The military is modernizing its systems for telehealth by implementing telecritical care programs that enable 24/7 monitoring of critically ill patients.
The program equips intensive care unit rooms with telehealth technologies, allowing care providers to remotely monitor patients in real time and provide remote support to onsite medical staff.
Col. David De Blasio, chief of medicine at Womack Army Medical Center, says a lack of trained staff — his facility currently has just one pulmonary doctor — has underscored the value of connecting onsite patients to offsite medical experts.
“It gives us after-hours and weekend ICU expertise and consultation that otherwise would not be available,” he says. “That gives our pulmonary critical care doctor the opportunity to sleep at night, so that he can come back refreshed during daylight hours.”
Telecritical care brings additional care capabilities to WAMC, De Blasio says. That includes providing critically ill patients with access to 24/7 monitoring in the intensive care unit.
How Telehealth Creates an Accessible Environment for Veterans
Through real-time audio and video monitoring, telecritical nurses can monitor patients remotely. They access clinical notes, images, labs and telemetry, all in real time.
Telehealth makes care much more accessible and convenient for veterans, says Gina Jackson, spokesperson for the Department of Veterans Affairs. The VA has established:
- Universal, continuous access to virtual intensivists and virtual nurses for all acutely ill veterans
- Complete clinical, laboratory and radiographic data
- Real-time links to bedside electronic health records
“Many veterans prefer the comfort and convenience of accessing care from home, particularly for mental health appointments,” Jackson says. “Since the pandemic began, there has been massive and sustained demand for VA telehealth services.”
The Department of Defense has audiovisual connections with many of its medical treatment facility ICUs, centralized intensivists and critical care nurses, who provide telemedicine services.
“DOD is in the process of developing a telecritical care program with integrated clinical data interfaces and analysis,” Jackson says, noting that there are ongoing discussions between the VA and the DOD to develop an interoperable federal telecritical care system.
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Working to Better Connect Agencies and Patients
Telecritical care is an attempt to help people who may not have the ability to get medical expertise on a regular basis, says Maj. Nikhil Huprikar, Army chief of Pulmonary and Critical Care Medicine Service at Walter Reed National Military Medical Center.
“In the DOD, we have people who are far forward; we have people who need our level of expertise in Japan and in South Korea, Germany and Kuwait,” Huprikar says. “The utility of telecritical care is that you can beam into that room and offer help without necessarily constantly having someone there.”
The DOD’s joint National Emergency Tele-Critical Care Network with the Department of Health and Human Services is based in San Diego, and Huprikar says there are plans to connect more sites so it can expand insights, oversight and care access.
Military medical specialists will be able to tap into more advanced predictive analytics tools powered by artificial intelligence as the platform evolves, he adds.
“I think the other thing that happens in the future is movement beyond bedside trajectory, pushing the service further forward into smaller units,” Huprikar says. “Maybe it starts becoming handheld or facilitated with a GoPro, or something along those lines."
MORE FROM FEDTECH: How the VA is integrating machine learning.