JMIR Publications

ABSTRACT

Background:

In 2016, the U.S. Department of Veterans Affairs (VA) implemented a national initiative to distribute video-enabled tablets and peripheral devices, such as blood pressure monitors and weight scales, to patients facing geographic, clinical, or socioeconomic challenges. Such patients could potentially benefit from health monitoring in conjunction with video-based care, as peripheral devices offer opportunities to enrich care received during a video visit, and also support tracking of health-related data collected outside of clinical care, or patient-generated health data (PGHD). However, little is known about experiences with the devices and how they could support improved access to care.

Objective:

We explored patients’ experiences with VA-issued peripheral devices and their impact on video-based care and health monitoring outside of clinical visits.

Methods:

We conducted in-depth semi-structured interviews among patients who received a VA-issued tablet and one or more peripheral devices between 2023 – 2024. Purposive sampling was used to gather views based on gender, age, race/ethnicity, and rurality. Interviews were transcribed and analyzed using rapid qualitative analysis, guided by the Unified Theory of Acceptance and Use of Technology (UTAUT).

Results:

Among 25 interviewees, most received a blood pressure monitor (84%), weight scale (56%), and/or pulse oximetry device (48%). The majority reported using their peripheral devices (92%) and tablets (76%) to monitor their vital signs and attend video visits. Qualitative analysis yielded 10 themes reflecting experiences and impacts of the device, organized by UTAUT constructs: [performance expectancy] 1) using devices for an assortment of clinical needs, 2) everyday use of blood pressure monitor, weight scale, and pulse oximeter, 3) health monitoring for peace of mind, 4) improving vital signs and lifestyle behaviors, 5) desiring an overall picture of health; [social influence] 6) supporting care team connections, 7) promoting awareness of tablets and peripheral devices; [facilitating conditions] 8) removing obstacles to in-person care; [effort expectancy] 9) familiar and easy to use devices, and 10) challenges with Bluetooth and measurements. Overall, patients described using peripheral devices during virtual visits by syncing data to the tablet for real-time access by their care team. They also reported manually tracking and sharing PGHD with their care team. Despite some challenges with Bluetooth pairing, patients found the devices easy to use and contributed to improved health and motivation. Devices also reduced logistical burdens of in-person visits, especially for those with limited mobility, visual impairments, mental health needs, or transportation barriers, reinforcing that the devices are being received by the intended patient population.

Conclusions:

Patients perceive that peripheral devices can enhance video-based care and support their health care access and chronic disease management. Patients reported benefits to health, behavior, and communication with care teams. To maximize impact, future program enhancements should prioritize device interoperability, accessible training, and expanded outreach.