JMIR Publications

ABSTRACT

Background:

Widespread adoption, use, and integration of patient-facing technologies into the workflow of healthcare systems has been slow, thus limiting realization of their potential. A growing body of work has focused on how best to promote adoption and use of these technologies and measure their impacts on processes of care and outcomes. This body of work currently suffers from limitations (e.g., cross-sectional analyses, limited patient-generated data linked with clinical records) and would benefit from institutional infrastructure to enhance available data and integrate the voice of the patient into implementation and evaluation efforts.

Objective:

The Veterans Health Administration (VA) has launched an initiative called the Veterans Engagement with Technology Collaborative (VET-C) cohort to directly address these challenges. This paper reports the process by which the VET-C cohort was developed and describes the baseline data being collected from cohort members. The overarching goal of the VET-C cohort is to directly engage Veterans in the evaluation of new VA patient-facing technologies and in so doing, to create new infrastructure to support related quality improvement and evaluation activities.

Methods:

Inclusion criteria for Veterans to be eligible for membership in the VET-C cohort include: 1) being an active user of VA healthcare services; 2) having a cellular phone; and 3) being an established user of existing VA patient-facing technologies as represented by use of the secure messaging feature of VA’s patient portal. Between 2017 and 2018, we recruited over 2,700 Veterans who met these criteria and administered a survey to them over the telephone. In this paper, we present frequencies of responses to key variables from that survey.

Results:

The majority of participants were male (83.0%), White (82.4%), living in their own apartment or house (93.4%), and had completed some college (43.5%) or an advanced degree (43.6%). Cohort members were 59.9 years old, on average. The majority self-reported their health status as being good (38.7%) or very good (19.2%). Most cohort members owned a personal computer (95.7%), tablet computer (59.5%), and/or smartphone (89.6%) at the time of survey administration.

Conclusions:

The VET-C cohort is an example of a VA learning healthcare system initiative designed to combine patient-generated data, clinical records, and measures of technology use to support the data-driven implementation of patient-facing technologies into practice and measurement of their impacts. With the VET-C cohort, VA is building capacity for future, rapid, rigorous evaluation and quality improvement efforts to enhance understanding of the adoption, use, and impact of patient-facing technologies.