Conclusion
The VISN 22 EBP TMH Center and Regional Pilot have established the infrastructure of interfacility clinics to use EBPs for the treatment of PTSD. Also, the center has provided consultation and guidance to facilities interested in developing their own TMH programs. The TMH Center now plans to expand mental health services and include medication management and EBP services for non-PTSD psychiatric diagnoses. The established infrastructure will allow providers from one facility to cover the mental health service needs of other facilities when there are absences or gaps due to leave or delays/challenges in hiring in rural locations. Finally, TMH offers the potential to offer after-hours services to veterans in other time zones during providers’ regular tours of duty.
Several other TMH programs are now expanding services into veterans’ homes. There are several sites within the VHA that have piloted this TMH modality and developed guidelines and recommendations for further expansion. Currently VACO is encouraging all VHA facilities to increase in-home telehealth services, and the Office of Telehealth Services provides details on implementation. Interested parties are encouraged to routinely visit the VACO website for updated information.
Developing and implementing a new TMH program can be an arduous task, but the program has great potential to provide veteran-centered care. As TMH sessions progress, the provider and veteran become less aware of the camera and software and more aware of the therapeutic process. Challenges and delays in implementation are to be expected—these can occur frequently during the development and implementation stages of a TMH program. Maintaining consistent communication with staff at remote sites is essential for the success of any program.
As the VHA focuses on veterancentered care, TMH services will improve access to providers with specific, needed expertise. The authors hope these experiences can facilitate the continued growth of TMH and assuage any concerns a facility or provider may have about this modality of care. Delivery of TMH care can be challenging, but the ability to provide these services to veterans at times and locations convenient to them makes these challenges worthwhile.
Acknowledgments
Dr. Hauser wishes to thank Cathy, Anika, Jirina, Katia, and Max Hauser, and Alba Pillwein for their continued support. In memory of Beverly Ostroski.
Author disclosures
The authors report no actual or potential conflicts of interest with regard to this article.
Disclaimer
The opinions expressed herein are those of the authors and do not necessarily reflect those of Federal Practitioner, Frontline Medical Communications Inc., the U.S. Government, or any of its agencies. This article may discuss unlabeled or investigational use of certain drugs. Please review the complete prescribing information for specific drugs or drug combinations—including indications, contraindications, warnings, and adverse effects—before administering pharmacologic therapy to patients.