3038 — A Veteran-Centered Participatory Approach to Designing and Enhancing Integrated Digital Health Services

Haun JN, HSR&D Center of Innovation on Disability and Rehabilitation Research, James A. Haley Veterans Hospital; Nazi KM, Veterans and Consumers Health Informatics Office, Veterans Health Administration, Department of Veterans Affairs; Chavez M, HSR&D Center of Innovation on Disability and Rehabilitation Research, James A. Haley Veterans Hospital; Lind JD, HSR&D Center of Innovation on Disability and Rehabilitation Research, James A. Haley Veterans Hospital; Antinori N, HSR&D Center of Innovation on Disability and Rehabilitation Research, James A. Haley Veterans Hospital;

Objectives:
The objective of this study was to utilize a Veteran-centered approach to understand how Veterans want to use and interact with VA digital health services to manage their health conditions and exchange information. The aim of this project was to develop evidence-based products to inform the current VA system-wide initiative to enhance VA digital health technology services (i.e. My HealtheVet, VetLink Kiosks, Telehealth, Mobile Health Technology).

Methods:
This study utilized participatory-based research methods with Veterans and an expert panel of VA clinicians and operational partners to represent stakeholder groups. Data collection methods included: (1) focus groups with self-administered surveys, a pairwise comparison activity, and human factors visual modeling techniques with Veterans; and (2) digital health matrix model development and a pairwise comparison activity with expert panel members.

Results:
Through an iterative participatory process, study results included: (1) a VA digital health matrix model that outlines current and emerging VA digital health services; describing their features, benefits, limitations and contexts for use; (2) visual modeling displays of VA digital health platforms based on Veteran feedback to depict their preferences for design and function; and (3) qualitative descriptive domains including Veterans' current uses, preferences, facilitators and barriers to using VA digital health services; recommendations for synchronizing, integrating, and standardizing VA digital health services; and preferences on data sharing and delegation.

Implications:
This presentation highlights the practical, technological, and personal factors that facilitate and inhibit use of current digital health services, and provides a Veteran-centric vision for an integrated enterprise-wide digital health system. The digital health matrix model and visual modeling displays inform points of improvement for digital health service usability, thereby encouraging the adoption and sustained use to support patient self-management and clinical care coordination in ways that are directly aligned with Veteran preferences.

Impacts:
This study was conducted in collaboration with Connected Health Program to align with the VA Blueprint for Excellence and inform enhancements to existing and emerging VA digital health services to ensure delivery of personalized, pro-active and patient-driven health care based on Veteran preferences and experiences. Findings inform an integrated, synchronized, and standardized approach to designing and delivering enterprise-wide digital health services.