Aleda E. Lutz VA Medical Center Nurses Use Technology to Improve Veteran Health and Access to Care

Nurses at the Aleda E. Lutz VAMC are linking technology to nursing practice to improve health outcomes. In this International Year of the Nurse, VA is highlighting the roles of nurses as leaders, teachers, scientists and professionals in health care. Among them are nurses who use informatics in many areas of clinical practice to promote high-quality, safe, Veteran-centric care.

The science of informatics utilizes nurses’ clinical expertise to drive innovation. It combines both computer and information science and advances the management of health care, ensuring Veterans get the right care, at the right time, in the right place.

Informatics nurses examine data, review workflow, review trends and explore the uses of technology to enhance health care. They are an advocate and educator among their peers to promote the use of technology, resulting in improved efficiency and the highest quality of care. Informatics nurses strive to keep up with advancements and new challenges in the healthcare field. What VA learns from these nurses helps many avenues of health care, such as virtual care. No Wound Left Behind, VA’s award-winning TeleWound Care Practice Program (TWCPP) is an example of this innovation.

TeleWound allows Veterans and their families to continue treatment of pressure sores, diabetic foot ulcers and other wounds while they are at home. Nurses use remote technology to see the wounds and guide care.

This program is currently offered through medical centers’ Wound Care and Ostomy Program, at VA facilities across the country. It was created by Mona Baharestani, PhD, Associate Chief Nurse for Wound Care and Research at Mountain Home VA Medical Center in Tennessee. Dr. Baharestani received a national FedHealthIT Innovation Award for No Wound Left Behind.

Even before coronavirus became a health concern, more and more Veterans were relying on the science of informatics to improve their well-being and increase their access to care. Now, it’s become even more important as Veterans stay home to stay safe.

One of the primary ways that informatics has changed nursing practice is through documentation. Paper charting with handwritten notes are a thing of the past. Today, nurses input notes into electronic health records that keep a patient’s medical history up-to-date and easily accessible. MyHealtheVet is a great example of informatics innovation, where Veterans easily communicate with their Patient Aligned Care Team (PACT) from the safety of their homes. The VA has over 5 million Veterans enrolled, with instant access to their health records, health education, pharmacy services, and appointment management. This tool remains important, especially during times where social distancing is highly encouraged.

In addition to the TeleWound Care Program, remote health care helps Veterans and their clinicians monitor blood pressure, track their blood glucose, manage their weight, quit tobacco usage and access mental health counseling. Telehealth is an essential tool in VA’s COVID-19 response. Nationwide, thousands of VA nurses are delivering care virtually.

Our Telewound Care Program is used to connect Veterans at any location to our wound provider. VA Video Connect is a platform which allows Veterans to use their own personal technology, smart phones, iPADs, laptops and/or tablets, to connect to their VA provider. VA Video Connect can also be utilized to connect wound care patients to their provider.

Home Telehealth Program- Remote Patient Monitoring is a program which pairs care management principles, health informatics, and disease management with in-home and mobile monitoring technology. The goal of the Home Telehealth program is to improve clinic outcomes and access to care while reducing complications and educating the Veteran on their specific health conditions to encourage self-management.

One of our Home Telehealth Registered Nurses was reviewing vital signs on Veteran who had just enrolled for high blood pressures. The RN was working closely with the PACT team to report blood pressure levels, which helped the team modify their approach to treatment with medication changes. The day the RN was reviewing the vitals, she noticed something was off, the Veteran showed an extremely low heart rate. The RN called the Veteran immediately and he reported feeling unusually fatigued. The RN had the Veteran complete a health check using the Home Telehealth equipment while on the phone with her and noticed discrepancies in the data. Putting the information together, the nurse recommended the Veteran seek emergency medical care immediately. The nurse called ahead to the local hospital to inform them of the Veterans condition and situation. The Veteran was assessed and admitted for a complete heart block, a disorder in the heart’s rhythm caused by an obstruction to the natural electrical impulse which signals the constriction of the heart. He underwent a necessary placement of an artificial pacemaker. The Veteran’s PACT provider credits Home Telehealth, and this RN specifically, for saving the patient’s life.

“VA telehealth services use the science of health informatics, disease management and technology to improve the quality of health care and access to care,” said Barbara Bates, Medical Center Director. “VA relies on the expertise of nurses utilizing informatics to improve the health of Veterans through informatic care services every day.”

For more information about No Wound Left Behind and other telehealth services offered at Aleda E. Lutz VAMC visit https://www.saginaw.va.gov/. To learn more about VA nurses using informatics and VA nursing careers, visit https://www.va.gov/nursing/.