The purpose of this project was to determine whether ability to use VA Video Connect (VVC) by older Veterans (OV) differed by age, race, or rurality. A service to help older Veterans learn to use VVC was developed. As part of an ongoing QI project, demographics, willingness to attempt a VVC test call and outcomes of test calls were collected on all referrals. Descriptive statistics, Chi-square, and Fisher’s exact test were used to examine differences in success rates by group. Of the 66 OV (age 60+) referred by their primary care providers, we were able to contact 63 by phone. Of those, 46 (73%) scheduled a VVC test call, 7 (11%) chose not to participate, and 10 (16%) were already using VVC for appointments. Of the 40 who continued the VVC test call, 31 (77.5%) were successful without issues, 7 (17.5%) were successful with help resolving issues, and 2 (5%) disconnected before finishing the call because it became too difficult. Of the 63 OV contacted, 38 (57.5%) had a successful VVC test call. However, those residing in rural (vs. urban) settings were less likely to have a successful test call (43% vs. 57%, p=0.04). There was no statistically significant difference in success rates for the test calls between whites vs. non-whites (52% vs. 48%, p= 0.2), or those aged 75 years or above vs. 60-74 years (53% vs. 46%, p=0.6). More work is needed to identify barriers to use of VVC, especially among OV living in rural settings.

Background Telehealth is increasingly used for rehabilitation and exercise but few studies include older adult participants with comorbidities and impairment, particularly cognitive. Using Veterans Administration Video Connect (VVC), the aim of the present study is to present the screening, recruitment, baseline assessment, and initial telehealth utilization of post-hospital discharge Veterans in a VVC home-telehealth based program to enhance mobility and physical activity.Methods Older adult Veterans (n = 45, mean age 73), recently discharged from the hospital with physical therapy goals, were VVC-assessed in self-report and performance-based measures, using test adaptations as necessary, by a clinical pharmacy specialist and social worker team.Results Basic and instrumental ADL disabilities were common as were low mobility (Short Portable Performance Battery) and physical activity levels (measured by actigraphy). Half had Montreal Cognitive Assessment (MoCA) scores in the mild cognitive impairment range (< 24). Over 2/3 of the participants used VA-supplied tablets. While half of the Veterans were fully successful in VVC, 1/3 of these and an additional group with at least one failed connection requested in-person visits for assistance. One-quarter had no VVC success and sought help for tablet troubleshooting, and half of these eventually “gave up” trying to connect; computer literacy issues and physical impairment (particularly dexterity) were described prominently in this group. On the other hand, Veterans with at least mild cognitive impairment (based on MoCA scores) were present in all connectivity groups and most of these used caregiver support to facilitate VVC.Conclusion Disabled older post-hospital discharged Veterans with physical therapy goals can be VVC-assessed and enrolled into a mobility/physical activity intervention. A substantial proportion required technical support, including in-person support for many. Yet, VVC seems feasible in those with mild cognitive impairment, assuming the presence of an able caregiver. Modifications of assessment tools were needed for the VVC interface, and while appearing feasible, will require further study.ClinicalTrials.gov NCT 04045054 05/08/2019