Patient Perceptions of Video Visits Using Veterans Affairs Telehealth Tablets: Survey Study

Abstract

Background Video-based health care can help address access gaps for patients and is rapidly being offered by health care organizations. However, patients who lack access to technology may be left behind in these initiatives. In 2016, the US Department of Veterans Affairs (VA) began distributing video-enabled tablets to provide video visits to veterans with health care access barriers. Objective This study aimed to evaluate veterans’ experiences with VA-issued tablets and identify patient characteristics associated with preferences for video visits vs in-person care. Methods A baseline survey was sent to the tablet recipients, and a follow-up survey was sent to the respondents 3 to 6 months later. Multivariate logistic regression was used to identify patient characteristics associated with preferences for care, and we examined qualitative themes around care preferences using standard content analysis methods for coding the data collected in the open-ended questions. Results Patient-reported access barriers centered around transportation and health-related challenges, outside commitments, and feeling uncomfortable or uneasy at the VA. Satisfaction with the tablet program was high, and in the follow-up survey, approximately two-thirds of tablet recipients preferred care via a tablet (194/604, 32.1%) or expressed that video-based and in-person care were “about the same” (216/604, 35.7%), whereas one-third (192/604, 31.7%) indicated a preference for in-person care. Patients were significantly more likely to report a preference for video visits (vs a preference for in-person visits or rating them “about the same”) if they felt uncomfortable in a VA setting, reported a collaborative communication style with their doctor, had a substance use disorder diagnosis, or lived in a place with better broadband coverage. Patients were less likely to report a preference for video visits if they had more chronic conditions. Qualitative analyses identified four themes related to preferences for video-based care: perceived improvements in access to care, perceived differential quality of care, feasibility of obtaining necessary care, and technology-related challenges. Conclusions Many recipients of VA-issued tablets report that video care is equivalent to or preferred to in-person care. Results may inform efforts to identify good candidates for virtual care and interventions to support individuals who experience technical challenges.

Rapid Integration of Home Telehealth Visits Amidst COVID‐19: What Do Older Adults Need to Succeed?

“…Indeed, a recent study estimated that 38% of Medicare beneficiaries were unready to engage in home telehealth 19 . However, when given the opportunity, many older patients can effectively engage in telehealth 13,20‐25 . We hypothesized that telehealth might improve access to care, but we were unsure if our patients were interested or if they had the technology and confidence to attempt a home telehealth visit 1 …”

Telemedicine for Acute Conditions During COVID-19: A Nationwide Survey Using Crowdsourcing

“…[2][3][4][5][6][7] Patients feel that telemedicine yields high satisfaction, allows good communication, saves time, and is cost-effective. [5][6][7][8][9][10] Telemedicine decreases hospitalization rates and visits to the emergency room. 6 Studies also found that telemedicine yields similar results as face-to-face encounters.…”

“…6 Studies also found that telemedicine yields similar results as face-to-face encounters. 8,9,[11][12][13][14] It was even considered to be the major channel for care delivery 15 ; however, its implementation and usage have still been relatively low. 16 The advent of the COVID-19 outbreak resulted in a rapid and significant adoption of telemedicine for both chronic and acute conditions.…”

Patient interest in and barriers to telemedicine video visits in a multilingual urban safety-net system

“…Authors * Elaine C Khoong, MD MS 1,2 * Blythe A Butler, BA 3 Omar Mesina, MD 3,4 George Su, MD 5 Triveni B DeFries, MD MPH 1 Malini Nijagal, MD MPH 6 Courtney R Lyles, PhD Before the COVID-19 pandemic, telemedicine video visits were uncommon, especially within safety-net settings. A 2018 survey found only 44% of community health centers used any telehealth.…”

“…[3] Prior studies on interest in video visits focused on the subset of patients who had already completed a video visit, representing early adopters who are likely different from the general population. [4,5] As telemedicine becomes a standard modality for healthcare, little is known about the interest in or challenges to video visits among low-income, diverse racial/ethnic, or non-English speaking populations. These populations already face disparities accessing healthcare and are already less likely to use digital health tools due to disparities in device ownership, broadband access, and digital literacy.…”