va telehealth services delivered many possible outcomes. we have increased access to primary care and specialist consultations leading to reduced wait times. telehealth improved patient outcomes resulting in reduced utilization of inpatient care. for example, in physical year '14 when we studied veterans receiving home telehealth services for non-institutional care needs and non-chronic care management, those enrolled veterans had 54% decrease in va bed days and 32% decree in va hospital admissions veterans compared to themselves in the year prior to their enrollment in home telehealth. veterans receiving mental health services what we call telemental health, had 35% reduction in acute psychiatric bed days of care. in addition va telehealth services programs reduce the necessity for veterans to travel to va facilities for care. clinical video telehealth and storing forward tell a health shown to result in average cost savings of 35 to $40 per patient consultation. home telehealth decreased costs for va and non-va care and reduced cost by $2,

it reduces the necessary for veterans to travel to va facilities for care. clinical telehealth has been shown to result in an average cost saving of $35-$40 per patient per consultation. it has been shown to decrease va net patient cost by $2,000 per veteran receiving nelt. and the most importantly the stat status -- satisfaction rate is high. the va is transforming to being veteran centric. for many veterans, travel to the centers can be complicated and argerous. travel time is time away from the veteran's work or family. va's telehealth care revolutionize the travel challenges by changing the locations where health care service is provided, improving access and helping the veterans take a more active role in the management of their health and wellbeing. this concludes my testimony and i am please today answer questions you or other members of the committee may have. >> thank you. dr. skubic. >> thank you for allowing me to be here between the senators and visitors. i want to tell you about eva who lived at tiger place. the aging in place senior housing facility in columbia, m

and telehealth has a decrease cost of the va and has been shown by $2,000 those of the receiving home telehealth. most important between 80 and 94 percent approval for these types but in conclusion the veterans administration is changing services for many veterans and loved ones it can be complicated and sometimes arduous task. natalie that travel time is time away from family. the telehealth is services program revolutionizes challenge by changing the rotation to split access to care and help them take a more active role in the management of their health and well-being. this concludes my testimony. i will answer any questions you may have. >> dr. skubic. >> thank you for the opportunity to be here on this panel and visitors. i want to tell you a story about even of whom lived a life and aging in place in colombia and misery residents can stay there through the end of life if they need extra help for services delivered a private corporation to operate the housing and dining and clinical operations are handled through the nursing school and university of missouri. a nursing professor w

at the va you focused on various telehealth purchase. i want to expand that a little bit. in a state like arkansas we face a couple of challenges that are relevant here, one is a small member of providers, second is also the sometimes slow nature of broadband services in rural areas like east arkansas, mountains. how much of the telehealth challenges do you think are going to revolve around that kind of infrastructure limitation, how much is going to revolve around the resistence to change that we all have a as natural human instinct? >> that's a good question. i think there's a requirement for multiple parts administratively from the patient's perspective. we can tell you stories of eldery patients that coached younger providers in a way that has been very positive for everybody. we use device connection, we use the interactive voice responses and then we use the web browses. the interactive voice responses is how people do their banking, they put their number in the phone and what they want to do with what accounts and so forth. you can do by pushing buttons or voice rec