Department of Defense: Telehealth use in fiscal year 2016
The Department of Defense (DOD) uses telehealth to provide healthcare services to its beneficiaries who include active duty servicemembers, dependents, and retirees. DOD defines telehealth as the use of telecommunication and information technologies to provide health assessments, treatments, and other services across distances. GAO’s analysis of DOD telehealth service encounter data for fiscal year 2016 found that DOD provided about 59,000 telehealth service encounters between providers and patients or between two providers. Of DOD’s 59,000 telehealth encounters:
- About three-fourths were provided through DOD’s direct care component of military treatment facilities, while one-quarter were provided through its purchased-care networks of civilian providers; and
- about 88% were synchronous or “real time” interactive communications such as those between providers and patients during live video, and the remaining 12% were asynchronous or “store and forward” encounters involving the transmission and interpretation of medical images between providers.
GAO’s analysis of telehealth use by active duty servicemembers shows that the types of clinical services that DOD provided using telehealth varied according to the type of encounter:
- Synchronous encounters were commonly used to provide mental health and pulmonary disease services.
- Asynchronous encounters were commonly used to provide cardiology and dermatology services.
Among all active duty servicemembers, GAO found that relatively few—about 1%—received telehealth services in fiscal year 2016. That is, among the roughly 1.2 million active duty servicemembers, about 11,000 were involved in at least one synchronous encounter and about 2,000 were involved in at least one asynchronous encounter, such as a consultation for a diagnosis.
The Army provided the largest volume of telehealth service encounters to active duty servicemembers, compared with the Navy, Air Force, and National Capital Region combined. Further, seven military treatment facilities provided almost all of DOD’s telehealth encounters to active duty servicemembers. The seven facilities with the highest volume of encounters are located in the United States (HI, TX, MD, VA, GA, and CA) and Germany (Landstuhl). DOD officials explained that a small number of facilities provided most of the telehealth encounters for several reasons: Leaders at these facilities have actively encouraged telehealth use, four of the seven facilities maintain hubs, two facilities maintain portals that support a high volume of synchronous and asynchronous telehealth encounters, and these facilities have a large number of providers who can provide specialty care with telehealth.
