Is the DOD Underutilizing Telehealth?

Is the Department of Defense (DOD) fully utilizing telehealth? That’s the question at the heart of a new report to Congress from the Government Accountability Office (GAO), which examines the department’s use of the technologies in FY 2016. The short answer? The DOD has a ways to go when it comes to expanding its use of telehealth services, but promising efforts are underway to do just that. As Fierce Healthcare first reported, the GAO report highlights some of the limitations that still exist at the department when it comes to telehealth, while also delving more deeply into some of the trends in utilization.

In 2015, the department began looking at ways to increase telehealth utilization with its more than nine million patients. The goal of broadening the use of telehealth, per the GAO report, was “to help ensure the health of servicemembers by providing access to care for a wider range of conditions and at duty locations and in areas where servicemembers may be injured.” In 2016, there were just under 60,000 telehealth encounters (59,075), nearly three quarters of which involved active-duty personnel, and 88 percent of which were synchronous, real-time visits. Of all the branches of the armed services, Army providers conducted the most telehealth visits. Put differently, this means that only about one percent of all active-duty servicemembers had telehealth visits—“relatively few,” as the GAO puts it. What’s more, across all branches of the military, the vast majority of the encounters took place at just seven facilities. Per the DOD, this is “because leaders at these facilities have actively encouraged telehealth use, and four of the seven facilities maintain telebehavioral hubs while two of the facilities maintain portals that support a high volume of synchronous and asynchronous encounters among patients across the United States and overseas.”

By contrast, the Department of Veterans Affairs (VA) has been a leader in its use of telehealth services to care for patients. In 2015, for example, the agency’s providers completed more than 2.1 million telehealth visits, 45 percent of which were with rural patients. It’s seeking to bring those numbers up, too, through its Anywhere to Anywhere VA Health Care initiative. But as Fierce Healthcare’s Evan Sweeney points out, the DOD’s usage numbers will likely see an increase in the coming years. One reason: a provision in the FY 2018 National Defense Authorization Act that requires the DOD to expand telehealth services over the course of the next fiscal year. In addition, the department recently began covering in-home remote monitoring services through its TRICARE program. And to combat providers’ underreporting of telehealth encounters—usually due to errors in coding—the Army has been seeking to better train providers in coding, also putting financial incentives in place.

Click here to read the Fierce Healthcare article on the DOD’s use of telehealth.

Click here to read the full GAO report on the DOD’s use of telehealth.

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