TelePain Increases Veterans’ Access to Nonpharmacological Care for Chronic Pain
April 2, 2025
Takeaway: VA’s TelePain program makes it easier for the many Veterans who suffer from chronic pain to access VA’s nonpharmacological pain management services. HSR and QUERI studies show that the introduction of TelePain increased the reach of VA specialty pain care services for Veterans, and that Veterans who were referred to TelePain were more likely to receive at least one VA specialty pain visit within six months. Veterans have reported general satisfaction with the TelePain program, positive experiences with their providers, and appreciation for the convenience that TelePain provides. TelePain is now offered through VA facilities across the country, with TelePain interdisciplinary Pain Management Teams completing 54,144 telehealth encounters with Veterans in FY2024.
Background
Chronic pain is more prevalent in Veterans than in the general population, increasing their risk of depression, poor sleep, substance use disorders, and other health problems.[1] Multimodal, nonpharmacological pain care can help relieve pain while reducing the risk of opioid-related harms, but interdisciplinary pain teams are often located at large urban healthcare systems, making it difficult for home-bound and rural Veterans to get the care they need. VA’s TelePain program makes it easier for Veterans to access comprehensive VA nonpharmacological pain management services by enabling them to use technology to meet with specialty providers remotely rather than traveling to providers’ offices.
Following the introduction of TelePain at VA’s Northwest Health Network, TelePain has been adopted at VA medical centers throughout the country as HSR and QUERI investigators have provided evidence for TelePain’s effectiveness and best practices for its implementation.
In 2021, VA’s Pain Management, Opioid Safety, and Prescription Drug Monitoring Program adopted TelePain as its national model for virtual pain care.
Impacts on Policy, Practice, and Patients
- Findings from QUERI published in 2021 indicated that many rural Veterans who were referred to TelePain reported general satisfaction with the program, positive experiences with their providers, and an appreciation for the convenience that TelePain provides. Areas identified for improvement included streamlining the program’s referral and scheduling process and increasing Veterans’ motivation to engage in psychological pain treatments.
- Using pilot data from VA’s Northwest Health Network, investigators from HSR’s Seattle-Denver Center of Innovation for Veteran-Centered and Value-Driven Care led a QUERI partnered implementation initiative (published in 2022) with VA’s Pain Management, Opioid Safety, and Prescription Drug Monitoring Program (PMOP) to evaluate the impact of implementing TelePain. The project included twice-monthly briefings with VA national leaders in pain management and the resulting evidence helped spur nationwide adoption of the TelePain model of care in VA.
- QUERI partnered evaluation findings and further impacts include:
- Following the introduction of TelePain at VA’s Puget Sound healthcare system, receipt of specialty pain care in that system increased by about 5% for patients with moderate to severe pain. Among rural vs. urban Veterans who received specialty pain care, a much higher percentage of rural Veterans’ visits were delivered by telehealth following the establishment of Telehealth Pain Management Teams (nearly 12% in the post-TelePain period vs. 3% among urban patients).
- In 2022, national VA pain priorities changed to include expansion of TelePain.
- In FY2022 and FY2023, PMOP invested more than $26 million to support implementation of TelePain in all VA Clinical Resource Hubs.
- In FY2023, 14 out of 18 VA regional systems of care (VISNs) adopted TelePain and built Clinical Resource Hub TelePain teams.
- TelePain interdisciplinary Pain Management Teams completed 54,144 telehealth encounters with Veterans in FY2024. Of the Veterans who were referred to TelePain, 45–76% received at least one VA specialty pain visit within six months of a referral. In contrast, 6–44% of Veterans who did not have the opportunity to use TelePain had a VA specialty pain visit within six months of referral.
- A 2024 TelePain evaluation funded by the Office of Rural Health and PMOP and co-authored by HSR investigators examined patient-reported outcomes of the TelePain-Empower Veterans Program (EVP), a pain rehabilitation program that promotes active self-care, to determine TelePain-EVP’s effectiveness. Quantitative data indicated that TelePain-EVP improves patient-reported measures related to pain (catastrophizing), psychology (anxiety, depression), and acceptance (activities engagement) for Veterans with chronic pain. Qualitative data from the same evaluation showed that Veterans who participated in TelePain-EVP reported improved pain management coping skills, interpersonal relationships, and sense of community, but no reduction in pain or medication use. The findings led to program improvement recommendations to inform future implementation of TelePain-EVP and similar telehealth pain management programs.
Partners
- Office of Patient-Centered Care and Cultural Transformation
- Office of Rural Health
- Pain Management, Opioid Safety and Prescription Drug Monitoring Program Office
Jessica Chen, PhD
“Our QUERI center provided implementation support and research/program evaluation to advance the rollout of TelePain, a nationally significant initiative that has expanded access to high-quality, multimodal pain treatment for tens of thousands of Veterans. Our work shows that TelePain connects Veterans in underserved areas with the specialized pain care they need to improve their health and well-being.”—Jessica Chen, PhD, lead of TelePain Evaluation, Metrics, & Pain Outcomes (TEMPO) QUERI Partnered Evaluation Initiative
[1] https://www.research.va.gov/pubs/docs/va_factsheets/Pain.pdf
