A joint project of the Veterans Health Administration (VHA) and the U.S. Department of Defense (DoD), the recently launched VA Virtual Medical Center (VA-VMC) provides remote access to diabetes education and support for U.S. military veterans and active-duty personnel around the world.

A panel of clinicians and diabetes care and education specialists discussed and demonstrated the new program Saturday morning, June 26, during the Scientific Sessions symposium ADA Education Recognition Program Symposium—VHA and DoD Virtual Diabetes Self-Management Training (DSMT)—A Novel, Learner-Centered, Avatar-to-Avatar Remote Alternative for Providing Remote Certified Diabetes Education. The session can be viewed by registered meeting attendees at ADA2021.org through September 29, 2021. If you haven’t registered for the Virtual 81st Scientific Sessions, register today to access all of the valuable meeting content.

The VA-VMC is a state-of-the-art, virtual U.S. Department of Veterans Affairs (VA) hospital and online collaborative learning environment for patients, providers, and staff. It’s the first virtual, avatar-to-avatar national diabetes self-management education and support (DSMES) program recognized by the ADA, said Brian V. Burke, MD, FACP, Chief of Diabetes Service, Dayton VA Medical Center, and Co-chair of the VHA Diabetes Field Service Advisory Counsel.

“The evidence for self-management training is abundant,” he said. “As a result of this project, DSMES will now be available to veterans and active-duty personnel across all time zones, all hours of the day, all days of the week, and weeks of the year in both synchronous and asynchronous formats.”

The program, he said, goes well beyond the traditional video session or audio-only encounter, offering a bidirectional, avatar-to-avatar virtual information technology experience.

“Patients can interact synchronously in real time with health care professionals in the delivery, knowledge exchange, and assessment of core principles of diabetes patient education as outlined by the national standards for diabetes self-management education and support,” Dr. Burke said. “The education of patients in a virtual environment not only affords a direct exchange of information, but also the ability to employ additional learning tools, such as interactive diagrams, visual aids, and gaming.”

The capabilities and broad reach of the VA-VMC DSMES program offer an effective and efficient way to deliver important resources to a historically underserved patient population, said Mary M. Julius, RDN, LD, CDCES, National Quality Coordinator for the VA Diabetes Self-Management Education Program.

“Diabetes self-management training provides evidence-based foundational information to help empower individuals with a diagnosis of diabetes to navigate all the self-management activities required,” she said. “The data is loud and clear. Diabetes self-management training has been shown to improve clinical outcomes and to improve behavioral outcomes.”

The numbers illustrate the need and the potential impact of the program, added Stephanie De Leon Ansley, MS, RD, CSSD, LD, CDCES, Quality Coordinator, Department of Defense Virtual Medical Center Diabetes Self-Management Training Program. More than 200,000 people with diabetes are currently empaneled to the Defense Health Agency (DHA), which includes active duty, dependents, and retirees, and an estimated 1.6 million veterans are currently living with diabetes, she said.

“This is so important because nearly two-thirds of the VA medical centers do not have a recognized DSMES program,” she continued. “Additionally, in the VHA it’s estimated that about 50% of veterans do not receive diabetes education when appropriate. The DoD challenges include few recognized DSMES programs throughout military treatment facilities, as well as limited CDCES physicians.”

Moving forward, the VA-VMC will serve as a model for implementing future virtual health care campuses for veterans, said Brian James, MEd, Associate Director, Learning Solutions Team, VHA Employee Education System.

“The VA-VMC makes it easy for veterans, service members, and providers from around the world to connect and share information efficiently and effectively inside a virtual world with avatars,” he said. “We are looking to continue to build partnerships, both internal and external, so more veterans and more service members can receive education and training programs throughout the VA-VMC.”