Telehealth’s Boom in 2020 and Beyond at Veterans Affairs

The outbreak of COVID-19 in the U.S. placed exceptional demands on the Department of Veterans Affairs, requiring multiple areas of emergency readjustment to ensure continued functionality of essential services.

The VA stands as both America’s largest civilian agency and its most extensive integrated health care network, with the Veterans Health Administration providing care for approximately 9 million veterans annually. This alone presented a dual challenge for the VA: how to provide emergency services for patients with potentially life-threatening COVID-19 symptoms while sustaining other forms of physical and mental health care.

Despite the abrupt stressors of the pandemic, the VA went into 2020 having already invested considerable development in telehealth as a central component of the agency’s broader IT modernization program.

The VA’s launch of the ATLAS program in late 2019 represented a forward step in the agency’s efforts to provide care to veterans in more remote areas, or who might otherwise have challenges reaching in-person care centers. With a survey finding that roughly one-third of the veterans served by the agency live in rural areas, VA leadership made it an essential priority to provide the means to deliver a baseline of care.

Much of this has included providing both the infrastructure and internet access for veterans who might lack those same capacities in the home, as well as distributing medical devices to provide essential biometric readings. This latter development is especially important for veterans needing to monitor crucial symptoms of ongoing and potentially serious health conditions such as diabetes or cardiac disease.

This infrastructure has largely been established through partnerships with local veterans organizations as well as private sector partners, allowing VA patients to access telehealth booths much closer to home — especially if they might lack the in-home technology and internet connection necessary to take advantage of telehealth.

In addition to the complexities of physical distancing and renewed need to provide remote care, the VA has also fostered a rapid shift toward remote counseling for veterans seeking mental health services, a priority that has only been compounded by veterans looking for therapy during the pandemic. The VA’s expanded telehealth network allowed the agency to manage an increase in remote mental health services that began in March. As VA disclosed in April 2020, mental health care and consultations delivered by phone in March had increased nearly fourfold over those in February.

In addition to this expanded access to mental telehealth services, the VA also launched impromptu initiatives for helping support veterans’ well-being during a time of newfound isolation. This included the distribution of 7,400 new video-calling devices to veterans and their families in partnership with Facebook, a program designed to help retired service members better stay in contact with those closest to them. The VA also launched an initiative with OnStar to provide more direct access to mental health and crisis support services through a veteran’s smartphone, another means of helping overcome the sense of isolation that can prove a strain on veterans struggling with post-service trauma.

VA has recognized the benefits of these adjustments and the necessity for continuing to expand the agency’s telehealth capacities. Beyond these quicker responses, VA is looking to continue building upon these developments. The director of the VA’s Office of Connected Care recognized there is still work to be done in further refining the agency’s telehealth programs and bridging the rural care divide.

This prioritization has been met by material published by President-elect Joe Biden’s transition team, with the incoming administration pledging to continue funding and supporting the expansion of VA telehealth services upon those already established over the prior four years.