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Health Services Research & Development

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2005 HSR&D National Meeting Abstract

3076 — Opportunities and Barriers in Tele-Health

Author List:
Hopp FP (Center for Practice Management and Outcomes Research)
Whitten P (Michigan State University)
Subramanian U (Richard L. Roudebush VAMC)
Woodbridge P (Richard L. Roudebush VAMC)
Mackert M (Michigan State University)
Goldsmith AJ (Center for Practice Management and Outcomes Research)
Lowery JA (Center for Practice Management and Outcomes Research)

The objectives of this study are (1) to obtain information on perceptions of direct providers of tele-health services, physicians, and administrators concerning barriers and opportunities for tele-health development; and (2) to make prescriptive recommendations for program development in tele-health, for persons considering development of tele-health both inside and outside the VA.

A telephone survey methodology is being conducted among three types of VA staff members at five VISN 11 hospitals (1) clinicians directly delivering tele-health services; (2) a random sample of primary care practitioners; and (3) hospital administrators. Surveys include both open-ended and closed-ended questions designed to elicit staff opinions of tele-health in several domains, including (1) technical issues; (2) advantages to staff; (3) advantages to patients, (4) training/support; (5) communication/rapport; (6) clinical applicability; and (7) perceived outcomes.

Initial results, based on 19 completed interviews conducted at the Indianapolis VAMC, indicate that all three stakeholder groups perceived potential for tele-health at the VA. However, there were also group differences in perceptions and priorities. Administrators focused on the crucial role of making sure tele-health resources are adequately prioritized against other facility needs. Referring providers were enthusiastic about the time they saved by the elimination of patient visits to the clinics, but were frustrated with organizational problems leading to delays and challenges. Tele-health nurses were the most enthusiastic about the long-term potential impact on patient outcomes, but felt the required learning curve was underestimated and detrimental to implementation.

Data from this study indicate the importance of recognizing the wide variability in perceptions among key internal stakeholders. Input and support from these groups are needed to address potential barriers to implementation and ensure successful program development.

The VHA is devoting considerable financial resources to the development of tele-health programs in VA hospitals throughout the United States. This study addresses the need for more information about opportunities and barriers to the development of tele-health programs from the perspective of VA staff members, and the findings should be helpful in the design of policies and procedures related to the dissemination of tele-health in the VHA system.

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