Provider Perceptions of Telemedicine Video Visits to Home in a Veteran Population

Clinical Video Telemedicine to Home (CVTH) allows primary care clinicians to conduct clinical encounters with patients in remote locations through a secure synchronous video connection, offering improved access to care and increased patient satisfaction. Although implementation of CVTH continues to grow, little is known about clinician perceptions of clinical applicability or utilization barriers. We assessed provider attitudes and perceived barriers toward implementation of CVTH visits at the Seattle Veterans Affairs Primary Care Clinic. Data are presented from a cross-sectional survey. A total of 49 clinicians, including faculty, MD residents, nurse practitioner residents, and pharmacists, were surveyed with 13 questions gauging opinions of CVTH and prior experience with video telemedicine. Forty-seven providers (96%) were interested in incorporating CVTH into their practice. Forty-one clinicians (83.7%) were concerned about patient technological competency, and 39 (79.6%) were worried about insufficient internet connectivity. A large majority of providers saw opportunities to provide medication reconciliation and improve access to care for geographically distant or homebound patients. Although limited by its descriptive data and analysis, this study provides evidence that primary care providers are most likely to offer CVTH visits to patients who find it physically challenging to attend a clinic appointment or have chief complaints perceived as not requiring a physical examination. Although most providers are interested in using video visits to care for patients who live remotely, they are concerned about using CVTH visits for patients who might require a physical examination or technological assistance.