WEST HAVEN, CONN. — Over the last few years, telemedicine has partially redefined how health care is delivered to patients, especially those who do not live near medical centers. For the most part, it has been a one-to-one exchange. One patient communicates with one physician, or one physician communicates with a specialist at another facility.
VA’s SCAN program, which began rolling out last month, looks to change that ratio, using telehealth technology to create the medical equivalent of a force multiplier.
SCAN will connect subspecialists with whole groups of physicians online, providing expertise that will not only help a single patient but will help improve the ability of primary-care physicians to treat an entire disease state.
Telemedicine Force Multiplier
SCAN is based on a program out of the University of New Mexico called Project ECHO (Extension for Community Healthcare Options). ECHO, which began in 2004, linked urban healthcare specialists with primary-care providers in rural settings, giving those providers access to the expertise needed to better treat their patients. Instead of teleconferencing a specialist with the patient, ECHO put a specialist online with a group of primary-care physicians to act as a mentor and educator.
At the same time ECHO was starting up, VA was beginning its own telemedicine initiative based on a more traditional model. Eventually VA became aware of the work ECHO was doing and initiated a national grant program to emulate it.
“This really originated with President Obama’s mandate to transform VA into a 21st century healthcare organization,” explains Jerry Grass, MD, director of the VA SCAN program for Region 1, which covers the Northeast and Mid-Atlantic areas. “What we’d like is for every veteran to have access to health care, especially subspecialty service, when they need it and where they need it.”
The grants for VA SCAN were awarded April 5 and cover all seven VA regions. “We realize that you can’t have a subspecialty physician in every facility in every VISN and CBOC,” Grass says. “Our job is to bring telemedicine capability to the desktop of every primary care provider in this region so that they can access specialists at specified times, present patients, and have discussions about treatment options.”