VA clinic will move to new location

By Dec. 1, military veterans in the northeast Montana area will be making visits for medical care at a new location in Glasgow. The VA Montana Healthcare System is ending its contract with Frances Mahon Deaconess Hospital and opening a VA-staffed clinic in Glasgow. The new location is 630 Second Ave. S., known as the Pratt Building.

VA Montana is moving toward VA-staffed clinics, said Teresa Bell, the VA's public affairs officer at Fort Harrison. There is only one other contract site in Montana.

The clinic will be staffed by a nurse practitioner, who can prescribe medications, a licensed practical nurse and a clerk. The only one whose hiring is official is the clerk, Charlotte Hrabak, who has worked with the VA in Glasgow for years.

"Charlotte is a long-standing, very devoted VA employee," Bell said.
The clinic will operate in 2,800 square feet of space housing three exam rooms, a nurse work area, lab, waiting room, telehealth room and a healthcare provider's office.

Bell said the clinic will offer ambulatory primary care, preventive care and physicals. Lab samples can be taken at the clinic and sent to FMDH for analysis. Patients needing X-rays will be sent to FMDH. Cases that are complex or that require surgery will be referred to the VA Medical Center and Ambulatory Care Clinic at Fort Harrison, near Helena.

The clinic in Glasgow will feature extensive use of telehealth and video conferencing. This is already being used for mental health services, connecting veterans with one of the four VA psychiatrists in Billings and Helena. New technologies to be used here will send results in real time to monitoring physicians, if the nurse practitioner thinks it is necessary. With these instruments, a distant doctor will be able to see in the patient's ear or eye as well as the nurse in the room. There are digital blood pressure cuffs and stethoscopes in the global media cart  too.

"We're very excited about that piece of equipment that allows an exam without the vet's having to travel," Bell said.

Distant education is possible with telehealth technology. For example, a vet with blood pressure problems or pre-diabetes can talk face-to-face with a dietitian about changing eating habits and heading off a serious disease.

When Randy Holom, the CEO of FMDH, was asked if telemedicine technology is good enough for clinic care, he said, "It depends on what you're using it for."

Holom said visiting specialists at the Glasgow Clinic use it for follow-up visits, and they plan to expand its use. They have had some telemedicine technology for about 15 years, mostly for mental health, but now they are starting to see its use in other branches of medicine, such as radiology.

"I think we will see growth in telemedicine applications," Holom said. "The quality of the equipment has certainly improved in the last 10 to 15 years. It won't replace face-to-face."

The VA clinic in Glasgow served 557 patients in fiscal year 2008-2009, Bell said. She quoted statistics on the VA's market penetration of the veteran population in some area counties, the number of VA clinic enrollees compared to the total number of veterans. In Valley County the VA has a 57 percent market penetration, the highest in the northeast corner. Sheridan is 49 percent, Roosevelt is 39 percent, Daniels is 32 percent and Richland is 48 percent.

Bell encouraged veterans to enroll for health care, regardless of whether they are eligible for it now or want to use it now. In 2003 the VA stopped taking retired service personnel who make over a certain income, but the laws may change, Bell said, and people whose applications are on file would be notified of their new status. Enrolling can be done at a VA clinic or at www.va.gov.
The VA operates 13 clinics in Montana, including Fort Harrison, and is opening two additional telehealth clinics with a nurse on site in Hamilton and Plentywood, Bell said. It is new for the VA to develop outreach clinics rather than full-blown clinics, she said. These community-based outreach clinics provide primary care and mental health. At present, there are no visiting doctors at these clinics.

Holom said the VA has had a contract with the Glasgow Clinic at FMDH for 10 or 11 years, Certain physicians and nurse practitioners are credentialed to care for veterans at VA expense. Holom has previously said that the VA did not give the hospital advance notice of their intentions before advertising for medical staff and space for the new clinic. He said that the contract only requires notification if the VA is extending the contract for another year. He said the hospital contacted the VA to clarify what would happen with patients who were scheduled to be seen in the Glasgow Clinic after Dec. 1. They will be going to the new facility.

Holom said the change should not have a great affect on the Glasgow Clinic.

"Most VA beneficiaries are also beneficiaries of other programs," he said. "We'll see what happens. Some are on Medicare or another program. I don't think we're going to have a problem."

The telephone number of the new clinic has not yet been assigned. Enrollees will receive a notice in the mail when there is a number. For more information now, call the VA clinic at its present location in FMDH, 228-3554.