Overcoming Obstacles: Barriers to Virtual Care Use Among Video-Enabled Tablet Recipients in the Veterans Health Administration.
health services access
telemedicine
veterans health administration
virtual care
Journal
Journal of general internal medicine
ISSN: 1525-1497
Titre abrégé: J Gen Intern Med
Pays: United States
ID NLM: 8605834
Informations de publication
Date de publication:
01 Nov 2023
01 Nov 2023
Historique:
received:
06
07
2023
accepted:
06
10
2023
medline:
2
11
2023
pubmed:
2
11
2023
entrez:
2
11
2023
Statut:
aheadofprint
Résumé
The Veterans Health Administration (VHA) distributes video-enabled tablets to individuals with barriers to accessing care. Data suggests that many tablets are under-used. We surveyed Veterans who received a tablet to identify barriers that are associated with lower use, and evaluated the impact of a telephone-based orientation call on reported barriers and future video use. We used a national survey to assess for the presence of 13 barriers to accessing video-based care, and then calculated the prevalence of the barriers stratified by video care utilization in the 6 months after survey administration. We used multivariable modeling to examine the association between each barrier and video-based care use and evaluated whether a telephone-based orientation modified this association. The most prevalent patient-reported barriers to video-based care were not knowing how to schedule a visit, prior video care being rescheduled/canceled, and past problems using video care. Following adjustment, individuals who reported vision or hearing difficulties and those who reported that video care does not provide high-quality care had a 19% and 12% lower probability of future video care use, respectively. Individuals who reported no interest in video care, or did not know how to schedule a video care visit, had an 11% and 10% lower probability of being a video care user, respectively. A telephone-based orientation following device receipt did not improve the probability of being a video care user. Barriers to engaging in virtual care persist despite access to video-enabled devices. Targeted interventions beyond telephone-based orientation are needed to facilitate adoption and engagement in video visits.
Identifiants
pubmed: 37914909
doi: 10.1007/s11606-023-08468-x
pii: 10.1007/s11606-023-08468-x
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Health Services Research and Development
ID : IK2HX003139-01A2
Organisme : Quality Enhancement Research Initiative
ID : PEC 18-205
Organisme : ORH
ID : CIN 13-412
Informations de copyright
© 2023. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.
Références
Administration VH. VA.gov | Veterans Affairs. https://www.va.gov/health/aboutvha.asp (accessed 24 October 2022).
VA.gov | Veterans Affairs, https://www.ruralhealth.va.gov/aboutus/ruralvets.asp (accessed 3 February 2023).
Zulman DM, Wong EP, Slightam C, et al. Making connections: nationwide implementation of video telehealth tablets to address access barriers in Veterans. JAMIA Open. 2019; 2: 323–329.
doi: 10.1093/jamiaopen/ooz024
pubmed: 32766533
Armstrong CM, Wilck NR, Murphy J, et al. Results and lessons learned when implementing virtual health resource centers to increase virtual care adoption during the COVID-19 pandemic. J Technol Behav Sci. 2022; 7: 81–99.
doi: 10.1007/s41347-021-00227-1
pubmed: 34722860
https://www.oversight.gov/sites/default/files/oig-reports/VA/VAOIG-21-02125-132.pdf (Accessed 12 June 2023).
Dhanani Z, Ferguson JM, Van Campen J, et al. Overcoming access barriers for Veterans: cohort study of the distribution and use of Veterans affairs’ video-enabled tablets before and during the COVID-19 pandemic. J Med Intern Res. 2023;25: e42563.
doi: 10.2196/42563
pubmed: 36630650
Garvin LA, Hu J, Slightam C, et al. Use of video telehealth tablets to increase access for Veterans experiencing homelessness. J Gen Intern Med. 2021;36: 2274–2282.
doi: 10.1007/s11606-021-06900-8
pubmed: 34027612
Solutions VWM. VA Video Connect, https://mobile.va.gov/app/va-video-connect (accessed 23 March 2023).
Microsoft Airband - Advancing Digital Equity | Microsoft CSR. Microsoft, https://www.microsoft.com/en-us/corporate-responsibility/www.microsoft.com/en-us/airband-initiative (accessed 10 April 2023).
Ferguson JM, Jacobs J, Yefimova M, et al. Virtual care expansion in the Veterans Health Administration during the COVID-19 pandemic: clinical services and patient characteristics associated with utilization. J Am Med Inform Assoc. 2020;28: 453–462.
doi: 10.1093/jamia/ocaa284
Kruse CS, Krowski N, Rodriguez B, et al. Telehealth and patient satisfaction: a systematic review and narrative analysis. BMJ Open. 2017;7:e016242.
doi: 10.1136/bmjopen-2017-016242
pubmed: 28775188
Kruse C, Fohn J, Wilson N, et al. Utilization barriers and medical outcomes commensurate with the use of telehealth among older adults: systematic review. JMIR Med Inform. 2020;8:e20359.
doi: 10.2196/20359
pubmed: 32784177
Muir SD, de Boer K, Nedeljkovic M, et al. Barriers and facilitators of videoconferencing psychotherapy implementation in Veteran mental health care environments: a systematic review. BMC Health Serv Res. 2020;20:999.
doi: 10.1186/s12913-020-05858-3
pubmed: 33131495
De Vera K, Challa P, Liu RH, et al. Virtual primary care implementation during COVID-19 in high-income countries: a scoping review. Telemed e-Health. 2022;28:920–931.
doi: 10.1089/tmj.2021.0377
Loizos M, Baim-Lance A, Ornstein KA, et al. If you give them away, it still may not work: challenges to video telehealth device use among the urban homebound. J Appl Gerontol. 2023;7334648231170144.
McKee M, Moran C, Zazove P. Overcoming additional barriers to care for deaf and hard of hearing patients during COVID-19. JAMA Otolaryngol Head Neck Surg. 2020;146:781–782.
doi: 10.1001/jamaoto.2020.1705
pubmed: 32692807
Reed NS, Altan A, Deal JA, et al. Trends in health care costs and utilization associated with untreated hearing loss over 10 years. JAMA Otolaryngol Head Neck Surg. 2019;145:27–34.
doi: 10.1001/jamaoto.2018.2875
pubmed: 30419131
Orrange S, Patel A, Mack WJ, et al. Patient Satisfaction and Trust in Telemedicine During the COVID-19 Pandemic: Retrospective Observational Study. JMIR Hum Factors. 2021;8. https://doi.org/10.2196/28589 .
Bashshur RL, Howell JD, Krupinski EA, et al. The empirical foundations of telemedicine interventions in primary care. Telemed J E Health 2016;22:342–375.
doi: 10.1089/tmj.2016.0045
pubmed: 27128779
Velsen L van, Tabak M, Hermens H. Measuring patient trust in telemedicine services: development of a survey instrument and its validation for an anticoagulation web-service. Int J Med Inform. 2017;97:52–58.
doi: 10.1016/j.ijmedinf.2016.09.009
pubmed: 27919395
Building Trust into Telehealth, https://hbr.org/2021/03/building-trust-into-telehealth (accessed 15 March 2023).
Castilla D, Botella C, Miralles I, et al. Teaching digital literacy skills to the elderly using a social network with linear navigation: a case study in a rural area. Int J Human-Comput Stud. 2018;118:24–37.
doi: 10.1016/j.ijhcs.2018.05.009
Kalicki AV, Moody KA, Franzosa E, et al. Barriers to telehealth access among homebound older adults. J Am Geriatr Soc. 2021;69:2404–2411.
doi: 10.1111/jgs.17163
pubmed: 33848360
Vollbrecht H, Arora V, Otero S, et al. Evaluating the need to address digital literacy among hospitalized patients: cross-sectional observational study. J Med Intern Res. 2020;22:e17519.
doi: 10.2196/17519
pubmed: 32496196
Sanyal C, Stolee P, Juzwishin D, et al. Economic evaluations of eHealth technologies: a systematic review. PLoS One. 2018;13:e0198112.
doi: 10.1371/journal.pone.0198112
pubmed: 29897921