Online Clinics

Here’s an example: A physician at a CBOC in rural Maine is treating a veteran recently back from Iraq who is struggling with severe back pain. Different treatment options have been tried and failed; different medications have been prescribed, with each failing to relieve the patient’s pain. The physician wants advice on where to go next but has no access to a pain-management specialist, and the patient lives far from the nearest VAMC.

With SCAN, that physician could go online and request a consultation with a pain-management specialist. The physician would supply the patient’s history, along with what treatments have been tried. SCAN’s administrators would arrange a group of specialists to get together to review the case, as well as other cases that have been referred to them. Then a teleconference would be arranged between the specialists and all of the physicians seeking help with pain management. A notice would also go out to other physicians inviting them to listen in.

“The specialists will be able to discuss their approach to the case, as well as giving the physician education on that specialty,” Grass says. “We’ll be able to help treat that patient and all the other patients in this panel. We don’t just want that doctor on the line. We want 10 or 15 physicians listening in.”

SCAN will begin by providing expertise in three specialty areas: pain management, diabetes, and hepatitis C. If the program is successful with those, they will begin to add more specialties.

“And if the physician doesn’t have the equipment — a videocamera and microphone — we’ll provide it,” Grass says. “And everything will operate seamlessly over VA’s secure Enterprise Network.”

Grass wants to have the first teleconference clinic sometime this month. “We’re trying to move ahead as quickly as we can,” he said. “We want primary-care providers to feel comfortable using this, and not just have it be one more thing to do.” 

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