Abstracts

Rationale: In alignment with Veterans Health Administration (VHA) MyVA Priorities the Epilepsy Centers of Excellence (ECoE) sought to enhance Veterans experience with a seamless, integrated, and responsive customer service by leveraging technology through tele-epilepsy. The implementation of technology is mandated for the ECoE in Public Law S.2162. Expansion of tele-medicine in the ECoE is aligned with MyVA goals of access, Veteran-centric care and quality improvement. Since inception of tele-epilepsy in the ECOE in fiscal year (FY) FY11, ECoE has expanded services by incorporating technology in different avenues. Methods: Between FY11 and FY16 ECoE employed the following options to expand services. (i) Telephone clinics provide opportunities for sharing test results and discuss patient's specific issues such as medications' side effects etc. (ii) Using computerized Patients' Records System (CPRS), Electronic - consults allow providers consultation services regarding patients. (iii) Clinical Video teleconference (CVT) from patient's nearest clinic location to a specialist at a distant location. Patients meeting specified criteria can connect from their homes for a tele-epilepsy visit. (iv) Store and Forward (SF) EEG infrastructure provides patients with testing services at their nearest clinic and EEGs are interpreted by a specialist. Results: In FY11 three ECoE sites provided telephone clinic services whereas, in FY16 all ECoE sites had telephone clinics. Number of patients who sought services and number of visits increased four times between FY11 and FY16 in telephone clinics. Electronic consultation among providers started in FY12 and by FY16 had increased four folds. Hub sites for CVT increased from four to 14 ECoE sites. Whereas, spoke sites increased from 10 to 87. Number of patients increased fourteen folds and number of encounters went up 16 folds in CVT. Home telehealth clinics began at two sites in FY16. During FY11 only Portland provided store and forward EEG services. Durham and Gainesville were also providers of store and forward EEG services in FY16. In all, 315 patients benefited from SF EEG during FY16. Conclusions: The VHA ECoE has made great strides in leveraging technology to improve access for Veterans diagnosed with epilepsy. Tele-epilepsy is Veterans-centric because it improves access to quality health care services in close proximity to their homes. Tele-epilepsy has broadened the outreach of primary care providers and patients to specialized services in the VA through the ECoE. Implementation of such initiatives embody the concept of the VHA motto which is founded in Abraham Lincoln's promise on behalf of the United States of America" To care for him who shall have borne the battle and for his widow, and his orphan." Funding: No funding