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Overcoming Obstacles: Barriers to Virtual Care Use Among Video-Enabled Tablet Recipients in the Veterans Health
Charlie M Wray1,2, Jacqueline M Ferguson3, Liberty Greene3
1Department of Medicine, University of California, San Francisco, San Francisco, CA, USA. Charlie.Wray@ucsf.edu.
Journal of General Internal Medicine
|November 2, 2023
Summary
Many Veterans using video tablets face persistent barriers to virtual care access. A telephone orientation did not improve video care use, indicating a need for enhanced interventions.
Area of Science:
- Health Services Research
- Telemedicine
- Geriatric Care
Background:
- The Veterans Health Administration (VHA) provides video-enabled tablets to improve healthcare access for individuals facing barriers.
- Underutilization of these tablets is a significant concern, prompting an investigation into contributing factors.
- This study identifies specific barriers and evaluates interventions aimed at increasing virtual care engagement.
Purpose of the Study:
- To identify patient-reported barriers associated with lower utilization of VHA video-enabled tablets.
- To assess the impact of a telephone-based orientation call on these barriers and future video care use.
- To inform the development of targeted interventions for improving virtual care adoption.
Main Methods:
- A national survey was conducted to identify 13 barriers to accessing video-based care among Veterans.
- Prevalence of barriers was calculated and stratified by video care utilization in the six months post-survey.
- Multivariable modeling examined the association between barriers and video care use, and whether telephone orientation modified this relationship.
Main Results:
- Key barriers included not knowing how to schedule visits, visit rescheduling/cancellation, and prior negative video care experiences.
- Vision/hearing difficulties and perceptions of low-quality video care were associated with a 19% and 12% lower probability of future use, respectively.
- Lack of interest and not knowing how to schedule visits reduced future use probability by 11% and 10%, respectively; telephone orientation did not improve usage.
Conclusions:
- Significant barriers to virtual care engagement persist even with provided technology.
- Current telephone-based orientation strategies are insufficient to overcome these adoption challenges.
- Novel, targeted interventions are essential to enhance the uptake and consistent use of video visits.
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