Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jul 28, 2025
Date Accepted: Oct 16, 2025
Date Submitted to PubMed: Oct 17, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Super Users’ Best Practices for Coordinating Proactive Integrated Use of Virtual Healthcare Resources: Promoting A Cultural Transformation
ABSTRACT
Background:
Proactive integrated virtual healthcare resource (VHR) use is the self-initiated coordinated use of applicable virtual systems as a team or as an individual for the purposes of coordinating timely delivery of high-quality healthcare. Proactive integrated VHR use improves workflow and workload efficiency, supports provider uptake and promotion, which increases patient adoption and sustained use, to improve care outcomes. Previous studies have not demonstrated established proactive integrated use of available VHRs, across the healthcare continuum, or within service-specific clinical workflows.
Objective:
The objective of this project was to describe VHR super users’ activities and outcomes to document their practices, as well as to inform identification and dissemination of current and best practices.
Methods:
A prospective concurrent mixed methods design leveraging qualitative interviewing and human centered design was used to accomplish the study objective. Purposive sampling was used to recruit and conduct interviews with super users across 5 specialty services (i.e., Cardiology, Whole Health, Spinal Cord Injury, Education, and Rehabilitation) at a large Department of Veterans Affairs (VA) hospital in the Southeastern United States. Tailored scripts and surveys were used to conduct data collection. Rapid iterative content analysis and data triangulation was used to inform data distillation and visualization.
Results:
Super user (N=15) data gleaned 58 best practices (49 data-derived and 9 established) using 60 virtual healthcare resources within 11 major categories of 43 tasks. While the findings were specific to 5 specialty services, practices can be applied across services throughout the care continuum workflow. Recommendations were also made for consideration for de-implementation of select practices.
Conclusions:
Findings can be used for training and education, establishing best and de-implementation of practices for VA clinical care teams. Future research should aim to evaluate outcomes associated with the use of best practices. These data-driven products lay foundational work in identifying and disseminating best practices in proactive integrated VHR use – to one day transform the Veterans Health Administration (VHA) learning healthcare system into a culture of VHR super users. Ongoing evaluation and examination is warranted to determine the value and currency of best practices in the ever-changing virtual care climate.
Citation
