Using Health IT to Connect Rural Vets With Their Data

Brett Coughlin | March 31, 2014

Connecting veterans with their health-care providers across the vast expanses of the country is not an easy task, but the White House Rural Health Council – with the help of ONC – has launched a pilot in Florida, Iowa, Nebraska and Minnesota to do just that.

The Department of Veterans Affairs and ONC recently launched the Veteran-Initiated Electronic Care Coordination Project to “help veterans use  Blue Button technology to access their health information stored in the VA’s system, and transmit this information to their local rural clinic or Critical Access Hospital,” says Leila Samy, ONC’s Rural Health IT coordinator.

This is no easy task. 47 million people live in rural America, which makes up 84% of land area and is 18% of the total population. While the federal government is working from the top down to help rural patients get access to better care using health IT, states are also working on the same types of projects from the bottom up.

Earl Wilson Ferguson MD, PhD – a former Air Force physician who worked on some of the first health IT programs with NASA and who lives “off the grid” in California– just completed the Digital 395 project in California, bringing  broadband to 36 rural communities between Barstow and Reno, NV—an  $11.5 million project funded by the California Broadband Cooperative.

Ferguson, a cardiologist who practices at Ridgecrest Regional Hospital, the hospital’s rural health clinic, and from his home (thanks to health IT), says rural health IT can help patients, but also saves “a lot of money.”

“Part of the reason I’m using health IT to practice cardiovascular care is when you have a patient at a rural hospital, or critical access hospital, and he presents with chest pain, 80 percent of the time — from my experience — you don’t have to transfer people to get another test,” Dr. Ferguson said.

“When you have the patient’s data available in a rural area, the practicing physician doesn’t have to do an additional test for a ‘rule out’ and you can save the transportation costs, on top of the cost of the additional test,” Ferguson said.

Another reason – maybe more importantly – is that rural veterans are often taking action to change their behavior because they have the information right in front of them, said Ferguson.

“It’s amazing what that information can do to help them change their behavior, so they don’t end up getting that chest pain or having to have a CT angiogram in the future,” Dr. Ferguson tells the Buzz blog.

One end user of the VA’s patient portal says its working for him. Marc Lanaux is an Army Vet with 23 years of service and suffers from PTSD. He served in Somalia and Afghanistan supervising mechanics and later working with ordinance and lives with his wife near Rome, NY. Lanaux uses MyHealtheVet – the VA’s health IT system – regularly, mostly for medication refills.

Lanaux said he doesn’t “like to be around people” and using health IT to message his primary care doctor or get a prescription refill is “less of a hassle.”

“I heard about it, but I didn’t know much about it, until probably about a year ago. I think I was at one of my therapy sessions and heard a few other veterans talking about it,” he said. “It’s been a pretty good experience, I have no issues. You can check history, I get to reorder my prescriptions, if I need to get a message to a provider, I’ll usually just call, but I can also use it,” he said, adding that it’s better than getting stuck on a phone tree for half an hour when he needs to reorder one of his anti-anxiety meds.

On the more mundane side, Lanaux – who is 47 – was told he was pre-Diabetic and needed to cut down on carbs, control his cholesterol and lose some weight. He and his wife started dieting and he’s lost 36 pounds. He uses MyHealtheVet to check his labs, like his hemoglobin A1C levels. The labs aren’t always up to date, but the system works well enough to monitor his progress, he said.

“It’s got some glitches, but my needs are being met,” he said.

Overlying the effort to hook up vets with their data is another program to help them get a job in health IT. Vets who are mustering out or unemployed get informatics training, under a Health Resources and Services Administration (HRSA) program. This is a “twofer” because it helps vets, but also the hospitals, clinics and physician offices which need good people to run their EHR systems.

“About 50,000 health IT workers are going to be needed in the next 10 years. It’s very critical for CAHs and small rural hospitals to have a highly-skilled workforce to implement and maintain systems such as EHRs, telehealth, mobile technologies and to meet the meaningful use standards,” said Natassja Manzanero, Rural Health IT Workforce program coordinator at HRSA. Manzanero is working to get access to training and employment in Health IT -related jobs that target rural populations and especially current clinical staff, veterans and the unemployed. The programs are offered at community colleges, FQHCs, hospitals and elsewhere to provide training areas for the potential health IT workforce.

Manzanero works with 15 grantees, each with $300,000 per year for three years, to help educators and clinical staff at hospitals and clinics get training.

Are you a veteran or Medicare patient, or know someone who uses Blue Button or MyHealtheVet? Leave a comment below and tell us what you think of the technology. Is it helping you be healthier?