic disease management among US veterans receiving high vs low levels of CRH-delivered primary care services and whether racial and ethnic minority veterans experience outcomes similar to those of White veterans when receiving CRH-delivered care.
Health Aff (Millwood)
January 2025
Thomas C. Tsai Harvard University and Brigham and Women's Hospital.
With the rapid expansion of veterans' access to community care under the Veterans Affairs Maintaining Internal Systems and Strengthening Integrated Outside Networks (VA MISSION) Act of 2018, ensuring that veterans receive high-quality community care has become a national priority. Using Veterans Health Administration (VHA) data and Medicare performance scores, we assessed how clinicians' performance on quality measures differed between those who treated veterans within the VHA Community Care Network and those who did not. We found that in 2022, 66.
View Article and Find Full Text PDFJ Head Trauma Rehabil
January 2025
Author Affiliations: Department of Rehabilitation Medicine, University of Washington, Seattle, Washington (Drs Bale and Hoffman); and Craig Hospital Research Department, Englewood, Colorado (Mr Sevigny).
Objective: To determine whether there are differences in healthcare utilization for chronic pain based on location (rural vs urban/suburban) or healthcare system (civilians vs Military Service Members and Veterans [SMVs]) after moderate-severe TBI.
Setting: Eighteen Traumatic Brain Injury Model Systems (TBIMS) Centers.
Participants: A total of 1,741 TBIMS participants 1 to 30 years post-injury reporting chronic pain at their most recent follow-up interview.
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