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Veterans Need Access to Health Care

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The barriers for Colorado’s military veterans to receiving the health care they need can seem daunting.

And so the Veterans Administration has tried to be among the leaders in pushing telehealth services across the frontier of acceptance in Colorado and across the rural and frontier West.

The early evidence is in black-and-white photos of 1950s-era VA psychologists in Nebraska trying a “two-way television link” for mental health counseling. Trace from there a direct line to the Eastern Colorado VA in 2016, more than 50 years later, placing new tablet computers directly in the homes of rural veterans so they can “see” their doctor by videophone from their living rooms.

In between, through that five decades of technology and health change, have been a relentless series of experiments and upgrades to the Eastern Colorado VA’s embrace of telehealth technology. One constant, said Marlys Withrow-Hill, the division’s home-based telehealth program manager, is empathy for what an ailing veteran goes through to get care.

“After a long drive, some veterans are so mad at their provider and the system that they won’t even fully reveal their conditions. They’re too angry to have a good visit,” Withrow-Hill said. “There are things people don’t bring up when they are distracted by anger, exhaustion and frustration. By the time they get in to see their provider in Denver, they are wiped. And then they still have to make it back home.”

Long veteran waiting times for appointments in Colorado and other states have prompted negative headlines and congressional queries. Colorado, like other states, has a large inflow of veterans returning from overseas conflict, but also has a general population surge from a robust economy and attractive lifestyle, VA officials said at the time.

Just under 1,000 of those veterans are now using home telehealth in Eastern Colorado, and 33,000 use video telehealth at a local clinic to get specialty care from long distance, said Doug Van Essen, facility virtual health coordinator for the Denver VA Medical Center.

Roy Hamilton is a Colorado Springs veteran who lost a leg in a motorcycle accident just before he left the U.S. Army. The upbeat Hamilton said it’s important to him to remain active, walking his dog, going on bike rides and water-skiing with an adaptive-abilities group. While he has seen the scheduling pressures on the VA at its local clinics, he said videoconferencing with VA doctors and consultants helped speed the fitting of a special waterproof prostheses.

Demand for video telehealth visits from satellite VA offices grew as “more and more soldiers returned from Iraq and Afghanistan, many with mental health factors,” Van Essen said. “One thing that made them uncomfortable was driving long distances and being at a large hospital with a large number of people.”

Improved and cheaper video technology made it possible for the VA to set aside remote clinic offices in Pueblo, La Junta or other locations, and set up live video visits with providers in Denver, Salt Lake City or other major medical centers.

“The technology is now catching up with what we want to do,” Withrow-Hill said.

Read more about the VA’s telehealth efforts and the Colorado Health Foundation’s work with partners to expand telehealth access in the state at www.coloradohealth.org/journal.

[Photo by James Chance, courtesy of the Colorado Health Foundation]

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