Sociotechnical Perspective on Implementing Clinical Video Telehealth for Veterans with Spinal Cord Injuries and...

Area of Science:

• Health Services Research
• Telemedicine
• Sociotechnical Systems

Background:

• Clinical video telehealth (CVT) enhances healthcare access for remote populations.
• The Veterans Health Administration uses CVT to improve care for veterans with spinal cord injuries and disorders (SCI/D).
• Factors influencing CVT implementation in SCI/D clinical practice remain unassessed.

Purpose of the Study:

• To identify factors influencing the implementation of CVT for veterans with SCI/D.
• To apply a sociotechnical perspective to understand CVT implementation barriers and facilitators.

Main Methods:

• Conducted semistructured telephone interviews with 40 healthcare providers.
• Interviewees were users of CVT for delivering services to veterans with SCI/D.
• Data analysis focused on identifying implementation influences from a provider perspective.

Main Results:

• Workflow and communication emerged as significant implementation barriers.
• Challenges included coordinating CVT appointment logistics and ensuring cross-facility team communication.
• Technical infrastructure, personnel, equipment, and space were also identified as influential factors.

Conclusions:

• CVT implementation for veterans with SCI/D is shaped by interconnected social and technical factors.
• Social elements, including interpersonal interactions, workflow integration, and communication, are paramount.
• Successful CVT requires robust teamwork and communication across distributed healthcare teams.