![]() With guidance from VA’s Office of Connected Care, these specialties were chosen due to higher use of virtual care. Rather than focus on a single specialty, we strove for variation in our interview sample and selected providers from the following 4 diverse areas of clinical practice: primary care, cardiology, spinal cord injury, and palliative care. ![]() A majority of providers had only begun offering virtual care in the last 1 to 2 years at the time of interviews. We used a combination of administrative data and provider referral to purposefully sample participants. Through a qualitative assessment of VA providers from diverse clinical settings, we sought to identify the most salient factors that impact providers’ decisions about when to offer patients virtual care.Īs part of a study of VA’s implementation of virtual care and distribution of video-enabled tablets to veterans with access barriers, we conducted a qualitative study of a national sample of VA clinicians. The US Department of Veterans Affairs (VA) has been a leading health care organization in the use of virtual care modalities, even before the onset of the COVID-19 pandemic. Systematic identification of the factors that providers consider when assessing the suitability of virtual care for a given patient and clinical need may inform the aforementioned tools and guidelines necessary for accessible, high-quality care. Fewer studies have examined how non–mental health care providers more generally make decisions about when to use virtual modalities. Though these studies may improve uptake and implementation of virtual care, they sometimes lack specifics on how and when to provide virtual care as a substitute or adjunct to in-person care. Well-known barriers include lack of institutional support and the infrastructure to support the technology needed for virtual care, low levels of digital literacy among both patients and providers, and poor integration of virtual modalities into existing clinical workflows, to name a few. Currently, these guidelines and tools are beginning to take shape, and it is critical that they are informed by an in-depth understanding of how providers make decisions about virtual care in their clinical practices.Ĭurrently, there is a plethora of qualitative studies describing provider and patient attitudes toward virtual care, as well as perceived barriers and facilitators to virtual care implementation and adoption. Due to the rapid implementation of virtual care during the pandemic, many providers were asked to provide virtual care with little or no formal training and without clinical guidelines and tools to assist with decision-making. ![]() Because of this, identifying optimal approaches to virtual care delivery that ensure patient safety, satisfaction, quality of care, and equitable access will remain a critical challenge facing health care organizations. While in-person care delivery has largely resumed, virtual care continues to play a major role in how health care systems deliver care to patients. Providers and patients have also reported unexpected advantages such as greater convenience and the ability to assess patients in their home environments. Many welcomed the availability of virtual care given benefits such as increased access to care, less travel time for patients, and often lower costs for both patients and health care systems. The COVID-19 pandemic spurred rapid and widespread implementation of virtual care, including both video- and telephone-based visits, to address acute and chronic needs of patients.
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