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The term connected health refers to technologies that extend the health care relationship beyond the traditional in-person synchronous encounters that for so long have been the centerpiece of patient/provider interactions. Connected health technologies include telehealth, telemedicine, patient
portals, mobile health applications (mHealth), wearable monitoring devices, and other technologies that connect patients to their health care team or
These connected health technologies are rapidly evolving, promoting a greater focus on patients and their caregivers, driving patient expectations for
easier sharing of personal health information, and necessitating change in how health care teams interact. The U.S. Department of Veterans Affairs (VA) is
taking advantage of these emerging technologies by developing new or enhancing existing Web, mobile, and point-of-care digital services to redefine
traditional VA care delivery.
Currently, more than one in four VA patients is engaged in the use of a connected health technology. One of VA's goals is to increase participation even
further, with an objective of improving the quality and experience of care for our patients and their caregivers, while simultaneously broadening access
Driving the accelerated adoption of connected health is the simultaneous improvement in information technology and the emergence of the increasingly
engaged and empowered patient. We anticipate increased demand for connected health technologies, which will be driven by consumers' expectations that health information, knowledge, direct care, and support should be delivered virtually—when and where it is needed, with ease
of access and use.1
As part of this health care consumer revolution, connected health technologies are expected to provide enhanced patient participation in self-care through remote health tracking, disease management support systems, and simple communication tools.
Consumers prefer systems with an easy-to-use interface, trustworthy source, perceived value, and effective integration with the other communication
channels of the business. The ability of these self-care connected health technologies to improve patient outcomes will likely continue to be driven by
individual tailoring, personalization, behavioral feedback, and clinical integration. 2,3
More effective bi-directional exchange of health data between patients and their health care teams
is a second major shift occurring as a consequence of the growth in connected health technologies. Patients are empowered by the health care system's
newfound ability to make personal health data available in near real time via digital tools for their personal consumption. Increasingly, VA expects
that patient-generated data, supported by powerful algorithms, will be a key ingredient used by health care organizations to personalize the patient
experience. Patient-generated data will further drive the shift from the still common paradigm that patients neither own nor control their health data to
the emerging concept that the data belongs to them.
The increasing demand and interest in virtual are delivery, either synchronous (example: clinical video telehealth) or asynchronous (example: secure messaging) is a third major shift being powered by connected
health technologies. These virtual care delivery modalities do not replace existing health care relationships, but augment them. Virtual care delivery
has the potential to reduce inefficiencies in traditional health care delivery, allowing improved access to care and a reduction in geography related
In early 2013, VA created a dedicated Connected Health Office with responsibility for overseeing the execution of a unified connected health strategy and
ensuring its alignment with VA's overall strategic plan. The office's overarching goals are three-fold:
(1) increasing and improving access;
(2) supporting Veteran self-care; and
(3) enabling VA employees to better meet Veterans' needs.
These high-level goals have been further defined by the
following priorities: (1) create a seamless, unified experience for Veterans across all VA patient-facing technologies; (2) expand Veteran access to care;
(3) engage Veterans and their families in
self-management of their health; (4) create patient-centered care through personalization of VA health care; (5) improve information sharing to increase
the value of communication;
(6) increase VA health care team efficiency and quality by moving relevant clinical data closer to the point of care; and (7) systematically and
intentionally deliver innovations that will improve health care.
The future impact of connected health technologies will depend upon both the effectiveness of the technologies and their reach—the number and percent of
Veterans with access to, adoption of, and use of the technologies. VA should adopt strategies to enhance access to these technologies for all Veterans,
including at-risk populations, such as Veterans with lower income, lower health and technology literacy—and those Veterans with health issues, including
traumatic brain and spinal cord injuries that can make access to technologies more challenging.
VA's Under Secretary for Health, Dr. Robert A. Petzel, has maintained that VA's goal is to put Veterans at the center of the agency's care and treat the
whole person, not just symptoms or diseases. He argues that connected health technologies are a critical tool to allow us to achieve that goal and that
they are rapidly changing how Veterans access the resources and information available to them. At a recent showcase of VA's leadership in connected health, Dr. Petzel remarked, "These technologies are helping us create a
system of care without walls, a virtual system of care. This is where medicine is going— the virtual care delivery system."
Frist, W. H. "Connected Health and the Rise of the Patient-Consumer," Health Affairs 2014; 33(2):191-3.
Gibbons, M.C. et al. "Impact of Consumer Health Informatics Applications," AHRQ Publication No.
09(10)-E019, Rockville, MD, 2009.
Jimison, H. et al. "Barriers and Drivers of Health Information Technology Use for the Elderly, Chronically Ill, and Underserved," Evidence Report Technology Assessment 2008; 175:1-1422.