Evaluating the Implementation of Home-Based Videoconferencing for Providing Mental Health Services
Evaluating the Implementation of Home-Based Videoconferencing for Providing Mental Health Services
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DOI：
10.1176/appi.ps.201700004
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发表时间：
2018-01-01
影响因子：
3.8
通讯作者：
Damschroder, Laura J.
中科院分区：
文献类型：
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作者：
Interian, Alejandro;King, Arlene R.;Damschroder, Laura J.
目标：退伍军人健康管理局（VHA）最近实施了视频到家庭（V2H）远程保健，作为改善获得精神健康治疗的战略的一部分。鉴于V2H远程保健改变了传统的面对面提供精神卫生服务，需要对这种模式进行实施研究。为了满足这一需求，通过检查与员工V2H经验水平相关的障碍和促进因素，以及区分具有不同V2H绩效水平的设施的因素，对V2H的实施进行了评估。方法：对来自三家医院的33名VHA人员进行半结构化访谈。这些设施是根据2015财政年度（财政年度）心理健康V2H访问的总数以及2014财政年度至2015财政年度访问数量的增长来选择的。通过定性分析，确定了影响实施的因素，对比了具有三种不同V2H经验水平（无经验、经验有限、经验最多）的参与者群体的反应，以及三种不同V2H生产力的设施（高访问量、高访问量增长、低访问量和低访问量增长）。结果：供应商似乎遇到了不同的障碍和促进因素，这取决于他们在V2H方面的经验水平。站点级别的分析说明了后勤支持的重要性，特别是对于新采用该技术的供应商。还确定和描述了区分设施的其他因素。结论：与V2H远程医疗实施相关的关键因素与供应商的购买和后勤支持有关。解决这些因素的设施级策略可能会促进提供者从不使用到持续使用的进展。
Objective: The Veterans Health Administration (VHA) has recently implemented video-to-home (V2H) telehealth as part of a strategy to improve access to mental health treatment. Implementation research of this modality is needed, given that V2H telehealth transforms the traditional face-to-face delivery of mental health services. To address this need, V2H implementation was evaluated by examining barriers and facilitators that were associated with level of staff V2H experience and factors that differentiated facilities with various levels of V2H performance.Methods: Semistructured interviews with VHA personnel (N=33) from three facilities were conducted. The facilities were selected by overall number of mental health V2H visits during fiscal year (FY) 2015 as well as by growth in number of visits from FY 2014 through FY 2015. Factors influencing implementation were identified through qualitative analyses that contrasted responses by groups of participants with three different levels of V2H experience (no experience, limited experience, most experience) as well as three facilities that differed in V2H productivity (high visit count, high visit growth, and low visit count and low visit growth).Results: Providers seemed to encounter different barriers and facilitators depending on their level of experience with V2H. Site-level analyses illustrated the importance of logistical support, especially for providers who are newly adopting the technology. Other factors that differentiated the facilities were also identified and described.Conclusions: Key factors related to implementation of V2H telehealth pertained to provider buy-in and logistical support. Facility-level strategies that address these factors may enhance provider progression from nonuse to sustained use.