The Department of Veterans Affairs, which already has the biggest telehealth program in the United States, is expanding its coverage to fill critical gaps in areas such as mental health and primary care.

In fiscal 2018, VA conducted more than a million patient visits through video, and more than 13 percent of veterans have received at least some of their treatment through telehealth.

Dr. Neil Evans, the chief officer for the Veterans Health Administration’s Office of Connected Care, speaking Thursday at a GovernmentCIO conference on health IT modernization, said the agency now provides intensive care unit-level treatment to its rural VA facilities.

“We’re really excited about seeing that continued expansion of how we reach patients and also how we can operate more efficiently as an integrated national health system,” Evans said.

The agency is also running a “virtual tick clinic,” where patients contact a call center, get connected by video to a provider and receive a diagnosis. Evans said the agency launched the virtual clinic in response to an increase in Lyme disease-related visits to VA facilities.

The virtual clinic, Evans said, represents part of the VA’s focus on “moving care out of the traditional face-to-face paradigm and engaging veterans where they are.”

The virtual clinic also echoes a project the Department of Health and Human Services launched last year, which focused on using emerging tech to address Lyme- and tick-borne illnesses.

VA is also currently building telehealth hubs focused on primary care and mental health aimed at ensuring there’s always providers available to see patients.

“We don’t have brick-and-mortar facilities in all those spaces. We’ve been, I think, unique as a health care system in that there has been a unique drive to say, we need to adopt virtual care,” Evans said.

Since the launch of VA Secure Messaging, Evans said patients and their providers have exchanged more than 72 million emails.

“Many of those [email] threads would have led to a visit, would have led to a frustrated veteran dealing with parking [and] would have led to essentially not the most efficient use of our health providers’ time,” Evans said.

For all the VA’s advances in telehealth, Evans said the agency doesn’t want to exacerbate the “digital divide” between patients who have access to reliable internet service and those with less reliable connectivity.

New VA.gov sees ‘double-digit’ traffic growth

Last November, the agency relaunched VA.gov, folding many functions from Vets.gov into the new site. Charles Worthington, the VA’s chief technology officer, said merging the two sites helped veterans find services where they expected to find them online.

Worthington said the VA has seen “double-digit” increases in key transaction on the overhauled website. Year-over-year, the application for health care on VA.gov has seen a 30 percent increase in traffic following the site’s relaunch.

Instead of quarterly website updates and releases, the team behind VA.gov has been able to release smaller updates on an ongoing basis.

“With the new tools that we have, using the cloud, using automation, that’s not really a thing anymore,” Worthington said. “We can keep teams autonomous and small, releasing very frequently. And because releases are easy to make, they’re also easy to undo.”

If something in a new release fails, Worthington said the team behind the site can immediately fall right back to the old release and tear down the new build.

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