Study Supports Increased Distribution of Video Tablets and Telehealth for Rural Veterans

January 29, 2021

Takeaway: HSR&D and QUERI investigators, partnering with VA’s Office of Rural Health, have generated several publications describing the distribution and impact of VA-issued tablets for Veterans with access barriers. Findings from their evaluation of VA-issued tablets were incorporated into the MISSION Act Report presented to Congress in Spring 2019.

Of the approximate nine million enrolled Veterans receiving VA healthcare, nearly one-third live in rural, highly-rural, and insular island areas, and many others experience transportation and financial challenges that are deterrents to using VA healthcare. These barriers are further compounded by the pandemic.

In 2016, VA’s Offices of Rural Health and Connected Care developed a pilot initiative to distribute video-enabled tablets to Veterans who did not have the necessary technology and who had a geographic, clinical, or social barrier to in-person healthcare.¹ During this pilot, 5,000 tablets were distributed to 6,745 patients at 86 VA facilities. More than half of tablet recipients live in rural areas and 75% have a mental health diagnosis, providing a unique opportunity to assess the effectiveness of this national dissemination of tablets.¹ Tablets were predominantly used for mental health care, but also for spinal cord injury care, primary care, palliative care, rehabilitation, and other services. In a study funded by QUERI and VA’s Office of Rural Health (ORH), investigators found that:

• Distributing video-enabled tablets to Veterans with mental health conditions appeared to improve access to and continuity of mental health services while also improving clinical efficiency.²
• Many recipients of VA-issued tablets reported that video care is equivalent to or preferred to in-person care; in a survey of tablet recipients, 32% of tablet recipients indicated that they would prefer to conduct their future VA appointments by video; 32% indicated they would prefer these visits in person; and 36% indicated their preference was “about the same.”³
• Among tablet recipients who completed a survey, 92% reported that the tablets saved them money or time; 89% reported saving money, and 71% reported saving time. Among those who reported monetary savings, 41% reported saving $25-50 and 31% reported saving >$50.

Partnering with ORH and VA’s Office of Connected Care (OCC), QUERI’s  Enhancing Veterans’ Access to Care through Video Telehealth Tablets project continues this work by examining the reach, adoption, and implementation of tablets to better target high-need patients – and is evaluating the effectiveness of tablets on Veteran access, clinical outcomes, and experience.

Impact

Informed by the findings of the QUERI evaluation, OCC expanded VA’s tablet distribution program; more than 80,000 Veterans have now received tablets, with more than 50,000 receiving a device during the COVID-19 pandemic.

1. Zulman D, Wong E, Slightam C, et al. Making connections: Nationwide implementation of video telehealth tablets to address access barriers in Veterans. JAMIA OPEN. October 2019;2(3):323-329.
2. Jacobs J, Blonigen D, Kimerling R, et al. Increasing mental health care access, continuity, and efficiency for Veterans through telehealth with video tablets. Psychiatric Services. August 5, 2019;
3. Slightam C, Gregory A, Hu J, et al. Patient perceptions of video visits using Veterans Affairs telehealth tablets: Survey study. Journal of Medical Internet Research. April 15, 2020;22(4):e15682.