SCI STORIES
Optimizing Access to Healthcare Services Allows Veterans Living with Spinal Cord Injury to Live [ Independently ]
by Colin Lenington, OTD, OTR/L, ATP, CAPS CLINICAL SPECIALIST OCCUPATIONAL THERAPY SPINAL CORD INJURY/ DISORDERS VA LONG BEACH HEALTHCARE SYSTEM
B Being able to freely move around your home and local community is something that many people may take for granted. The ability to get where you need to go to live your life can be a barrier for Veterans with limited mobility. Going into the kitchen to make yourself a meal, into the bathroom to take a shower, or even in and out of your house can pose major challenges. Veterans with spinal cord injury, ALS, or multiple sclerosis who use wheelchairs or other mobility devices can experience these challenges on an ongoing basis. The rehabilitation team at the Ernst Bors M.D. Spinal Cord Injury (SCI) Center at the Tibor Rubin Long Beach VA have the specialized expertise to complete complex home evaluations. They can make personalized recommendations to improve access within homes and increase participation in health-promoting activities. The gold standard for home evaluations has always been an in-person assessment conducted by multiple therapy disciplines, such as occupational or physical therapy. However, there can be obstacles to completing in-home evaluations. During the pandemic, for example, frequently going into people’s homes was not always an option. Long Beach is the hub site for SCI Veterans living within approximately 200 miles. Traveling those distances on a regular basis is not convenient for either the Veteran or clinical team. It can take weeks to schedule the average 4-hour block of time required for therapists to do a home evaluation. In partnership with the VA telehealth team, SCI therapy promotes physical access to Veterans’ homes by expanding
options for health care services. In part due to the COVID-19 pandemic, the awareness and use of telehealth services has increased across the VA and other health care systems. However, technology alone cannot address all the issues involved in improving access. Working with VA administrative teams, SCI therapy created a new therapy consult to identify Veterans’ needs, and scheduling directives to avoid confusion about whether an appointment is in-person at VA, in-person at their home, or via telehealth. At the core of the telehealth services is the VA Video Connect system. This offers a secure “medical room” for evaluations. The SCI telehealth team will do a test call and address any connection challenges. It is critical for a caregiver to be present in the home. With guidance from VA Long Beach SCI therapists, the caregiver can be directed to tour the areas of concern and take measurements. SCI therapists can then advise the Veteran on what solutions may be possible, and coordinate follow-up. As part of follow-up, a vendor may bring a trial piece of equipment to the Veteran’s house and demonstrate it during a telehealth session with the SCI therapist. Then the therapist and Veteran can see in real time how the equipment will work in their home. If coordinating during business hours is difficult, the VA MyHealtheVet Secure Messaging system allows for encrypted emails with picture attachments to be sent directly to SCI therapists for review. SCI therapists can also respond directly to Veterans.
SPRING 2023 17
Made with FlippingBook. PDF to flipbook with ease