Patients connect with psychiatrists
A Veterans Administration medical center is using telecommunications technology to expand its psychiatry practice to a community health clinic near the U.S.-Canadian border, allowing for one-on-one consultations between doctor and patient 128 miles apart.
In a pilot project, Dr. Andrew Pomerantz and six other psychiatrists and psychologists at the VA Medical Center in White River Junction, Vt., are counseling patients from the Northern Tier Center for Health's clinic in Richford, Vt., through web cameras, reaching people who sometimes went without such services.
The service, which will be expanded to three sites in New Hampshire, is available to veterans, members of the Vermont National Guard and their families.
Because of the wars in Iraq and Afghanistan, the VA is seeing more veterans with post-traumatic stress disorder and brain injuries, said U.S. Sen. Bernie Sanders, who helped secure an $842,000 federal grant for the project.
"If you live in a rural area, it is often extremely difficult to access the kind of quality psychiatric or psychological services that we want vets to have," Sanders said.
"The beauty of this is that veterans or soldiers can sit in a room in their communities and hook up with gifted, experienced counselors and get high-quality care without leaving their community," said Sanders, an independent from Vermont.
Located on the Vermont-New Hampshire border, the VA Medical Center serves veterans from all of Vermont and from the northern and western counties of New Hampshire. But for many in the rural states, the distance is too much.
"We're doing this because the majority of veterans do not get their primary care in the VA system in Vermont and New Hampshire," said Pomerantz, chief of mental health and behavioral sciences at the VA center. "We get 30 to 40 percent of the veteran population in VA clinics. For many, it's simply because they lived too far away."
The VA center has been using tele-psychiatry - which dates to the 1960s - with patients at a Bennington, Vt., VA clinic for several years. But this is the first time the VA has partnered with an outside entity to provide the care.
In November, the VA has installed a high-speed line allowing direct audio-visual communication, a 27-inch TV screen and a web camera and microphone in the Richford clinic.
"In the last few years, the concern from our clinicians has been that we don't have access to psychiatry," said Pam Parsons, executive director of the Northern Tier Center for Health. "We have social workers and they can do some counseling, but really we needed psychiatry and we didn't have access to it. When this opportunity came, we wanted to participate."
Most patients prefer in-person counseling, but they get used to the web version, Pomerantz said.
"They're awkward for a minute or two. People who are hard of hearing turn up the volume or move closer to the TV, which are things they'd never do in a room with me," he said.
One patient who participated in one of the sessions said he would have done without the psychiatric treatment he got with Pomerantz if the web hookup didn't make it possible.
"Frankly, when I went in, I thought it would be weird. But it isn't. Five minutes into it, I'd forgotten that he wasn't right there. It was quite the normal thing," said the man, a 63-year-old Colchester resident who did not want his name published.
The project is particularly timely, given the recent deployment of a 1,500-member Vermont National Guard contingent to Afghanistan.
"One of the best protectors against psychological distress is coming home to an intact family," Pomerantz said. "So our goal is to help the families maintain their mental health."
The VA plans to extend the project to five more locations by year's end - two in Vermont and three in New Hampshire.
The locations are:
Indian Stream Health Center in Colebrook
Coos Family Services in Berlin
Mid-state Health Center in Plymouth
Little Rivers Health Care in Wells River, Vt.
Clara Martin Center in Randolph, Vt.