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VA brings telemedicine to Bristol

COLLABORATING PARTNERS CUT the ribbon for a new “Virtual Living Room” at the American Legion in Bristol on Monday. From left are Ron LaRose, commander of American Legion Post 19; Shirley Bloomfield (NTCA-The Rural Broadband Association); Brett Rusch (White River Junction VA Healthcare System); Sarah Tyree (CoBank); Roger Nishi (Waitsfield & Champlain Valley Telecom); Todd Garthaffner (Waitsfield & Champlain Valley Telecom); Tina Kebalka (White River Junction VA Healthcare System); Pam Becker (Foundation for Rural Service).

BRISTOL — For veterans in Addison County and beyond, healthcare through the Veterans Administration just got a little easier.
On Monday, representatives from several organizations cut the ribbon on a brand-new “Virtual Living Room, or VLR, a private room at the American Legion Post 19 in Bristol, where veterans can speak to their healthcare providers by video link.
The VLR aims to address the difficulties that veterans in rural communities, like those in Addison County, often encounter when accessing health care services, according to Lynne Davis, public affairs specialist with the White River Junction VA Medical Center (VAMC).
“There may be a shortage of medical and behavioral providers in their community, and the nearest VA facility is too far away,” Davis said, in a press release. “Perhaps they lack a home internet connection or there are no broadband services in the community to support the option of telemedicine. The Virtual Living Room provides a viable, promising resource for area rural veterans to gain critical access to a broad range of medical and behavioral health care.”
Such services may come in handy especially during Vermont winters.
“If anybody was here last Friday (during the snowstorm) and you had an appointment (at the VA hospital in White River Junction), you certainly would have been happy if you could have done it here at the Virtual Living Room,” said Gulf War vet Todd Garthaffner. A supervisor at Waitsfield & Champlain Valley Telecom (WCTV), Garthaffner was instrumental in making the Bristol project happen.
WCTV has installed gigabit fiber optic internet service at the Bristol Legion.
Garthaffner was one of several speakers at the VLR grand opening, which was attended by more than 40 people. He offered some sobering statistics.
In 2018, the organization Disabled American Veterans offered 625,000 rides nationwide to veterans trying to get to their medical appointments, and DAV volunteers spend 1.4 million hours driving those vets more than 17 million miles.
“It’s precisely solutions like the Virtual Living Room that are going to help the VA to reach out, to have their doctors reach deeper into our communities,” he said.
The VAMC and its Community Based Outpatient Clinics in Bennington, Brattleboro, Burlington, Newport and Rutland, serve nearly 18,000 veterans in Vermont, many of them in Addison County.
Now, local veterans can receive health care closer to home, thanks to the VA’s collaboration with the Foundation for Rural Service (FRS), CoBank, Bristol American Legion and WCTV.

PILOT PROJECT
The VA is the nation’s largest provider of “telehealth” services like those now offered at the Bristol American Legion, but making those services available to rural areas has always been a struggle.
“At first you could only do this with a government-issued device,” said Katherine Tang, VAMC public affairs officer. “Vets would have to sign them out for things like a pre- or post-op telemedicine appointment, then return them afterward.”
And they required technology that’s still making its way into farming and other rural communities.
“I think about when I was a resident … and the telehealth journey was just getting started,” said Dr. Brett Rusch, a psychiatrist and the executive director of the VAMC. “It felt like ‘Back to the Future’ in some ways, like a really neat thing that someday we would get to, but wasn’t quite there at the time. You could telehealth from one big city to another, but not necessarily in rural areas where people need the help the most.”
That began to change in 2014, when a number of organizations dedicated to supporting rural communities began meeting and developing summits with the White House Rural Council.
In 2017 the very first VLR opened in McKee, Ky., an Appalachian town that’s barely a fifth of the size of Bristol. It was so successful that FRS, with assistance from CoBank, a cooperative bank whose mission is to serve rural America, decided to fund more VLRs.
Bristol’s is the second VLR in the nation, and plans are being made for more.
“Projects like this — you can’t just air-drop them,” said Sarah Tyree, VP of Policy & Public Affairs at CoBank. “You have to have a powerful community come together and pull it all together. The big question is ‘How do we take this great story, and the great work that you’ve done here and inspire other communities across the country to do the same thing? Because there are funds available, so let’s replicate it!”

HOW IT WORKS
The Bristol American Legion is in the process of developing a schedule with the VAMC, said Post 19 Adjutant Allen Smith.
Veterans from anywhere — not just Addison County — will be able to call Post 19 and set up an appointment to use the VLR.
The 8-foot-by-10-foot room, which was built by Lucas Sweeney and Donnie McCormick of Sweeney Construction in Lincoln, has a soundproof door, soundproof walls and an acoustic ceiling, Sweeney explained.
Using the VLR’s computer, vets will log into their email and click on the provided link to conduct a test call with the national VA help desk, to work out any kinks with the technology. Then they can follow another link to set up a video call with their healthcare providers.
“I was surprised by how easy it is,” said Tina Kebalka, the Facility Telehealth Coordinator for the White River Junction VA Healthcare system. “There’s nothing scary about this at all. It’s not just for the younger generation, and you don’t have to be a computer genius to use it.”
Once the scheduling has been developed and the system is running smoothly, vets with transportation issues or who feel too ill to travel long distances may be able to convert some of their existing VAMC appointments to VLR appointments.
All primary care and mental health providers at the VAMC have been set up to use VA Video Connect and have been trained, Davis said. Specialists, like surgeons, oncologists and cardiologists, as well as pharmacists, are also getting equipped and trained.
The new system could cut down significantly on the number of visits vets have to make to White River Junction or one of the VA’s satellite clinics.
During a test call on Monday, Dr. Dan O’Rourke, a cardiologist and the VAMC chief of staff, said he had seen six patients up to that point in the day, and five of them could easily have been served via VLR.

GET THE WORD OUT
“We facilitated the room,” said Lt. Col. Ronald L. LaRose, Post 19 commander. “Hopefully the word gets out there so that people will come here and not have to worry about driving or riding to the VA or the clinic.”
Pam Becker, executive director of FRS, agreed.
“Now the real work really happens,” she said. “Now we have to get people using it and comfortable with it.”
For more information about the new Virtual Living Room, visit whiteriver.va.gov.
Reach Christopher Ross at [email protected].

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