Regional Support Service Model Workgroup Model Review
Center Name: Veteran’s Administration Genomic Medicine Service (Telegenomics Program)
Website Address: http://www.telehealth.va.gov/
Mission and Contact
Information (if available)
Includes specific services that
the agency engages in to
address the mission
For the purposes of VA health benefits and services, a person who served in the
active military service and who was discharged or released under conditions other
than dishonorable is a Veteran.
VA Telehealth Services uses health informatics, disease management and
telehealth technologies to target care and case management to improve access to
care, improving the health of veterans. Telehealth changes the location where
health care services are routinely provided.
From the VA Genomic Medicine Program Advisory Committee:
Goal of using genetic information to optimize clinical care of veterans, and enhance
the study and development of diagnostic tests and treatments for diseases of
particular relevance to veterans.
Contact: Vickie Venne ([email protected] - 801.582.1565 x2195)
Organizational structure
How is the organization
organized internally (eg hub
and spoke model)? Nonprofit, for profit, government
agency?
Number and locations of
regional centers
Federal government agency using hub and spoke model.
Telegenetics is based at the Salt Lake City, UT VA center and covers 21/22
Veteran’s Integrated Service Networks (VISN) across the country including Guam,
Guam, Puerto Rico, American Virgin Islands, and the Philippines. VISN 22 (Southern
CA and Southern NV) is covered by clinical geneticist, Maren Scheuner, based in the
Los Angeles VA center.
Utah VA Telegenomics Program has seven full time genetic counselors. Clinical
geneticist on site for consultations with genetic counselors.
Los Angeles VA Center has one full time geneticist.
Started in June 2011 and have MOAs with 65 facilities and community based clinics
to provide telegenetics consultation from Utah Center. VA network has 153 VA
medical centers (VAMC) and over 700 community-based out-patient clinics.
124/153 VAMCs are affiliated with an academic medical center.
Patients/populations served
Indicate population the center
is attempting to reach (eg all
individuals with Down
Syndrome in a state) and the
actual number served (within
the context of a time frame)
The VAMCs and out-patient clinics have varied telehealth equipment set-ups.
Over 8 million veterans are signed up to receive care through the VA for a broad
range of services.
Utah Center
50-60 referrals per day (From 2011-2014, about 5000 patients referred)
58 appointments slots per week. Each slot is for 90 minutes.
Each GC sees 3-4 appointments per day.
1
Regional Support Service Model Workgroup Model Review
Since it’s the VA, mostly adult patients with adult disease referral. Some genetic
counseling for parents that have a child with a genetic disorder. Some prenatal
patients coming through due to family or pregnancy history.
Have a telegenetics preconceptual clinic that is held once per month. Talks about
teratogens, carrier screening, family history, other risk factors.
Services provided (eg direct
care, enabling infrastructure
building, population based)
Funding
What is the source of funding
and the amount of funding
over a specified period of
time? Include mechanism for
how funds are distributed (eg
accreditation, reimbursement,
satellite offices) and
percentage from all funding
sources.
If there is a central
coordinating body, how is it
funded? (excluding physician
fees unless the central
coordinating body is the
recipient or payer of such
fees)
Include budget when
available (if not available,
include % of budget used for
services being described)
How do they reach
underserved populations (if
they do)?
Cross-border challenges
(licensure, etc)
Impact
How do you measure the
impact and/or success of
your services? Please share
any data you have on impact
or outcomes.
Mental health services
provided
Resources
Is there a set of resources
that the central coordinating
body makes available to
Genetic counseling.
Recommendations for testing.
Federal VA system.
2016 VA Budget Request of $55 million for telehealth in the VA not including
telecommunications funding which is a separate line item.
VA wants 50% of all healthcare visits to be done by telehealth by 2020.
N/A.
Track number and type of referrals.
Track workload based on CPT codes.
Track savings based on appropriate testing identified or unnecessary testing not
being done.
Referral to appropriate VA services as necessary.
2
Regional Support Service Model Workgroup Model Review
satellite centers? If so, what
are these resources?
How does an entity (clinic,
provider, etc) become a part
of the system? (application,
evaluation process, etc)
Staffing (are there staffing
issues, who is a part of the
team)
Telephone Consultation
Telegenetic technology
(current or planned usage)
Please list any gaps/barriers
that you (as the reviewer)
have identified through the
review process:
VAMC or outreach clinic signs MOA with VA Telegenomics Program.
Easier to have all genetic counselors based in one center for supervision, support,
and education.
Centralized appointment calendar using Sharepoint is used.
Charting in EMR is required within 24 hours of seeing patient.
Services are exclusively done using telehealth methods.
•
•
•
Only available to eligible veterans.
Does not provide 24/7 coverage to account for time zones and work
schedules.
Funding supported entirely by federal government.
3