Congressman focuses on veterans issues

During a tour of veterans service centers across Montana, Congressman Steve Daines visited the Kalispell Veterans Affairs Community Based Outpatient Clinic on Wednesday to discover what his office could do to help improve health-care services.

“I’m here to get a ‘to-do’ list to take back to Washington,” Daines said. “We’re on recess now, but I thought it would be good to see what I can do to help.”

Some of the issues that were raised included the rural and isolated nature of clinics in Montana and the difficulty of recruiting qualified staffers.

“We’re very isolated here and this is it; this clinic has to serve more than 5,000 active patients,” Dr. Ben Rosetto said. “We can do basic and primary care, but for anything else, we have to contact Fort Harrison, which is just a basic hospital. We’ve got a lot of local resources right here in the private sector, but the referral process is draconian and not conducive to getting anything done.”

To help bridge that gap, the Department of Veterans Affairs has implemented a Telehealth system that allows remote consultations and patient evaluations for both physical and mental health issues.

When Daines asked if the Telehealth system was helpful or if anything could be improved, the response was overwhelmingly positive.

“Telehealth is absolutely a positive thing, and has helped us a lot,” said Dr. Mary Kujawa, a behavioral health service provider at the Kalispell clinic. “I’ve been pleasantly surprised by it and how easy it is for even elderly patients to use. It’s perfect for us.”

The system allows patients who cannot get to a full clinic to connect with doctors from satellite locations. Doctors can also upload case histories and photos or video of patient conditions and get specialist consultation in real time without having to travel.

“Something I’ve noticed with the Telehealth Services program that I am a little surprised at is you don’t get a sense that it’s a threat to job security,” Daines said. “Montana has 14 distinct care delivery sites to serve a huge state and one VA facility at Fort Harrison. There’s a challenge to deliver equitable health care throughout the state, but I think Telehealth is helping to take care of that. It’s the wave of the future.”

Although digital consultations and patient treatment within the Veterans Affairs system may be going along smoothly, there are still interface problems when private providers get involved.

“Most of the private physicians still use paper records, whereas we use electronic ones,” said Dr. Jonathan Bechard, the assistant chief of staff of ambulatory care for the Montana Veterans Affairs Healthcare System. “There have been issues with interfacing with the private sector before, and some of our colleagues in the private sector think we’re not cooperating.”

Bechard went on to say, that while some private physicians may not be enthusiastic about the electronic medical records, they has been convenient and helpful.

“When someone is admitted to the ER at a private hospital on a Friday night or Sunday, when a primary care physician might not be available, the hospital can just call Fort Harrison and get access to things like drug interactions, because there’s always someone there and they can access the system. If we still used paper, and that primary care physician wasn’t available, you’d be out of luck.”

Although Veterans Affairs is trying to standardize care and reduce costs at the same time, Daines said he realizes that a “one-size-fits-all” outlook may not be the right one.

“In the spirit of diversity, there are differences in all areas and what works for San Francisco, might not be right for Kalispell. But it sounds like things are moving in the right direction,” he said.

Reporter Melissa Walther may be reached at 758-4474 or by email at mwalther@dailyinterlake.com.