eHealth
Bedford, MA
Overview:
The QUERI eHealth National Partnered Evaluation Initiative (QUERI eHealth) aims to demonstrate the impact of VA connected care technologies on important outcomes, including Veterans’ perceptions of access and Veterans’ experience of care, clinical team member workload and satisfaction, and healthcare processes, while also identifying strategies that potentially could further the adoption of connected-care technologies among Veterans and clinical team members.
Recently, eHealth QUERI leadership launched a novel effort to develop and maintain a cohort of Veterans willing to provide feedback on the latest VA connected-care technologies to improve their usability, adoption, and meaningful integration into practice. Referred to as the “Veterans Engagement with Technology Collaborative” (VET-C), this effort directly engages Veterans in the evaluation of VA technologies that are intended to increase access, enhance coordination, and support self-management. Nearly 3,000 Veterans, from 14 different VA sites geographically spread across the United States, who have joined the VET-C cohort to date – and the associated cohort dataset – serve as the basis for the ongoing efforts of eHealth QUERI.
Findings and Impacts:
Market VA Connected-Care Technologies
Drawing on lessons learned from projects in the last year, QUERI eHealth is implementing a multi-component, multi-channel approach to market new and existing VA connected-care technologies to Veterans who have joined the VET-C cohort. A first round of marketing materials, including a newsletter, branded token incentives, and fact sheets developed through a collaborative process with Office of Connected Care leadership were disseminated to the nearly 3,000 Veterans in the VET-C cohort. These marketing efforts are intended to further build a user base for select technologies and to support evaluations that leverage the cohort moving forward, and are based on published best practices and lessons learned from other HSR&D studies for keeping cohort members engaged over time.
Evaluate Select VA Connected Care Technologies
QUERI eHealth is utilizing the VET-C cohort to evaluate connected-care technologies that are of the highest priority to VA’s Office of Connected Care. These include, but are not limited to the VA Online Scheduling app, the Annie Automated Text Messaging System, and the VA Video Connect app that supports real-time video visits between Veterans and their VA healthcare teams. A foundational step to support these evaluations has been understanding important baseline characteristics of the nearly 3,000 Veterans that currently comprise the cohort. Analysis of telephone survey data collected from these Veterans indicate that they are predominantly male (83%), white (82%), married or in a civil union (65%); completed some college or vocational school (44%) or post-graduate degree (44%); are about 60 years old; and receive most of their healthcare at the VA (79%). Most of these Veterans own a smartphone (90%) or non-smartphone cellphone (10%), tablet computer (60%) and/or laptop or desktop computer (98%). Of note, most Veterans in the cohort (55%) also consider themselves to be early adopters of new technology. As new activity and usage data for Office of Connected Care technologies become available and are merged with the existing VET-C database in the months ahead, evaluations will be conducted to inform refinements to the technologies before their rollout—and to understand their impact on Veteran perceptions of and experiences of care.
Evaluate Health Coaching Support in Technology-based Interventions for Goal Setting
Using the VET-C cohort, eHealth QUERI is preparing to conduct a randomized pilot trial evaluating Veterans who receive automated text messaging compared to those who receive automated text messaging plus health coaching support. eHealth QUERI is refining the text messages and health coaching scripts to be used in the pilot trial—and conducting a beta test of their perceived appeal and usability among a group of Veterans. This pilot trial will provide preliminary insights regarding efficacy and feasibility, and will add to the knowledge about how health-coaching enhances the effect of an automated texting system on outcomes. It also will provide data on how best to incorporate health-coaching into the adoption and use of connected-care technologies for health behavior and behavior change.
Principal Investigators: Timothy Hogan, PhD, also is part of HSR&D's Center for Healthcare Organization and Implementation Research (CHOIR) in Bedford, MA; contact at timothy.hogan@va.gov.
Operational Partners: VA’s Office of Connected Care.