# Presentation: 200116

- Adam Darkins, Chief Consultant for Care Coordination, Veterans Health Administration

- THE MANAGEMENT OF CHRONIC CONDITIONS IN THE VETERANS HEALTH ADMINISTRATION USING CARE COORDINATION/HOME TELEHEALTH

- The Chronic Care Working Group Meeting
- August 16th 2006, Washington DC

##  	VHA - a major contributor to 

- 	USA health care

-  Medical care to 7.6 million veterans

-  Largest single provider of health professional 	training in the world

*** ***One of the largest and most productive research 	organizations in the country

-  Becoming the principal Federal asset for medical
- 	assistance in large scale disasters

*** ***Largest direct care provider for homeless
- 	persons in the country

**Notes:**
_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________	

## Unique Patients Treated FY 1997-2004

## No. of outpatient Visits FY 1997-2003

## No. of Inpatients Treated FY 1997-2004

## Veterans Health Administration Changing Trends in Long-term Care

-  Nursing home utilization 0.7% lower p.a.
-  Disability rates decreasing by 2.2% p.a.
-  Over 65’s increasing by 1.5% p.a
-  Over 85’s increasing by 2.2% p.a
-  2% of patients 20-30% of costs
-  Complex needs unmatched to service delivery
-  Patients falling through the cracks in system

##  VHA Identified Chronic Care Needs 

-  Chronic Heart Failure
-  Chronic Obstructive Airways Disease
-  Depression
-  Hypertension
-  PTSD
-  SCI
-  MS
-  Dementia
-  Parkinson’s Disease

-  VHA Identified Chronic Care Needs

## Care Coordination in VHA:“The use of health informatics, disease management and telehealth technologies to enhance and extend care and case management to facilitate access to care and improve the health of designated individuals and populations with the specific intent of providing the right care in the right place at the right time.”

## Care Coordination

**Telecom server**
**Databases**
**Health data repository**
**Data is linked to**
**Intranet and sent to VistA**

- HOME

**Vital sign data**
**Disease management data**
**E-health information**

**Ethernet**
**56k**
**DSL**
**Cable**

**Intranet**

**Patient**
**Caregiver or**
**Care  Provider takes measurements**

**VSB**

**Hospital**

**Internet**

**Firewall **
**Encryption**
**PKI**

- National VHA Care
- Coordination Infrastructure

## VHA CCHT Patient Numbers

- Numbers 3/30/06 12,000

## Slide 11

## Care Coordination/Home Telehealth

- Care Coordination
- Patient Education
- Patient-Held Health Record
- Defining veteran patient need
- Clinical implementation
- Technical implementation
- Logistic issues
- Management and support
- Resource considerations