Family caregivers of roughly 1,000 seriously injured veterans from Iraq and Afghanistan are now using iPads loaded with a variety of healthcare-related apps, provided by the Department of Veterans Affairs.

The iPads, delivered in late May and June, are part of a yearlong VA pilot designed to test how veterans and their caregivers respond to mHealth tools and services. VA officials said they want to know which apps are most popular and which deliver positive outcomes not only for veterans but also for their family members.

"Many of these caregivers are living rather hectic lives," said Neil Evans, associate chief of staff for informatics and co-chief of the Primary Care Washington D.C. Veterans Affairs Medical Center. "Accessing data and interacting with the healthcare system can be very difficult and inconvenient."

"We … could really learn a lot from them," he added.

Evans and Kathleen Frisbee, director of web and mobile solutions for the VA, said they launched this pilot to help the caregivers as much as the veterans. Frisbee said researchers want to know how mHealth tools like iPads can help reduce stress levels in caregivers and improve their ability to help care for their family members, how mHealth can improve clinical outcomes, and how different combinations of apps impact the caregiving experience.

"It's essentially a new IT platform for us," said Frisbee, who's coordinating several mHealth pilots at the moment. Added Evans: "We see (mHealth) as improving the quality of interactions between caregivers and patients."

The VA Mobile Health Caregiver Pilot was originally offered to about 4,000 family caregivers enrolled in the VA program, Evans said. About 1,000 responded to the offer to participate, and were shipped an iPad pre-loaded with 9 apps: Care4Caregiver, Health Advocate; Health Assessment Journal; Notifications and Reminders; Pain Coach; PTSD Coach; RxRefill and Summary of Care.

According to Evans, in studying which apps to choose for the pilot, VA officials learned that caregivers are most interested in social networking apps – so that they could talk with other caregivers and share lessons learned – and journaling apps.

VA officials, meanwhile, are interested in moving beyond the stand-alone apps that just gather information, Evans said. They want interoperative solutions that can gather data in the home setting and plug it into the electronic medical record, where it can then be used by healthcare providers to improve care.

Frisbee said a 10th app on the iPad will enable the VA to survey participants six months into the pilot to determine whether the apps are doing what they should be doing, at which time the VA could make adjustments. Another survey will be taken when the pilot ends in a year, she said.

Both Frisbee and Evans said the VA has long been interested in how to interact with veterans and their caregivers at home and in places other than the VA hospital or clinic, but they've been slow to move into the mHealth field because of concerns about sustainability and using the right devices and apps. With more devices and apps being introduced and refined, they said, the time is right.

Other pilots underway, Frisbee said, include a Veteran Appointment Request Web App project involving roughly 600 veterans in the Washington D.C. and Palo Alto, Calif. regions, in which veterans are testing the viability of scheduling primary care and mental health appointments through mHealth devices; and a test of the Mobile Blue Button project. Other apps in development, she said, include ones focused on women's health and even games.

"We have a lot of ideas in development," she said.