Category: Military and Veterans Affairs; Health Services Research
Virtual Medical Modalities (VMM), such as kiosks, mobile, MyHealtheVet, telehealth, are implemented on patient aligned care teams (PACT) to deliver Veteran-centered care in the Veteran Health Administration (VHA). The purpose of this study was to inform the VHA’s system-wide efforts to increase proactive integrated use of VMM among PACT providers. This study used a community-based participatory research approach to identify PACT-focused implementation strategies.
A descriptive study involving PACT participants in qualitative focus groups and interviews. Rapid analysis was used to identify preliminary themes.
PACT participants were recruited from a VA medical center, a primary care annex, and community-based outreach clinics.
Participants (or Animals, Specimens, Cadavers):
Sixty-five providers on PACTs who were users of VMM participated in one of 21 focus groups designed to elicit information regarding integrated use of VMM. The PACT members represented medical doctors, physician assistants, registered nurses, licensed practical nurses, and front desk clerks.
Interventions: Not applicable.
Main Outcome Measure(s): Implementation strategies.
All focus group participants reported using Secure Messaging (SM) with patients, while most reported using Telehealth and Kiosks. PACT teams coordinated the use of SM, but while no one described proactive integrative use of VMM. Both high and low utilization groups reported needing more training and education. The main difference between high and low utilization groups was that the low group reported preferring more implementation strategies. The most often cited preferred implementation strategy was education.
These results suggest that proactive use of VMM is limited and not integrated. For promoting use of VMM, team members identified education as the main implementation strategy. Strategies for establishing an integrated VMM system are needed. Competing priorities leave PACT members with limited time thus VMM training interventions need to be targeted and relevant to performance improvement metrics.
Bridget Cotner– Health Science Specialist, James A Haley Veterans Hospital, Tampa, Florida
Margeaux Chavez– Health Science Specialist, James A Haley Veterans Hospital, Tampa, Florida
Wendy Hathaway– Qualitative Researcher, Department of Veterans Affairs, Tampa, Florida
Christine Melillo– Health Science Specialist, James A. Haley VA, Tampa, Florida
William Messina– Chief Nurse, Ambulatory Care, James A Haley Veterans Hospital, Tampa, Florida
Brian Zilka– ACOS Ambulatory Care, James Haley VA, Tampa, Florida
Shilpa Patel-Teague– Director of Clinical Programs, Veterans Health Administration, Washington, District of Columbia
Tammi Mercedes– Head Nurse, James A Haley Veterans Hospital, Tampa, Florida
Jolie Haun– Director of Implementation & Dissemination, James A. Haley Veterans Hospital, Tampa, Florida
Kim Nazi– Independent Consultant, Veterans and Consumer Health Informatics Office, Veterans Health Administration, New York, New York