Making Connections: Nationwide Implementation of Video Telehealth Tablets to Address Access Barriers in Veterans

Authors
Donna M Zulman
Emily P Wong
Cindie Slightam
Amy Gregory
Josephine C Jacobs
Rachel Kimerling
Daniel M Blonigen
John Peters
Leonie Heyworth
Peer-Reviewed Article
August 2019
JAMIA

Headline

An initiative to distribute tablets to high-need veterans successfully reached individuals with barriers to health care access.

Context

Veterans frequently have complex medical, behavioral, and social needs, but often experience barriers in accessing health care services from the Department of Veterans Affairs (VA), the largest integrated health care system in the U.S. The most common barriers include transportation, cost, and geographic isolation in highly rural areas. Telehealth has increased access to VA care in recent years, but was limited to clinic-based video care. This study evaluates a national initiative to expand access to care for high-need VA patients through home-based tablet video technology.

Findings

More than 80 VA facilities around the country distributed tablets to nearly 6,800 patients in rural and geographically isolated locations. Four out of five recipients used the tablet in the study period, and recipients with complex medical and mental health needs were more likely to use the tablet if they were older and had fewer chronic conditions. Some challenges for participating providers with tablet use included staffing shortages, insufficient training, lack of provider interest, and tablet connectivity issues. Some VA sites were able to overcome these challenges through sharing lessons and materials across sites and gaining leadership buy-in to allocate resources and increase provider engagement.

Takeaways

Use of tablets can help increase access to health care to people with complex needs via an integrated health system.

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