VA Video Connect to Improve Access to Multi-disciplinary Specialty Care
Takeaway: This study is expected to determine the effectiveness of multidisciplinary HIV care delivered via VA Video Connect compared to routine care. This research also will provide models and evidence for a transformative solution to increase all Veterans' access to multidisciplinary care.
Treatment of complex conditions like HIV requires multidisciplinary care and monitoring at regular clinic visits with multiple providers. VA is one of the largest providers of HIV care in the US – and improving retention in care and HIV suppression is associated with improved survival with HIV. Care for Veterans with HIV is delivered primarily in VA medical centers, which poses logistic and stigma-related barriers to Veterans’ access to multidisciplinary HIV care. VA Video Connect (VVC) – a VA-supported mobile health video technology that allows Veterans and providers to complete clinical visits from any remote location, including the home – has the potential to transform the delivery of multidisciplinary care for HIV and other chronic conditions by increasing access to care. While VVC is gaining a foothold in mental healthcare, it has not been used widely in specialty medical care.
This ongoing study (January 2020 – December 2023) will determine if multidisciplinary care delivered by VVC can improve retention in care and clinical outcomes for Veterans in need of specialty medical care for HIV. Investigators also will work to refine and evaluate their implementation facilitation (IF) strategy to improve the reach of VVC-delivered HIV care, increase provider and Veteran adoption, and determine the potential for sustainability.
This effectiveness-implementation study will enroll 360 Veterans within the Michael E. DeBakey VA Medical Center infectious diseases clinic, which cares for nearly 1,000 Veterans with HIV. Investigators will randomize Veterans to either be offered or not offered VVC. The primary outcome will be retention in care. Secondary outcomes include adherence to antiretroviral therapy, HIV suppression, and safety measures. Investigators will then use a mixed-method evaluation on top of the effectiveness trial, enrolling 40 Veteran participants and numerous staff in in-depth interviews at all phases of the trial.
No findings to report thus far.
It is expected that this project will be successful, and investigators will work with partners to disseminate and implement VVC for multi-disciplinary HIV care throughout VA. They also will foster work in other chronic medical conditions. Therefore, study results could lead to the accelerated uptake of VA Video Connect, improved access to care, and improved health for many Veterans.
Thomas Giordano, MD, MPH, and Jan Lindsay, PhD are part of HSR&D’s Center for Innovations in Quality, Effectiveness and Safety (IQuESt) in Houston, TX.
None to report at this time.