A telemedicine office at the Veterans Affairs Department has spent nearly $39 million in congressional funding amid the COVID-19 pandemic, VA leaders told lawmakers Tuesday.
Congress had allocated $17.2 billion to the Veterans Health Administration under the Coronavirus Aid, Relief, and Economic Security Act to support operations during the pandemic, as well as an additional $2.15 billion specifically for the VA's Office of Information and Technology. Since March, the VA's Office of Connected Care has spent $39 million of that funding.
"The CARES Act funding has been critical for enabling us to support both veterans and providers," said Dr. Kevin Galpin, executive director of telehealth services at the Office of Connected Care, during a hearing Tuesday hosted by two subcommittees of the House Committee on Veterans' Affairs.
Since the start of fiscal 2020, VA clinicians have conducted 1.9 million video visits and 16.7 million telephone visits with patients.
The Office of Connected Care so far has used the funding to provide 20,000 internet-connected iPads to veterans who didn't have technology to access telemedicine, as well as iPads, webcams and headsets to clinicians who needed equipment. It's also expanded the VA's telemedicine help desk to address a growing call volume.
It now takes the help desk just two seconds to answer patients calling in with questions. Ninety-five percent of calls are successfully resolved.
Galpin said the Office of Connected Care plans to allocate additional funding toward building out the VA's tele-critical care program.
That's "going to be critical to fortifying our ICU services both during this emergency and future emergencies," Galpin said.
On top of the $39 million, the VA has allocated nearly $6 billion of the CARES Act funding toward other activities that help providers in the field address patient care needs. Some of those patient care activities include telemedicine efforts, said Dr. Jennifer MacDonald, chief consultant to the deputy undersecretary for health at the Veterans Health Administration.
Banks cautioned that as the VA continues to build up its telemedicine efforts, investments and spending need to be guided by data and evidence.
"Even with the recent influx of IT dollars, VA cannot afford speculative technology ventures," Rep. Jim Banks (R-Ind.) said. "We have to be building toward a well-established target."
For video telemedicine visits, the agency uses VA Video Connect, a telemedicine app it began rolling out in 2017. The VA plans to integrate the app into its Cerner Corp. electronic health record system, once it's deployed.
The VA faces fewer regulatory barriers to telemedicine expansion compared to other healthcare providers. While state licensing restrictions have posed a challenge for telemedicine adoption nationwide, the VA in 2018 implemented a policy that lifted those requirements for VA providers practicing virtual care.
VA leadership doesn't have a specific expectation for the proportion of care it expects to deliver virtually after the pandemic subsides, according to Galpin. For now, the agency's goal is to expand access so it's available as an option for all patients.
"When do we say we've gotten where we need to go? I don't think we know that yet," he said.