Proactive integrated virtual healthcare resource use in primary care

Abstract

Background Proactive integrated virtual healthcare resource (VHR) use can improve efficiency, maximize resource capacity for delivering optimal coordinated care and improve patient outcomes. Proactive integrated VHR use is vital for delivering high quality care. Our objectives were to identify proactive integrated VHR use among primary care teams, best practices and targeted implementation strategies to promote proactive integrated VHR use. Methods This is a mixed-method descriptive study. We employed a community-based participatory approach to collect data and the Consolidated Framework for Implementation Research to analyze and contextualize findings. A cross-sectional sample of primary care team members (n = 65) from a Department of Veterans Affairs medical center participated in focus groups, follow-up interviews (n = 16), and respond to self-report surveys. Operational subject matter experts (n = 15) participated in informant interviews. Results Survey data described current use and factors that influenced singular VHR use and were convergent with qualitative findings. Focus group and interview data described no evidence of proactive integrated VHR use. Differences and similarities were identified between both utilization groups, such as facilitators and barriers, recommendations, patient education and preferred implementation strategies. All groups reported issues around VHR availability knowledge and access and functionality. Participants identified the need for best practices that are specific to care tasks and performance measures. Expert informant interviews identified a list of VHR tools that could be proactively integrated across the healthcare continuum. Conclusions Health systems are leveraging technologies to proactively integrate VHR to maximize information exchange, clinical decision support and patient engagement. VHR is critical during global pandemics, such as COVID-19, to maintain access to care coordination and delivery while abiding by public health recommendations. Though recent requirements for reducing contact create an intrinsic motivation, cultural change through education and best practices of proactive integrated use across the healthcare continuum is needed to create a culture of VHR super users.

Improving Veteran Engagement with Virtual Care Technologies: a Veterans Health Administration State of the Art Conference Research Agenda

“… 7 , 9 – 11 , 22 – 26 However, less is known about the role of factors at clinical team, facility, or healthcare system levels. 12 , 16 , 17 While some factors may be modifiable, the group noted that others may be less so. For example, age cannot be modified; however, strategies can be developed to address age-related changes that could affect engagement.…”

“…1 , we introduce the Virtual Care Engagement Framework, which the present authors developed based on a review of the existing evidence. Factors at multiple levels can interact to influence Veteran virtual care engagement, including patient (e.g., age, health status/functioning, race, ethnicity, rurality), 9 – 13 clinical team member (e.g., digital literacy, perceived burden, perceived value, proactive use of virtual care technologies), 14 – 17 and system level factors (e.g., technology infrastructure, workflow, policy, and regulations). 2 , 15 , 18 , 19 Technical factors can vary by a technology or technology-assisted intervention itself, and may be cross cutting, requiring attention at different levels.…”

Tangible and Intangible Factors Affecting the Organizational Performance of Remote Health Workers

“…This environment creates more motivation and higher performance among healthcare workers (Marjanovic et al, 2020). Furthermore, flexible organizational culture supports this agenda (Ebenso et al, 2020;Haun et al, 2021;Springs, 2021). These conversations lead to the construction of hypotheses.…”

Provider reported value and use of virtual resources in extended primary care prior to and during COVID-19

“…3 Department of Psychology, University of South Florida, 4202 E. Fowler Avenue, Tampa, FL 33620, USA. 4 Department of Anthropology, University of South Florida, 4202 E. Fowler Avenue, Tampa, FL 33620, USA. 5 Department of Psychiatry and Behavioral Neurosciences, University of South Florida, 4202 E. Fowler Avenue, Tampa, FL 33620, USA.…”

“…VA has spent the last decade improving patient-centered care through promotion of proactive integrated use of VHR, specifically within primary care. Proactive integrated VHR use is defined as 'a self-initiated approach to coordinated use of applicable VHR systems for the purposes of coordinating and delivering timely high-quality patient-centered care' [4]. Provider openness to use VHR was promoted by system preparedness (e.g., IT systems, software, policies) and the necessity brought on by COVID-19 pandemic.…”