VA Wants to Move Telehealth Beyond State Borders and Into Vets’ Homes

The US Department of Veterans Affairs (VA) would like to remove barriers to telehealth and allow its providers—including physical therapists (PTs)—to conduct telehealth activities across all 50 states and in non-federal sites, including patients’ and providers’ homes.

In a proposed rule, the VA describes how its current telehealth program is limited by many state professional licensure laws and regulations, which restrict telehealth activities to within state borders. Additionally, writes the VA, many VA medical centers only allow telehealth on federal property out of concern that its providers will run afoul of state regulations, thereby eliminating the possibility of a patient receiving telehealth at home.

Full story at APTA

From PTJ: Group-Based Physical Therapy No More Effective Than 1-on-1 Care for Knee OA

In a recent clinical trial published in the May issue of Physical Therapy (PTJ), APTA’s science journal, group physical therapy for individuals with knee osteoarthritis (OA) was found to be no more effective in reducing pain and improving functional outcomes than 1-on-1 sessions—contrary to researchers’ expectations.

Researchers randomly assigned 320 patients with pain, aching, stiffness, or swelling associated with knee OA at a Veterans Administration (VA) medical center to either group or individual physical therapy. Most (88%) were male. Authors hypothesized that group-based physical therapy would lead to superior outcomes, citing several advantages of this setting, including the potential for more visits per patient, better ways to deliver education and support for chronic conditions, and stronger peer support that could lead to greater adherence to exercise-based interventions.

Most aspects of care were the same for both groups. All patients were instructed in a home exercise program, educated on joint protection and activity pacing, and screened to determine if they required braces, assistive devices, or shoe lifts. To start, they all were instructed to perform the same 4 stretching exercises daily and 6 strengthening exercises 3 times a week. As they progressed, they were given opportunities to increase the difficulty of their exercises.

Full story of group PT versus 1-on-1 care for knee OA at APTA

Deal on VA Includes Money for More Providers, New Facilities

After weeks of appearing to be another victim of a gridlocked Congress, a bill to improve access to health care in the Department of Veterans Affairs (VA) system is now poised for a vote in both chambers.

Called the Veterans Access, Choice, and Accountability Act, the compromise bill was reached by leaders of the Senate and House veterans affairs committees, and was developed in response to news early this year of lengthy wait times—and alleged administrative efforts to cover up those waits—for patients in the VA system. The issue sparked congressional hearings and ultimately led to the resignation of then-VA head Eric Shinseki, but legislative efforts to address the problem seemed to stall as the summer wore on.

Full story of VA bill for health care at APTA

EHR and Patient Safety: A Real Danger, Even for Experienced Users

When it comes to electronic health records (EHRs) and patient safety, experience might be a great teacher, but it doesn’t guarantee straight-A performance. According to a new study, even in longstanding EHR systems such as the one used by the Department of Veterans Affairs (VA) health care system, “many significant EHR-related safety concerns … remain.”

In a study of investigations of EHR-related safety violations launched through the VA’s Informatics Patient Safety office (IPS) from 2009 to 2013, researchers looked at 100 closed cases at 55 VA facilities. Of those cases, 74 involved unsafe technology, and 25 involved unsafe use of technology, which authors write “most commonly involved the dimensions of people, clinical content, workflow and communication, and human interface.” A majority of cases (70%) involved both unsafe technology and unsafe use. The study was published online in the June 20 issue of JAMIA.

Full story of EHR and patient safety at APTA

VA Will Use More Private Care to Reduce Delays

In an effort to respond to criticism that the US Department of Veterans Affairs (VA) has subjected veterans to excessive and potentially deadly waits for care, the VA has announced that it will increase veteran access to private hospitals and clinics.

As reported in the Los Angeles Times, Huffington Post, Washington Post, and other media outlets, the May 24 announcement from VA Secretary Eric Shinseki stated that VA centers are enhancing capacity wherever possible, and that in areas where expansion isn’t an option, the agency will increase use of non-VA care.

Full story of private care for VA’s at APTA