Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Oct 7, 2022
Date Accepted: Mar 12, 2023
Opportunities to enhance the implementation of VA video-based care: Qualitative perspectives of providers from diverse specialties
ABSTRACT
Background:
Increasing the adoption of virtual care tools, including video visits, is a long-term goal for the U.S. Department of Veterans Affairs (VA).While previous work has highlighted patient-specific barriers to the use of video-visits, little work has examined how clinicians view such barriers and how they have overcome them during the rapid uptake of virtual care.
Objective:
This study sought input from providers, given their role as critical participants in video visit implementation, to qualitatively describe successful strategies providers used to adapt their practices to a virtual care setting.
Methods:
We conducted interviews with 28 VA providers (physicians and nurse practitioners) from four specialties that represent diverse clinical services: primary care (n=11), cardiology (n=7), palliative care (n=5), and spinal cord injury (n=5). All interviews were audio recorded and transcribed, and transcripts reviewed and coded according to an iteratively created codebook. To identify themes, codes were grouped together into categories and participant comments reviewed for repetition and emphasis of specific points. Finally, themes were mapped to Expert Recommendations for Implementing Change (ERIC) strategies to identify evidence-based opportunities to support video visit uptake in the VA.
Results:
We identified four primary themes: (1) Peer-based learning and support improved providers’ perceived value of and confidence in video visits; (2) Providers developed new and refined existing communication and clinical skills to optimize video visits; (3) Providers saw opportunities to re-visit and refine team roles to optimize the value of video visits for their care teams; (4) Implementing and sustaining virtual care requires institutional and organizational support.
Conclusions:
This work highlights strategies to support video visits that align with established ERIC implementation constructs, which in turn can be utilized by healthcare systems to improve video visit implementation. Clinical Trial: N/A
Citation
Per the author's request the PDF is not available.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.