Implementation and Evaluation of Diabetes Management via Clinical Video Telehealth.

“Telehealth” is a delivery of health-related services and information via telecommunications technologies. Clinical video telehealth (CVT) is a form of telehealth using a real-time video and audio transmission that is used to virtually connect a health care professional and a patient. CVT links the patient at a clinic closer to his or her home to a provider at another location. The goal of telehealth is to improve clinical outcomes and access to care while reducing costs, time, and risks with traveling to themainmedical center. Typical patients are veterans in postacute care settings and high-risk patients with chronic disease states (1). We implemented a CVT pharmacotherapy clinic for patients with diabetes at the West Palm Beach Veterans Affairs Medical Center (WPBVA). These patients were managed by a clinical pharmacy specialist. Auxiliary personnel included nurses and telehealth technicians. In the Veterans Health Administration, the clinical pharmacy specialist practices autonomously under a scope of practice. Incorporating a CVT clinic into the diabetes specialty clinic allows patients to receive their care at affiliated community-based outpatient clinics (CBOCs) closer to their homes to reduce travel burden. The primary objective was to assess patient satisfaction with the CVT program via a patient satisfaction survey. The secondary objective was to evaluate the impact of the CVT program on Veterans Health Administration resources, including total travel mileage saved and clinic utilization. Patients were enrolled in the CVT clinic via a specialized consult in the computerizedpatient record system.Datawere collected from all patients enrolled in the CVT clinic from1October 2012 to 30 April 2013 and analyzed using descriptive statistics. Data collected included clinic demographics (age and clinic utilization), baseline HbA1c, CBOC location, distance from the patient’s home to the WPBVA, and distance from the patient’s home to the CBOC location. There were 14 patients enrolled in this CVT clinic. The average age of the patients was 65 years old. Of the 25 scheduled encounters, there were 6 missed visits, calculated as a 24%missed clinic visit utilization rate. The average baseline HbA1c was 9%. Of the 19 CVT encounters, the average distance from the patient’s home to the WPBVA was 59.4 miles and average distance from patients’ homes to their respective CBOC was 11.6 miles. The total miles averted for our patients was 1,795 miles. The average miles averted per patient