title: Meeting veterans where they're @: a VA Home-Based Telemental Health (HBTMH) pilot program.
abstract: OBJECTIVE
  The first Home-Based Telemental pilot program (HBTMH) in the Department of Veterans Affairs addresses the significant challenge of access to mental health treatment for rural veterans. Though the feasibility of telemental healthcare in clinic-based settings has been well documented, the feasibility of telemental health via webcam and computer in a patient's home or other non-clinic settings is unknown.
  
  
  METHODS
  The HBTMH program, established in December 2009 at the Portland VA Medical Center, delivers a wide range of mental health services into the homes and other non-clinic settings of rural veterans via webcam, secure and encrypted software and veteran-owned personal computers. The program adhered to a Standard Operating Procedure (SOP) Manual, evaluated patients with the Assessment for Suitability for Home Based Telemental Health (ASH-25), utilized a Patient Support Person (PSP), and incorporated a peer technical consultant to provide assistance to veterans. The authors describe satisfaction and safety survey results from the initial 40 veterans enrolled.
  
  
  RESULTS
  Survey results support the feasibility and safety of using webcams, secure/encrypted software and veteran-owned personal computers for the delivery of mental health services into the home. Veterans report high levels of satisfaction and perceived safety with home-based telemental health. RESULTS also suggest fewer no-show appointments in home-based telemental health compared to clinic-based telemental health.
  
  
  CONCLUSIONS
  The authors discuss the strength and limitations of the program as well as potential areas of future research.
authors.affiliation: Portland VA Medical Center, Oregon Oregon Health and Science University, Portland.
authors.forename: Peter
authors.initials: P
authors.lastname: Shore
authors.affiliation: Portland VA Medical Center, Oregon Oregon Health and Science University, Portland.
authors.forename: Anders
authors.initials: A
authors.lastname: Goranson
authors.affiliation: Portland VA Medical Center, Oregon.
authors.forename: Mark F
authors.initials: MF
authors.lastname: Ward
authors.affiliation: Portland VA Medical Center, Oregon Oregon Health and Science University, Portland.
authors.forename: Mary W
authors.initials: MW
authors.lastname: Lu
mesh_terms: D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D017060:Patient Satisfaction; D010865:Pilot Projects; D011613:Psychotherapy / Q000295:instrumentation / Q000379:methods*; D012424:Rural Population; D017216:Telemedicine / Q000295:instrumentation / Q000379:methods*; D014481:United States; D014493:United States Department of Veterans Affairs / Q000458:organization & administration; D014728:Veterans / Q000523:psychology*
keywords: behavioral medicine; telehealth; telemedicine; veterans; videoconference