Since 2005, 1 million veterans have been screened for traumatic brain injury (TBI) in the VA’s Polytrauma System of Care (PSC).
The 1 million milestone “reflects [the] VA’s success in building an integrated polytrauma care program,” says VA Under Secretary for Health David Shulkin, MD. The PSC was created to address the need for a multidisciplinary system of care for veterans who have 2 or more disabling physical, cognitive, functional, or psychological impairments.
The VA has 110 polytrauma rehabilitation sites that offer comprehensive inpatient or outpatient rehabilitation. Services include interdisciplinary evaluation and treatment, development of a comprehensive plan of care, case management, patient and family education, psychosocial support, and use of advanced rehabilitation treatments and prosthetic technologies.
Another tool that supports clinical TBI care is the mobile phone application, Concussion Coach. The app provides a self-assessment tool for measuring symptoms, including feedback and a symptom tracker; relaxation exercises and other coping tips; and immediate access to crisis resources, personal support contacts, or professional health care resources.
All veterans are screened for possible TBI with a 4-question test. Those with a positive screen are referred to a TBI specialist for a Comprehensive TBI Evaluation, but specialists are often located at VA medical centers that not all veterans can easily reach. Therefore, the Office of Health Care Transformation funded a project to develop a standardized Comprehensive TBI Evaluation protocol delivered via telehealth technology. In 2013, a pilot project began at 16 sites; more than 40 sites have since been trained.