Telehealth turns obstacle into opportunity for transplant patient

VA New Jersey’s Dr. Rebecca Connell encountered a dilemma recently when one of her patients needed a consultation for a lung transplant. In addition to the stressful prospect of surgery, the Veteran and her husband/caregiver faced traveling from their home in New Jersey to Madison, Wisconsin, where the VA lung transplant team is located, to attend the in-person consultation. The trip was not a viable option in terms of time, cost, or patient safety, so Connell sought another way to get her patient the care she needed.

She turned to VA New Jersey’s telehealth services team. Nichol Shabazz, the lead facility telehealth coordinator, quickly scheduled a clinical video telehealth pre-transplant appointment for the patient, and Renita Wilson, a telehealth clinical technician supervisor, stepped in to lead the patient through her first ever telehealth experience.

Easing the learning curve

The key to success, they all knew, was to make the patient feel comfortable right away. Luckily, Wilson understands firsthand the ups and downs that come with learning telehealth technologies. She became a telehealth technician in 2010 after years of working in traditional VA clinics. The move to a new technology was daunting, but she jumped at the opportunity.

“I was nervous because I wasn’t sure what I was getting in to,” said Wilson of her transition. “It was all new to me. I found it was intense. It was overwhelming.” After the initial learning curve, though, Wilson found her stride and began enjoying the process. “I became very driven.”

Now the telehealth clinical technician supervisor for the New Jersey North Region, Wilson is adept at teaching patients and fellow staff members to use the technology. More importantly, she has not forgotten what it was like to be a beginner. So, when she stepped in to lead the patient through the transplant consultation, she knew that the first order of business was addressing the patient’s concerns and potential pain points during the visit.

Small details, big impact

Wilson was determined to put the Veteran and her husband at ease from the moment they arrived. She met the patient—who uses an oxygen tank and cannot walk long distances—at the front entrance with a wheelchair and a full tank of oxygen. She asked the valet services to park the car so that the patient’s husband could walk her into the building. Once inside, Wilson led them to their room and began to explain the process for telehealth appointments, starting with the cart that houses the videoconferencing camera, monitor, microphone, speakers, and other peripheral telehealth devices used to transmit clinical images or data.

“I explained to them in detail about all that the cart can do and how telehealth will assist them,” she continued. “It’s all about how telehealth is presented, and how it’s set up for the patient’s visit. It makes a big difference when you give them that information.”

Familiarizing patients with telehealth tools can help them to relax and focus on their discussion with the provider on-screen. These small comforts count, especially when there is stress about chronic health conditions or potential procedures such as a transplant. “If that’s all that you have left to hold onto besides everything else that you worry about in this world, I’m going to give you that,” said Wilson.

In the end, the preparation paid off. The Veteran felt comfortable in her first telehealth experience and noted that she and her husband were able to speak with the transplant team 1,000 miles away in Wisconsin “as if they were in the same room together.” More than anything, they were grateful for the convenience of the process. Dr. Connell also commended the telehealth team for delivering “first class service” and “going above and beyond for the patient.”

Telehealth and culture change

Despite success stories like this, some patients may still be hesitant to use telehealth technology.

Veterans may be skeptical about interacting with a provider through CVT or remote devices. “They are used to that face to face meeting,” said Wilson. “They are used to someone touching them and saying, ‘Breathe like this.’

“Telehealth is about convenience for our Veterans. I hope that even more people are willing to give it try.”

Last year more than 393,000 Veterans used telehealth to access VA quality care, and similar to this Veteran and her husband, these Veterans able to interact with their VA care team across town or across the country “as if they were in the same room together.”

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Treva Lutes is a communications specialist with VA’s Office of Connected Care.