Message below on behalf of Dr. Anthony Albanese, Acting Chief of Health Professions Education. Please share this widely with VA site directors.
Within the last few months, the Office of Academic Affiliations (OAA) has received many inquiries regarding using remote or virtual supervision for health professions trainees (HPT) at VA Medical Centers (VAMCs). We realize that the future of health care will increasingly utilize technology to provide quality healthcare, and that the trend will likely include the use of technology to provide or bolster the supervision that is provided to HPTs. This issue is on our radar, and we are exploring how tele-supervision can be provided in a safe and effective manner.
In the interim, our hope is that this email provides clarity about the current state of tele-supervision for live patient encounters in VA. At present, tele-supervision is not permitted for any clinical HPTs without prior written approval from OAA’s Chief Officer. All HPTs must always function under the supervision of qualified and licensed supervising practitioner(s). The supervising practitioner must be physically present at the VAMC in which training takes place. Real-time video conferencing may not substitute for face-to-face educational supervision requirements, per guidance outlined in the VHA Handbooks 1400.01 and 1400.04.
Presence of tele-medicine staff who serve in non-supervisory roles and may be located at remote VA locations (e.g., consultants, specialists or other clinical and/or education staff) is not considered tele-supervision, and is permissible. This practice can aid in ensuring that HPTs get both the onsite supervision that is required and benefit from the expertise of consultants who work at other locations.
This guidance on tele-supervision does not apply to community based or home-based clinical rotations. Please refer to VHA Handbooks 1400.01, Resident Supervision at http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2847 and 1400.04, Supervision of Associated Health Trainees at http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3087 for additional information. An update to 1400.01 is also nearly ready for publication.
Until there is better clarity, guidance from accrediting bodies, and evidence for efficacy, tele-supervision waivers are not likely to be granted and will require a unique circumstance. For a few professions (e.g., Psychology), the training program accreditation standards already allow tele-supervision. Even in these circumstances, tele-supervision in VA requires prior OAA approval by the Chief Academic Affiliations Officer.
For further information, please contact the appropriate OAA service line by selecting “e-mail the team” next to the OAA section name at https://vaww.portal2.va.gov/sites/oaa/public/SitePages/contacts.aspx.