San Francisco VA Health Care System
Telehealth Improves Veterans’ Health
It’s no understatement to say that COVID-19 has changed the face of health care. In a time when face-coverings, six feet of physical distancing, and Shelter-in-Place orders are the new norm, the conventional expectations of health care delivery have been turned on their head. Fortunately, providers at the San Francisco VA Health Care System (SFVAHCS) have confronted this challenge head-on, embracing innovative telehealth technologies, and adapting to constantly changing protocols—all while delivering the same level of high-quality care to Veterans from the Oregon border to the San Francisco Bay Area.
Telehealth is the use of digital information and communication technologies, such as computers, tablets, and smart phones, to access and manage health care services remotely. The U.S. Department of Veterans Affairs (VA) has embraced telehealth as a transformational approach to care delivery that ensures patient convenience and accessibility. It allows Veterans more flexibility in how they receive care, and its popularity is only growing. In 2019, over 900,000 Veterans received their health care through VA telehealth. Since the onset of this year’s COVID-19 health pandemic, requests for telehealth video appointments have increased ten-fold. To adapt to this rapidly changing landscape, the SFVAHCS recently launched Express Care, a virtual urgent care program where Veterans with pressing, non-emergency health needs can be seen by a VA provider using a computer or mobile device.
Bay Area resident and U.S. Air Force Veteran David Leeper can attest to just how effective telehealth technology can be. Leeper had been in declining health, with noticeable weight gain, increased blood pressure, and worsening edema. After several remote telephone appointments, Leeper was diagnosed with Congestive Heart Failure (CHF) exacerbation. His care providers, Dr. Joseph Yang and Nurse Practitioner Robert Malloy, worked closely to develop an in-patient treatment plan, but Leeper expressed concern about being admitted to the medical center in light of potential COVID-19 exposure.
His providers transitioned his initial treatment plan to an outpatient one. He was monitored closely via regularly scheduled at-home telehealth visits, in addition to occasional, as-needed face-to-face visits. The multi-pronged approach worked. “Through motivational interviewing, frequent telehealth visits, optimization of medical therapy…and close monitoring of weights, blood pressures, and lab results, Mr. Leeper was able to safely stay at home without hospitalization,” said Malloy.
After eight weeks of treatment, Leeper showed marked improvement in his condition. In addition to improved breathing ability and increased energy levels, he reported losing almost 30 pounds. Leeper is pleased with the care he received through telehealth technology. “For long distance care, it worked great…and is still exceptional,” said Leeper. “The care was well done, well-managed, and quite informative. Thank you for restoring me to a normal life.”
Dr. Michael Nejad, an attending physician in the SFVAHCS Emergency Department, is not surprised by such sentiments, stating, “The feedback I have gotten from Veterans [on telehealth] has been universally positive. They express a high level of appreciation.” He believes telehealth is the future of health care delivery, and sees it as a positive for Veterans seeking care from the VA. “Telehealth is convenient, saves time and money… and is a way to keep Veterans in our system, where they get a higher quality of care delivered in a manner that reflects our appreciation of their service.”