Tuesday, August 14, 2012

Telemedicine Reshaping VA Healthcare, Natl Guard & Reserves ...

Front & Center: Military Talk Radio w/Rick Rogers

Show No. 74, Aug. 12, 2012

Listen to show here.

Guests this week:

James Rebholz, national chairman of the Employer Support of the Guard and Reserve. Tape 12 min.

Drs. Steven Thorp and Martin Paulus on telemental health. The next big thing in treating veterans who live in outlying areas.

SEGMENT I:

Hello and welcome to Front & Center: Military Talk Radio.

A nice and very timely show is coming your way today.

On Wednesday I spent the day at San Diego Chapter for the National Defense Industrial Association expo. There I met James Rebholz, chairman of the Employer Support of the Guard and Reserve.

It was good luck to run into Mr. Rebholz because just the week before the Army announced proposed changed the training requirements for the National Guard and Reserves.

I was able to get a quick interview with him on this and few other issues.

Then a really interesting segment that might offer a glimpse of what the future of health care will look like.

A San Diego VA doctor and researcher will discuss telemedicine. That?s where streaming video is used to treat patients, especially those in outlying areas who can?t easily get to a specialist.

So a great show is headed your way. Hope you can stay for the fastest hour in radio.

But if you can?t, Front & Center episodes are at: www.defensetracker.com.

Today?s show is episode is No. 74 in my never-ending quest to deliver you the best news and information on issues important to veterans, troops and military families. And let?s not forget defense contractors.

The Society of Professional Journalists recently named my website the best military blog so check out www.defensetracker.com and see what they are talking about.

And don?t forget that Front & Center: Military Talk Radio shows are available on iTunes. Subscription is free.

Pause

Before getting to my guests today, let?s take a look at stories making headlines on the Morning Report.

The Morning Report is brought to by the law offices Haytham Farj, a nationally recognized attorney specializing in military and veterans? law.

To learn more, call 619-752-3950.

Pause

This segment is also sponsored by Diversity Solutions. Diversity Solutions is holding a career fair for vets, troops and military family members at the Scottish Rite Event Center in Mission Valley on Aug. 15.

Just got an updated list of the companies that will be in attendance and it is very impressive. It includes:

For more information call Diversity Solutions at (888) 313-5782.

* Starting in Southern California. Marines and sailors at Miramar Marine Corps Air Station welcomed a new commanding general.

Maj. Gen. (select) Steven W. Busby is the new 3rd Marine Aircraft Wing commander, taking over from Maj. Gen. Andrew W. O?Donnell, Jr.

Busby comes to San Diego from a staff job at the Pentagon.

O?Donnell is transferring to Yokota Air Base, Japan, to be the deputy commander for U.S. Forces Japan.

* More than 200 Camp Pendleton Marines and sailors are returning to Southern California this week after spending the last year at war in Afghanistan.

Regimental Combat Team 5 served as the ?command and control element? over the Marine battalions deployed to the Afghan districts of Garmser, Marjah, Nawa and Khan-Neshin.

Ladies and gentlemen, welcome home.

* This week Camp Pendleton Sgt. Matthew Abbate was

posthumously awarded the Navy Cross for extraordinary valor on Oct. 14, 2010 when his unit was ambushed by Taliban.

The 3rd Battalion, 5th Marine died two months later, on Dec. 26, 2010, he killed by a series of IED explosions.

Music pause

* This is kind of a cool thing. Did you hear about what they are doing at Camp Pendleton? A chow hall there will soon have a drive-through window. How great is that?

This mess hall will be located near the airfield and is part of the base?s multibillion-dollar makeover.

Camp Pendleton has 15 mess halls for the more than 45,000 troops stationed at the base.

* This is not such a cool thing.

A U.S. Navy ship has collided with an oil tanker in the Strait of Hormuz. This happened early this morning.

The Norfolk-based guided missile destroyer USS Porter bumped into a Japanese-owned oil tanker Otowasan in Strait of Hormuz.

No further details to report.

Saw some photos of this and there is a sizable hole mid-ship well above the waterline on the porter.

* Here is a story that really caught me by surprise the other day.

It said that Medal of Honor recipient Dakota Meyer tried to kill himself in 2010, just a year before he became the first living Marine in 38 years to receive the nation?s highest valor award.

That is among several revelations in a new book written by Meyer and best-selling author Bing West.

The book is called ?Into the Fire: A Firsthand Account of the Most Extraordinary Battle in the Afghan War,? due to be published Sept. 25.

The book chronicles Meyer?s childhood in Kentucky, his time in the Marine Corps and the disastrous mission on Sept. 8, 2009, that saw Meyer and his team of American and Afghan troops ambushed, overrun and trapped for hours.

Meyer, 24, received the Medal of Honor from President Obama in September for braving enemy fire multiple times that day to recover the bodies of missing members of his team.

In an interview, Meyer said he decided to disclose the suicide attempt because it shows the realities of war. The close call occurred in September 2010, just days after the first anniversary of the battle in Afghanistan?s Kunar province.

He had been drinking at a friend?s house in Kentucky and on the way home pulled over and pulled out what he thought was a loaded pistol.

Meyer pulled the trigger and was shocked when it didn?t go off, he wrote in the book. He suspects someone else unloaded the pistol, but declined to disclose who it was. He subsequently sought treatment for post-traumatic stress and is doing better now, he said.

?That right there was rock bottom,? he said in the interview. ?I could never get lower than that, you know? And seeing how close it was that I was to take my own life, I think it?s something that a lot of veterans go through coming back and dealing with the realities of war.?

The book describes in detail the heavy combat he and others faced during the Battle of Ganjgal. Meyer recalls not only burning through thousands of machine-gun rounds while manning the turrets in several Humvees, but killing an enemy fighter in hand-to-hand combat.

For every soldier killed in war this year, about 25 veterans now take their own lives.

An astonishing 45 percent of those who served in Iraq or Afghanistan are now seeking compensation for injuries, in many cases psychological ones. It?s unclear how many are exaggerated or even fraudulent, but what is clear is this: the financial cost of these disabilities will be huge, yet it is dwarfed by the human cost.

* Things are heating up in the Middle East between Israel and its neighbors over a possible attack on Iran?s nuclear facilities.

Saudi Arabia warned it would intercept Israeli fighter jets that enter its airspace en route to an attack on Iran.

The warning was relayed via Washington and raised by top U.S. administration officials who recently visited Jerusalem.

* There?s a new law that limits how close demonstrators can come to funerals of military members.

The law expands the buffer zone around military funerals from 300 feet to 500 feet, and increases the buffer around access routes to a funeral service from 150 feet to 300 feet. It also creates harsher penalties for violators.

* From the this has got to end file.

Six Americans killed in on day by turncoat Afghanistan forces.

Two Afghan soldiers tried to gun down a group of NATO troops outside a military base in eastern Afghanistan. No international forces were killed, but one of the attackers was killed by NATO forces.

That was the second attack by Afghan forces on their international counterparts this week. Earlier two gunmen wearing Afghan army uniforms killed a U.S. soldier and wounded two others.

So far this year, 27 coalition service members have been killed in 20 green-on-blue attacks, according to an Associated Press tally. That compares with 11 fatal attacks and 20 deaths the previous year. In 2007 and 2008, there were a combined total of four attacks and four deaths.

Then on Friday, A man in an Afghan military uniform killed three U.S. troops in southern Afghanistan, the latest in a series of assaults against NATO soldiers by Afghans clad in security force garb.

The three troops killed were part of a Special Operations Forces mission meeting with local officials.

And yet again: A man in civilian clothing opened fire on a base shared with Afghan forces, killing three NATO troops, a spokesman for the International Security Assistance Force said Saturday.

The shooting occurred late Friday in Afghanistan?s volatile Helmand province, the same region where three American soldiers were killed hours earlier by a man in an Afghan military uniform, officials said.

Afghan and ISAF officials offered conflicting accounts over the latest shooting in Garmsir District, where U.S. Marines have been working with Afghan forces at a joint outpost.

An Afghan official said a local police officer opened fire, killing three Marines, while ISAF said the gunman was wearing civilian clothes.

* The Vietnam War ended nearly 40 years ago, but deadly legacy continues to snake through the population of that country.

Dioxin from the defoliant Agent Orange courses through the bodies of Vietnamese to this day.

The chemical linked to cancer, birth defects and other disabilities, has seeped into Vietnam?s soils and watersheds.

This week for the first time the U.S. will begin cleaning up Agent Orange that was stored at the former military base, now part of Danang?s airport.

The $43 million project begins as Vietnam and the United States forge closer ties to boost trade and counter China?s rising influence in the disputed South China Sea.

* The Social Security Administration is putting a rare lung disease found in some veterans exposed to burn pits and fires in Iraq and Afghanistan on its ?compassionate allowances? list, a designation that should speed the process to receive Social Security disability benefits for those diagnosed with

constrictive bronchiolitis.

* A Southern California-based charity is the latest charity to come under scrutiny for its financial practices.

The organization is ?Help Hospitalized Veterans? and it is no stranger to controversy. Four years ago its founder and then-president Roger Chapman was hauled brought before Congress to answer questions about his management of millions of dollars in private donations.

Well, now that same organization is in the news again for all the wrong reasons.

California?s Attorney General Kamala Harris is suing the Riverside County-based charity over alleged violations of state codes.

I?m going to try to get Charity Watch on the show next week to talk about the huge issue of organizations taking donations on behalf of veterans, troops and military families and then blowing the money on themselves.

* The U.S. military has its first openly gay flag officer with the promotion of Tammy Smith to the rank of Army brigadier general.

Smith serves as deputy chief at the Army Reserve office in Washington, D.C.

* Spent Wednesday at the San Diego Conference Center attending the National Defense Industrial Association expo.

A really strong turn out. I was told it was the biggest in years.

There I interviewed James Rebholz, chairman of the National Committee for Employer Support of the Guard and Reserve

We spoke about a story first brought up on the show last week. Big changes coming for the peacetime operations of the Guard and Reserves.

Those citizen-soldiers who thought that a return to the old construct of one weekend a month and two weeks a year after the fighting overseas ends in 2012 are in for a shock.

The end of the fighting will NOT mean a return to a peacetime schedule that 550,000 Guardsmen and Reservists once knew.

For some their yearly obligation will grow from two weeks to seven weeks a year.

There is also talk of reducing their pay for weekend duty.

But this might also be a way of thinning the ranks so the government doesn?t have to pay retirements. Just make it too bothersome for folks to stay in.

I predict employers will not be happy and that the number of part-time troops filing Uniformed Services Employment and Reemployment Rights Act violations will rise.

The Morning Report was sponsored by the law offices of Haytham Farj. For more information, give him a call at 619-752-3950.

Time for a quick break, but stay tuned. Coming up an interview with James Rebholz, chairman of the Employer Support of the Guard and Reserve is coming up on the side of the break.

You are listening to Front & Center: Military Talk Radio. Heard in the finest military communities every week.

1st Commercial Break

Segment II

Taped interview with James Rebholz. 12 minutes

*** That was an interview I did on Wednesday. So, Jim Rebholz, chair of the Employer Support of the Guard and Reserve does not believe that any changes to the training calendar of our citizen soldiers is going to meet with push back from employers. I hope he is right about that.

I however, have my doubts. I?ll keep my eye on this and let you know how this all pans out.

Well up next very special and important interviews with that might just give you a glimpse of how medicine will be practiced in the future.

Find out how streaming video might just take the place of visits to the doctor?s office.

You are listening to Front & Center: Military Talk Radio with Rick Rogers. The first and only military talk show for troops, veterans and military family members of its kind in the land.

Segment III

Welcome back to Front & Center: Military Talk Radio.

Podcasts of the show at www.DefenseTracker.com.

Pause

Not so many years ago the idea of a doctor being in one place while seeing patients in another seemed fantastic.

But that was before Internet broadband and ?streaming video gave birth to telemedicine.

This cross-pollination of telecommunication and information technology could revolutionize care delivery, especially for those living in rural areas.

In some ways telemedicine is tailor made for the Department of Veterans Affairs because often VA facilities are centrally located while their patients are dispersed.

Overcoming the tyranny of geography is the goal of the San Diego VA Healthcare System?s tele-mental health program.

Joining me to talk about the VA?s pilot tele-mental health program being developed in San Diego and Imperial counties are Steven Thorp and Martin Paulus.

Steven Thorp is Program Director of PTSD Clinical Team at the San Diego VA. He also teaches at University of California, San Diego.

Martin Paulus is a psychiatrist at the University of California San Diego and the Veterans Affairs Health Care System San Diego.

Gentlemen, welcome to you both.

* Let?s start with you Steven Thorp. Give our audience a thumbnail of the telemental health program.

* In background information on the program the ?great and growing need? for effective mental health treatment for veterans was cited. What are the specifics of that?

* Martin Paulus, what does the early reports say about the quality of care that vets are getting through telemental health?

* Where is this work done? How secure are the links?

* How expansively is this used? Do vets seem to like it?

* Who seems to be the biggest users of telemental health?

* Steven Thorp, this program goes well beyond San Diego and Imperial counties. Tell me about that. What ultimately would the VA like to do with telemedicine in general?

* Martin Paulus, what types of treatments are provided via the Internet? Can these patients also see someone in person?

* Post Traumatic Stress is a key ailment that telemental health program is treating. How receptive are the veterans?

(Number of patients that dropped out of treatment was higher for IP (29%) as compared to TMH (6%))

* I know that at one time there was a waitlist for telemental health. Does that still exist?

* What are the reasons for their acceptance for this program?

* Is this still a randomized program? If it still is, when can vets opt for tele-appointments?

* How many people in the program? Where are your clients?

(Nonetheless, therapists conducting evidence based psychotherapy using TMH have completed over 3,000 therapy hours. 10 offices with TMH)

This Spring the VA San Diego Healthcare System was selected to start a new mental health program to provide mental health services via Internet link to Veterans across the Western United States who live long distances from their nearest VA treatment facilities.

Opened in April, the Telemental Health Center uses a secure Internet connection and web camera to connect Veteran patients who would otherwise be unable to get psychotherapy treatment due to geographical constraints.

Rather than traveling long distances for treatment for issues such as post-traumatic stress (PTS), patients can now connect with their therapist via webcam through the convenience of their local regional Vet center or VA outpatient clinic.

?The regional center is a place to provide evidence-based psychotherapy along with infrastructure for participating community-based outpatient clinics and staff,? said Dr. Martin Paulus, Western regional director of telemental health. ?This is the future of mental health care in the 21st century.?

At its full capacity, the Telemental Health Center will treat up to 85 patients a week from areas as far away as Alaska and Guam. According to Paulus, this will save time for patients who normally would travel long distances to their regional VA medical center for care. Providing state-of-the-art psychotherapies to rural patients using the Telemental Health program will also allow staff to offer more appointments and allow more time to treat a greater number of serious mental health cases.

VA San Diego is one of three regional locations selected for Veterans Affairs telemental health centers across the United States. The others are in Charleston, S.C. and San Antonio, Texas.

2nd Commercial Break

Welcome back, you are listening to Front & Center: Military Talk Radio. Heard here every week.

Close

Well that wraps up another edition of Front & Center: Military Talk Radio with Rick Rogers.

Want to thank my guests James Rebholz and Martin Paulus and Steven Thorp.

Don?t forget that Diversity Solutions is holding military a career and resource fair this Wednesday, Aug. 15, at the Scottish Rites Center in San Diego. Call 1.888.313-5782.

Please join me next Sunday 11 to noon right here as we chat about military and veterans? issues that matter right here, right now in Southern California and across the country.

See you on the beach.

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