VA Telemedicine in Action highlights some of the ongoing innovative applications which utilize different communications technologies to improve health care for veterans. 
 

Teleradiology- VA has led the way in the development and implementation of filmless digital radiology systems in clinical settings. The Baltimore VAMC implemented the first filmless radiology dept. in the US in 1993 and currently links facilities in the VA Capitol Network (VISN 5) for teleradiology support. 
 

Telepathology- The National Performance Review Hammer Award winning telepathology project linking the Milwaukee-Iron Mountain VAMCs in the VA Great Lakes Health Care System (VISN 12) provides unique telepathology service utilizing a hybrid dynamic/store and forward telepathology system. 
 

Telecardiology- The VA through the Pacemaker Surveillance Center Programs located on the East Coast at the Washington VAMC and on the West Coast at the San Francisco VAMC provides timely, cost effective and important followup pacemaker monitoring for thousands of patients annually. 
 

Telemental Health- A clinical research project is underway at the Baltimore VAMC to evaluate and examine the use of distance videoconferencing in the assessment/treatment of mood disorder. A demonstration project at the Milwaukee/Iron Mountain VAMCs provides improvement in access to rural mental health care using compressed digital videoconferencing linkages. 

Teledermatology- Dermatologists at the Baltimore VAMC utilize videoconferencing and store and forward imaging to assess skin conditions. Researchers at the Durham, NC HSR& D have initiated a two year project evaluating and examining teledermatology. 
 

Telecare in Diabetes: Researchers at the Boston VAMC are using a home based information tool/clinical workstation to examine the effects of enhancing services for patients with diabetes. 
 

Teledentistry- Innovative uses of digital imaging/dental radiology to enhance overall delivery of dental services and ongoing education. 
 

Telenuclear Medicine- For over twenty years, nuclear medicine images have been shared regularly between a number of VAMCs utilizing cost effective, "low tech" transmission to facilitate consultative services in nuclear medicine. 
 

Telephone Liaison Care Program (TLCP)- Telephone liasion care programs are in place at all VAMCs to provide information, guidance and direction for patients. Many facilities have had a TLC program in place for many years. TLCP has proven to be effective in improving customer satisfaction, reducing clinic waiting times both for appointments and the time to be seen by a team member. 
 

Networks in Action

• All networks are reviewing/installing some form of telemedicine.
• Network initiative to install telepathology and teleradiology (VISN 22)
• The VA Capitol Network (VISN 5) will further implement teleradiology, telepsychology and teledermatology as soon as infrastructure improvements have been accomplished. A task force has been established to create a network-wide virtual imaging capability.
• In conjunction with DoD and the Texas Technical University, telemedicine capabilities are being provided at three of the facilities in the VA Southwest Healthcare Network (VISN 18)
• In cooperation with Ohio State University and the PVA, the VA Healthcare System of Ohio (VISN 10) is installing desktop video conferencing in all facilities.
• Install telemedicine technology in support of reengineering laboratory services and pathology processes and install videoconferencing at all five medical centers in VA Healthcare System Upstate New York (VISN 2)
• Telepathology initiative between Iron Mountain and Milwaukee in the VA Great Lakes Healthcare System (VISN 12) received a Hammer Award 

FEEDBACK

Comments, questions or updates regarding Telemedicine in Action may be 
directed to: 

Bonnie Leibel at bonnie.leibel@mail.va.gov