Use of Telehealth to Improve Access to Care at the United States Department of Veterans Affairs During the 2017 Atlantic Hurricane Season.

Abstract

This brief report examines the shift from in-person care to US Department of Veterans Affairs (VA) telehealth services during 3 devastating hurricanes in 2017 (Harvey, Irma, and Maria). VA administrative data were used to analyze the number and percentage of telehealth services 30 d pre- and 30 d post- the 2017 hurricanes for 3 hurricane-impacted VA medical centers (VAMCs): Houston (Texas), Orlando (Florida), and San Juan (Puerto Rico). All 3 VAMCs remained open during the hurricanes. For the Houston VAMC, during the first week post-Harvey, in-person patient visits decreased while telehealth visits increased substantially. Similarly, for the Orlando VAMC, during the 1-wk post-Irma, telehealth use increased substantially. For the San Juan VAMC, there were many interruptions in the use of telehealth due to many power outages, resulting in a modest increase in the use of telehealth post-Irma/Maria. The most commonly used telehealth services at Houston and Orlando VAMCs during the hurricanes were: primary care, triage, mental health, and home health. Telehealth has the potential to improve post-disaster access to and coordination of care. However, more information is needed to better understand how telehealth services can be used as a post-disaster health-care delivery tool, particularly for patients receiving care outside of systems such as VA.