VA, Indiana University to study telehealth impact on brain injuries

Studying the effectiveness of telehealth for treating veterans with mild traumatic brain injuries is the impetus behind a five-year, $920,000 grant given to an Indiana University (IU) School of Medicine professor by the U.S. Department of Veterans Affairs, the school announced this week.

The system will focus on self-management of such injuries, according to Jacob Kean, who specializes in physical medicine and rehabilitation at IU and tasked with its development. Kean, according to the announcement, likened mild brain injuries to chronic conditions in that the victims "experience life-long consequences."

The professor said that initial efforts will focus on creating an "adaptive algorithm" by gathering data from interviews with self-management and brain injury experts, as well as veterans themselves. Patients then will test the algorithm to determine their self-management skill level.  

"It may be that the patient will get an iPad in a waiting room and answer five to eight questions, which in turn are informed by an algorithm that includes 200 questions," Kean said. "So, in a span of two minutes, they're measured against a broad continuum … using an ultra-brief assessment that's very precise and provides data that informs the clinical interaction."

Those assessments, according to Kean, then guide providers in making appropriate self-care recommendations to their patients. "[W]e need to conceptualize self-management to understand whether the steps we're asking our veterans to take are going in the right direction or the wrong direction," he added.

Five veterans hospitals will test the system: Walter Reed National Military Medical Center in Bethesda, Md.; Richard L. Roudebush VA Medical Center in Indianapolis; Michael E. DeBakey VA Medical Center in Houston; Brooke Army Medical Center in San Antonio; and Hunter Holmes McGuire Veterans Administration Medical Center in Richmond, Va.

The VA has heavily pushed telehealth and remote health lately. Earlier this month, the VA announced it set a goal of providing more than 200,000 remote mental health consultations through videoconferencing this year. The VA also announced recently that it is upgrading the Wi-Fi networks at all 26 of its medical facilities nationwide.

In April, news broke that the VA will be waiving copays on all telehealth visits with a goal of making "the home a preferred place of care."

To learn more:
- read the IU School of Medicine announcement