Study Shows Patient Satisfaction with VA Virtual Care Delivered by Video-Enabled Tablet
BACKGROUND:
The expansion of virtual healthcare services includes the use of video visits with patients via mobile or web-based applications. 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. During this pilot, 5,000 tablets were distributed to 6,745 patients at 86 VA facilities, with approximately half of the tablet recipients living in rural areas. Tablets were predominantly used for mental healthcare, but also for spinal cord injury care, primary care, palliative care, rehabilitation, and other services. To help inform optimal tablet distribution and technical support, investigators evaluated patient experiences with tablets through baseline and follow-up surveys. Primary objectives were to: 1) identify healthcare access barriers, 2) examine patient experiences with tablets and any changes in perceived satisfaction with VA care, and 3) investigate the patient characteristics associated with preferences for video vs. in-person care. A baseline survey was sent to 2,120 tablet recipients and a follow-up survey was sent to respondents 3-6 months later. A total of 764 Veterans completed both the baseline and follow-up survey and are included in the following results.
FINDINGS:
- Many recipients of VA-issued tablets reported that video care is equivalent to or preferred to in-person care. Among follow-up survey respondents, 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.”
- The most common barriers to in person care were travel time (66%), travel cost (55%), health conditions (54%), bad weather (57%), and feeling uncomfortable or uneasy at VA (33%).
- Between baseline and follow-up surveys, there were statistically significant increases in patient satisfaction regarding overall VA care, as well as primary care and mental healthcare. Satisfaction regarding technology and technical assistance also was high: 86% agreed or strongly agreed with statements regarding the ease of using the equipment, receiving help needed to learn the technology (84%), and that it was easy to ask questions (88%) and understand instructions (87%).
IMPLICATIONS:
- Strong satisfaction ratings for tablets and the fact that characteristics such as age, health literacy, and prior technology use were not significantly associated with tablet preference suggest that engagement in video-based care is possible for many types of patients, including those often considered part of the "digital divide."
LIMITATIONS:
- Investigators could not attribute changes in satisfaction to tablet receipt directly, since surveys were given to tablet recipients only and there was no control group with which to compare outcomes.
AUTHOR/FUNDING INFORMATION:
This study was partly funded through eHealth QUERI and VA’s Office of Rural Health. All authors are part of HSR&D’s Center for Innovation to Implementation (Ci2i), Palo Alto VA Healthcare System.
Slightam C, Gregory A, Hu J, Jacobs J, Gurmessa T, Kimerling R, Blonigen D, Zulman D. Patient Perceptions of Video Visits Using Veterans Affairs Telehealth Tablets: Survey Study Journal of Medical Internet Research. April 15, 2020;22(4):e15682.
