Utilization of Interactive Clinical Video Telemedicine by Rural and Urban Veterans in the Veterans Health Administration Health Care System

Adams, Scott V.; Mader, Michael; Bollinger, Mary; Wong, Edwin S.; Hudson, Teresa J.; Littman, Alyson J.

doi:10.1111/jrh.12343

Cited by 62 publications

(55 citation statements)

References 17 publications

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“…The Department of Veterans Affairs (VA) is a leader in telehealth and has been seeing an uptake in telehealth across the nation [ 4 ]. In 2018 alone, VA provided more than 2.29 million telehealth episodes of care through clinical video telehealth (CVT) services [ 5 ] to roughly 12% of the veteran population. Veterans can visit a community-based outpatient clinic (ie, VA satellite clinics often located in rural areas) close to their home and are connected to providers in the main medical centers via CVT.…”

Section: Introductionmentioning

confidence: 99%

VA Video Connect for Clinical Care in Older Adults in a Rural State During the COVID-19 Pandemic: Cross-Sectional Study

Padala¹,

Wilson²,

Gauss³

et al. 2020

J Med Internet Res

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Background The COVID-19 pandemic has accelerated the need for telehealth at home. Although the Department of Veterans Affairs is a leading provider of telehealth, disparities may exist in reaching older veterans living in rural areas. VA Video Connect (VVC) is a video conferencing app that enables veterans to connect with their health care provider via a secure and private session. Objective The aim of this study was to examine the capability and willingness of older veterans to participate in a VVC visit during the COVID-19 pandemic. Methods A cross-sectional study was conducted on older veterans (N=118) at the Central Arkansas Veterans Healthcare System. Participants were interviewed over the phone and responses to the following items were recorded: availability of internet, email, and an electronic device with a camera; veterans’ willingness to complete an appointment via a VVC visit; and availability of assistance from a caregiver for those who were unable to participate in a VVC visit alone. Results Participants’ mean age was 72.6 (SD 8.3) years, 92% (n=108) were male, 69% (n=81) were Caucasian, 30% (n=35) were African Americans, and 36% (n=42) lived in a rural location. The majority reported having access to the internet (n=93, 77%) and email service (n=83, 70%), but only 56% (n=67) had a camera-equipped device. Overall, 53% (n=63) were willing and capable of participating in a VVC visit. The availability of internet access was significantly lower in rural compared to nonrural participants (P=.045) and in those with or less than a high school education compared to those who pursued higher education (P=.02). Willingness to participate in the VVC visit was significantly lower in rural compared to nonrural participants (P=.03). Of the participants who reported they were able and willing to partake in a VVC visit (n=54), 65% (n=35) opted for VVC and 35% (n=19) preferred a phone visit. In total, 77% (n=27) of the scheduled VVC visits were successful. Conclusions Despite advances in technology, and willingness on the part of health care systems, there are some lingering issues with capability and willingness to participate in video telehealth visits, particularly among older adults residing in rural areas.

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Section: Introductionmentioning

confidence: 99%

VA Video Connect for Clinical Care in Older Adults in a Rural State During the COVID-19 Pandemic: Cross-Sectional Study

Padala¹,

Wilson²,

Gauss³

et al. 2020

J Med Internet Res

View full text Add to dashboard Cite

show abstract

“…Our study demonstrates that hospitals with a greater ratio of Medicaid inpatient days to total inpatient days were more likely to have telepsychiatry. This suggests that federal Medicaid policies could promote telepsychiatry adoption in these hospitals; surprisingly, pro t margins were not independent factors associated with telepsychiatry use, even though investing in telehealth systems is perceived as a way to increase the competitive advantage of a hospital [49]. This might be related to decreasing trends in average reimbursement for telepsychiatry [50].…”

Section: Discussionmentioning

confidence: 94%

Telepsychiatry Adoption Across Hospitals in the United States: A Cross-Sectional Study

Harrison

et al. 2020

Preprint

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Background Access to psychiatric care is critical for patients discharged from hospital psychiatric units to ensure continuity of care. When face-to-face follow-up is unavailable or undesirable, telepsychiatry becomes a promising alternative. This study aimed to investigate hospital- and county-level characteristics associated with telepsychiatry adoption.Methods Cross-sectional national data of 3,475 acute care hospitals were derived from the 2017 American Hospital Association Annual Survey. Generalized linear regression models were used to identify characteristics associated with telepsychiatry adoption. Results About one-sixth (548 [15.8%]) reported having telepsychiatry. Rural noncore hospitals were less likely to adopt telepsychiatry (8.3%) than hospitals in rural micropolitan (13.6%) and urban counties (19.4%), with a wide variation across states. Hospitals with both outpatient and inpatient psychiatric care services (marginal difference [95% CI]: 16.0% [12.1% to 19.9%]) and hospitals only with outpatient psychiatric services (6.5% [3.7% to 9.4%]) were more likely to have telepsychiatry than hospitals with neither psychiatric services. Federal hospitals (48.9% [32.5% to 65.3%]), system-affiliated hospitals (3.9% [1.2% to 6.6%]), hospitals with larger bed size (Quartile IV vs. I: 6.2% [0.7% to 11.6%]), and hospitals with greater ratio of Medicaid inpatient days to total inpatient days (Quartile IV vs. I: 4.9% [0.3% to 9.4%]) were more likely to have telepsychiatry than their counterparts. Private non-profit hospitals (-6.9% [-11.7% to -2.0%]) and hospitals in counties designated as whole mental health professional shortage areas (-6.6% [-12.7% to -0.5%]) were less likely to have telepsychiatry. Conclusions Telepsychiatry adoption was low in US hospitals in 2017 with substantial variations by urban and rural status and by state. It raises concerns about access to psychiatric services and continuity of care for patients discharged from hospitals.

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“…We used a previously developed algorithm to track clinical workload by location and type of health service. 5 , 6 …”

Section: Methodsmentioning

confidence: 99%

A rapid mobilization of ‘virtual’ primary care services in response to COVID-19 at Veterans Health Administration

et al. 2020

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Utilization of Interactive Clinical Video Telemedicine by Rural and Urban Veterans in the Veterans Health Administration Health Care System

Cited by 62 publications

References 17 publications

VA Video Connect for Clinical Care in Older Adults in a Rural State During the COVID-19 Pandemic: Cross-Sectional Study

VA Video Connect for Clinical Care in Older Adults in a Rural State During the COVID-19 Pandemic: Cross-Sectional Study

Telepsychiatry Adoption Across Hospitals in the United States: A Cross-Sectional Study

A rapid mobilization of ‘virtual’ primary care services in response to COVID-19 at Veterans Health Administration

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