Looking ahead, the Veterans Health Administration is increasingly focusing on bringing care into veterans' homes, VA higher-ups said at the mHealth and Telehealth World Conference in Boston. 

"I think that the number one thing we see for where telehealth is going in the organization is increasingly into the home and into patients’ daily lives," said Neil Evans, Chief Officer in the Office of Connected Care at the Veterans Health Administration. "Last year, 282,000 veterans had a clinical video telehealth visit. Only 6,300 of them had those visits into their home. So our telehealth is connecting our medical centers to our remote specialists, but we’re really committed to extending our penetration into our veterans’ daily lives."

That effort includes not only home telehealth, but remote patient monitoring programs and mobile apps. Until recently, these three technological areas were all administered separately at the VA, Evans said. Now, they're all organized under the Office of Connected Care.

"We’re developing an app which leverages WebRTC to deliver that video telehealth experience into the home on veterans' personal devices," Evans went on. "Likewise we’re expanding the number of veterans we serve through remote patient monitoring through, for example, a mobile text message program we call Annie, based on a two-way text message system that’s been developed at the NHS called Florence, named after Florence Nightingale. It allows us to engage veterans between visits, collect patient-generated data, and provide feedback to reinforce the care plan."

Dr. Kevin Galpin, acting chief consultant at the VHA Office of Connected Care, said another piece of the VA's future plans is figuring out how to incorporate family caregivers into veterans' care via telehealth. 

"You have caregivers, you have family members that want to be part of a veteran’s health, but they can’t always be at an appointment, they’re not living in the same state," Galpin said. "Yet that person is important to them, and would love to attend office visits and be an active part of keeping that person healthy. What we see going forward is being able to invite caregivers not just to existing virtual episodes of care, which would be easier, but to the ones that are currently in-person."

The VA is also looking into using mobile technology to connect veterans to friends and family for social weight loss or nutrition interventions, or even to do group therapy for PTSD with members of the same unit, who could work through shared experiences together.

Evans said that the VA portal currently has 3.5 million registered users and is accessed 9,000 times a day by veterans. It has processed 72 million prescription requests sincce it was launched 10 years ago. He also said that about 12 percent of VA patients in a given year receive some amount of care through telehealth. Galpin said the VA did 2 million episodes of care through telehealth last year.

Evans said the biggest challenge for the VA is driving provider adoption of telehealth tools, apps, and the patient portal, which he believes will drive patient adoption in turn.

"How do you encourage adoption and integration of these tools into the actual delivery of healthcare on the front lines?" Evans said. "How do we make sure telehealth is an intrinsic part of our core operations and not just a bolted add-on to the healthcare system? As our use of the portal has increased and we bring more apps online, how do we help our providers understand that this technology exists, understand how to use it, and bring on some that are slower to adopt? Because we know that when the healthcare team recommends a portal, apps, or telehealth, patient adoption and trust increases tremendously."