Meeting Veterans Where They're @: A VA Home-Based Telemental Health (HBTMH) Pilot Program

Shore, Peter; Goranson, Anders C.; Ward, M. K.; Lu, Mary

doi:10.2190/pm.48.1.b

Cited by 45 publications

(36 citation statements)

References 3 publications

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“…Indeed, such telehealth formats often come at a lower patient-side cost and with easier access for both patients and providers (Bose et al, 2001; Elford et al, 2000; Morland et al, 2010) and are effective means of service delivery (Bolton & Dorstyn, 2015). Several Department of Veterans Affairs (VA) and Department of Defense studies demonstrate that hub and spoke telehealth can be implemented within the existing system infrastructure (Shore, Goranson, & Lu, 2014; Tuerk et al, 2010; Williams et al, 2015), is cost effective (Fortney et al, 2005; Glueckauf, 2002; Jerome & Zaylor, 2000; Perednia & Allen, 1995), and is clinically effective (Morland et al, 2011). However, as patients must travel to satellite clinics, stigma and logistic barriers are still present in hub and spoke telehealth models.…”

Section: Barriers To Seeking Treatment and A Potential Solution: Homementioning

confidence: 99%

A non-inferiority trial of Prolonged Exposure for posttraumatic stress disorder: In person versus home-based telehealth

Acierno

Knapp

Tuerk

et al. 2017

Behaviour Research and Therapy

174

128

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This is the first randomized controlled trial to evaluate non-inferiority of Prolonged Exposure (PE) delivered via home-based telehealth (HBT) compared to standard in-person (IP) PE. One-hundred thirty two Veterans recruited from a Southeastern Veterans Affairs Medical Center and affiliated University who met criteria for posttraumatic stress disorder (PTSD) were randomized to receive PE via HBT or PE via IP. Results indicated that PE-HBT was non-inferior to PE-IP in terms of reducing PTSD scores at post-treatment, 3 and 6 month follow-up. However, non-inferiority hypotheses for depression were only supported at 6 month follow-up. HBT has great potential to reduce patient burden associated with receiving treatment in terms of travel time, travel cost, lost work, and stigma without sacrificing efficacy. These findings indicate that telehealth treatment delivered directly into patients’ homes may dramatically increase the reach of this evidence-based therapy for PTSD without diminishing effectiveness.

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Section: Barriers To Seeking Treatment and A Potential Solution: Homementioning

confidence: 99%

A non-inferiority trial of Prolonged Exposure for posttraumatic stress disorder: In person versus home-based telehealth

Acierno

Knapp

Tuerk

et al. 2017

Behaviour Research and Therapy

174

128

View full text Add to dashboard Cite

show abstract

“…Health Administration (VHA), especially for rural Veterans, has been a challenge [1]. About 2.9 million, 56% of all rural Veterans, are enrolled in VHA care [2].…”

Section: Veteran Access To Mental Health Care Within the Us Departmenmentioning

confidence: 99%

Dual Use of a Patient Portal and Clinical Video Telehealth by Veterans with Mental Health Diagnoses: Retrospective, Cross-Sectional Analysis (Preprint)

Abel¹,

Shimada²,

Wang³

et al. 2018

Preprint

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Background: Access to mental health care is challenging. The Veterans Health Administration (VHA) has been addressing these challenges through technological innovations including the implementation of clinical video teleconferencing (CVT), two-way interactive, synchronous videoconferencing between a provider and a patient, and an electronic personal health record, My HealtheVet (MHV).Objectives: The goal of this study was to describe early adoption and use of MHV and CVT among VHA users with mental health diagnoses. Methods:We conducted a retrospective, cross-sectional analysis of early MHV adoption and CVT engagement among Veterans with one or more mental health diagnoses who were VHA users from 2007-2012. We categorized Veterans into four eHealth technology use groups: MHV only, CVT only, complementary users who used both, and non-users of either. We examined demographic characteristics and mental health diagnoses by group. We explored MHV feature use among MHV adopters. We then explored predictors of MHV adoption, CVT engagement, and complementary use using multivariate logistic regression.Results: Among 2.17 million Veterans with one or more mental health diagnoses, only 32,723(1.5%) were complementary users, with most (71.7%) being non-users of both MHV and CVT.African-American and Latino patients were significantly less likely to engage in CVT or use MHV, compared to White patients. Low-income patients who met the criteria for free care were significantly less likely to be MHV or complementary users than those who did not. The odds of CVT engagement and complementary use decreased with increasing age. Women were more likely than men to be MHV or complementary users, but less likely than men to be CVT users. Conclusions: Use of these technologies was still relatively low, leaving much potential for growth. There were regional and socio-demographic disparities in access to MHV and CVT, and in complementary use of these technologies. There was also variation based on types of mental health diagnosis. More research is needed to ensure that these and other patient-facing eHealth technologies are accessible and effectively used by all vulnerable patients.

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“…Historically, Home Based Telehealth (HBT) was focused on remote monitoring, and more recently has been used to enhance management of chronic diseases such as diabetes, obstructive pulmonary disease, and congestive heart failure, preliminary research suggests HBT service delivery is associated with high patient satisfaction, reduced frequency and duration of inpatient hospital stays, and overall symptom improvement [7][8][9]. Although these preliminary data are promising, administrators and clinical providers have been reluctant to apply HBT service models to mental health interventions, citing concerns that HBT via video-conferencing may compromise therapeutic alliance, patient safety and confidentiality [10], issues addressed directly by the articles in this section.…”

Section: Home-based Telehealth (Hbt)mentioning

confidence: 99%

Editors' Note

Acierno

2014

Int J Psychiatry Med

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Meeting Veterans Where They're @: A VA Home-Based Telemental Health (HBTMH) Pilot Program

Abstract: The authors discuss the strength and limitations of the program as well as potential areas of future research.

Cited by 45 publications

References 3 publications

A non-inferiority trial of Prolonged Exposure for posttraumatic stress disorder: In person versus home-based telehealth

A non-inferiority trial of Prolonged Exposure for posttraumatic stress disorder: In person versus home-based telehealth

Dual Use of a Patient Portal and Clinical Video Telehealth by Veterans with Mental Health Diagnoses: Retrospective, Cross-Sectional Analysis (Preprint)

Editors' Note

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