In August, researchers from the Veterans Affairs Center for Innovation to Implementation and the Veterans Health Administration published an Open study in JAMIA Open Journal that examines an initiative to distribute tablets to high-need veterans with access barriers nationwide. Researchers studied tablet distribution rates and patient-level utilization rates along with sociodemographic and clinical characteristics between May 2016 and September 2017. Additionally, they surveyed 68 facility telehealth coordinators, and interviewed select coordinators in order to determine the most common barriers and facilitators of the tablet distribution program.
In total, the researchers discovered that 6745 veterans during that period received tablets, covering 18 geographic regions. Approximately 90% of those tablets were only capable of live video telehealth interactions, while 10% were capable of clinical monitoring. Additionally, 433 patients received a peripheral device, which was either a stethoscope, blood pressure monitor, thermometer, weight scale or pulse oximeter.
The demographic measures found that the mean age of a tablet recipient was 56 years old, with 36% over the age of 65, and half of the recipients lived in rural or highly rural geographic regions. The majority of recipients had more than one chronic conditions (an average of 5) and 74% of them had been diagnosed with a mental health condition specifically.
The largest barriers to implementing the tablet program reported by facility telehealth coordinators were staffing shortages, training needs and lack of provider interest. They also reported that the biggest facilitators of a successful program were site readiness assessments, local champions, licensure modifications and use of mandates and incentives that could encourage home-based video telehealth. The researchers conclude that the VA’s telehealth tablet initiative shows great promise for integrated health systems to address barriers to access. Even though some sites faced barriers in implementation, many were able to overcome them by developing internal and local strategies to encourage the dissemination and utilization of the tablets.