VETS Act seeks to increase access to telemedicine for veterans

WASHINGTON – Fourteen House members from both sides of the aisle are joining forces to sponsor a bill aimed at improving access to telemedicine services for veterans.

The Veterans E-Health & Telemedicine Support (VETS) Act of 2012 (H.R. 6107) would enable providers affiliated with the Department of Veterans Affairs to deliver telemedicine services across state lines, eliminating a requirement that the providers be licensed in the same state as their patients. The bill was introduced last week by House members Glenn Thompson, (R-Pa.) and Charles Rangel (D-N.Y.).

The bill follows several recent moves by the federal government to adopt telemedicine as a means of treating servicemembers, veterans and their families. So far this year, the VA has dropped co-payments charged to veterans for telehealth consultations and is setting a goal of providing 200,000 remote consultations by the end of this year (up from 140,000 last year). Also, last week the VA announced the launch of the $15 million, three-year Specialty Care Access Network-Extension for Community Healthcare Outcomes (SCAN-ECHO) program, designed to help rural healthcare providers receive training and assistance in delivering telemedicine services to veterans.

In a letter announcing the VETS Act, Rangel said the easing of restrictions on telemedicine would greatly enhance the use of telemental health, allowing providers to reach distant and remote veterans who are dealing with mental health issues and don't want to travel to a VA clinic. A RAND Corp. survey conducted earlier this year found that nearly 20 percent of military personnel returning from Iraq and Afghanistan have shown symptoms of post-traumatic stress disorder, or PTSD.

"The bipartisan legislation would allow Veterans Affairs (VA) health professionals, including contractors, to practice telemedicine across state borders if they are qualified and practice within the scope of their authorized federal duties, a big improvement on the status quo; currently, overly cumbersome location requirements can make it difficult for veterans – especially those struggling with mental health issues – to get the help they need and deserve," Rangel's letter said.

"Nearly 18 veterans commit suicide every day," he added. "Each one is a tragedy. By increasing the ease of access to mental health professionals, my hope is that this bill will help veterans struggling with mental health conditions."

"In 2011, Congress passed the Servicemembers Telemedicine & E-Health Portability Act, through which the Department of Defense is now working to expand access to our servicemembers through various existing programs," Thompson added in his announcement. "The VETS Act will enable the VA to implement the same reforms and provide greater access to care that our veterans need, have earned and rightfully deserve."

Both congressmen said the bill was introduced with the support of 12 additional Congress members from both sides of the aisle and has been endorsed by the American Telemedicine Association, the American Foundation for Suicide Prevention and the Veterans of Foreign Wars.

According to the Army Times, an Army study has found that telehealth is an effective medium for delivering a wide range of behavioral therapies targeting PTSD among isolated or dispersed soldiers, especially members of the National Guard Reserve, but the process is hindered by state laws that require providers to hold licenses in each state in which they deliver care.

“The requirement was for a provider to have multiple licenses, which can take months,” said Gary Capistrant, senior director of public policy for the ATA – which has long campaigned for cross-state licensing for telemedicine services – in the Army Times article. “It may be you just have one visit with a person in a particular state, and you’re not going to go through that for one person."

KLAS: More providers forming enterprise imaging strategies

OREM, UT – A new report from KLAS finds most healthcare providers have begun putting into place an enterprise strategy for imaging, with the goal of getting "the right image to the right place at the right time."

The study, "Enterprise Imaging 2012: Provider's Strategies and Insights," reveals that vendor-neutral archives (VNA) and PACS enterprise archive solutions are emerging as the top two preferred approaches for most providers.

GE and Philips were the vendors mentioned most often overall in the study as strategic enterprise imaging partners, according to KLAS, and every GE and Philips customer interviewed considered their vendor to be part of their go-forward imaging strategy – especially those going for a PACS enterprise archive centric strategy. Fuji, while not cited as often as the other two, also seems to have a strong PACS enterprise archive offering.

Agfa and Merge were the most-often cited vendors for a VNA-centric strategy, according to KLAS, which reports that Agfa customers using the IMPAX Data Center (IDC) remain committed, despite early indications that a lukewarm PACS experience will affect the IDC experience. Merge has many of the needed pieces, the study adds, but providers are still waiting for integration; Merge customers are looking forward to what they will be able to do with Merge's iConnect platform.

Acuo and TeraMedica are the primary non-PACS players in the VNA space. In most cases, early trends suggest that TeraMedica customers are pleased with the value of the system and hint toward favorable enterprise DICOM management, according to the report, which found that several providers were also leveraging TeraMedica's ability to store other clinical content in its native format.

Acuo clients say their vendor's core strength is in image distribution and data migration. Their increasing number of vendor partnerships and growing mindshare in the VNA space suggest that Acuo is a viable archive option for those who do not want to rely solely on a PACS archive.

Of the providers interviewed by KLAS, 27 percent indicate that a VNA would be central to their enterprise imaging.

"Image storage is a necessity, no matter what option is chosen," said Ben Brown, imaging research director at KLAS and author of the report. "As providers start to bring in more studies and the studies themselves increase in size, the need for storage will increase. In addition, as a provider explained, images will need to be managed as well as stored."

Carestream, Cerner, Dell, DR Systems, EMC, McKesson, ScImage, Sectra and Siemens are also mentioned in the report.