Supporting the Implementation of Connected Care Technologies in the Veterans Health Administration: Cross-Sectional Survey Findings from the Veterans Engagement with Technology Collaborative (VET-C) Cohort.
Supporting the Implementation of Connected Care Technologies in the Veterans Health Administration: Cross-Sectional Survey Findings from the Veterans Engagement with Technology Collaborative (VET-C) Cohort.
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DOI：
10.2196/21214
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发表时间：
2020-09-30
影响因子：
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通讯作者：
Hogan TP
中科院分区：
文献类型：
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作者：
Etingen B;Amante DJ;Martinez RN;Smith BM;Shimada SL;Richardson L;Patterson A;Houston TK;Frisbee KL;Hogan TP
面向患者的技术在医疗保健系统工作流程中的广泛采用、使用和集成一直很缓慢，从而限制了其潜力的实现。越来越多的工作集中在如何最好地促进采用和使用这些技术，并衡量其对护理过程和结果的影响。这项工作目前存在局限性（例如，横断面分析，有限的患者生成的数据与临床记录相关联），并将受益于机构基础设施，以增强可用数据，并将患者的声音纳入实施和评估工作。退伍军人健康管理局（VHA）发起了一项名为“退伍军人参与技术合作”的倡议，以直接应对这些挑战。本文报告了队列的开发过程，并描述了从队列成员收集的基线数据。退伍军人参与技术协作队列的总体目标是直接让退伍军人参与评估新的VHA面向患者的技术，并在此过程中创建新的基础设施，以支持相关的质量改进和评估活动。退伍军人有资格成为队列成员的入选标准包括：是VHA医疗保健服务的活跃用户，拥有移动的电话，以及是现有VHA面向患者技术的既定用户，如使用VHA患者门户网站的安全消息传递功能。在2017年至2018年期间，我们招募了符合这些标准的退伍军人，并通过电话对他们进行了调查。大多数参与者（N=2727）为男性（2268/2727，83.2%），白色（2226/2727，81.6%），住在自己的公寓或房子（2519/2696，93.4%），并完成了一些大学（1176/2701，43.5%）或高等学位（1178/2701，43.6%）。队列成员平均年龄为59.9岁。大多数人自我报告他们的健康状况良好（1055/2725，38.7%）或非常好（524/2725，19.2%）。大多数队列成员拥有个人电脑（2609/2725，95.7%），平板电脑（1616/2716，59.5%）和/或智能手机（2438/2722，89.6%）。退伍军人参与技术协作队列是VHA学习医疗保健系统计划的一个例子，旨在支持数据驱动的面向患者的技术实施到实践中并测量其影响。通过这一举措，VHA正在为未来的快速，严格的评估和质量改进工作建立能力，以提高对面向患者的技术的采用，使用和影响的理解。
Widespread adoption, use, and integration of patient-facing technologies into the workflow of health care systems has been slow, thus limiting the realization of their potential. A growing body of work has focused on how best to promote adoption and use of these technologies and measure their impacts on processes of care and outcomes. This body of work currently suffers from limitations (eg, cross-sectional analyses, limited patient-generated data linked with clinical records) and would benefit from institutional infrastructure to enhance available data and integrate the voice of the patient into implementation and evaluation efforts. The Veterans Health Administration (VHA) has launched an initiative called the Veterans Engagement with Technology Collaborative cohort to directly address these challenges. This paper reports the process by which the cohort was developed and describes the baseline data being collected from cohort members. The overarching goal of the Veterans Engagement with Technology Collaborative cohort is to directly engage veterans in the evaluation of new VHA patient-facing technologies and in so doing, to create new infrastructure to support related quality improvement and evaluation activities. Inclusion criteria for veterans to be eligible for membership in the cohort included being an active user of VHA health care services, having a mobile phone, and being an established user of existing VHA patient-facing technologies as represented by use of the secure messaging feature of VHA’s patient portal. Between 2017 and 2018, we recruited veterans who met these criteria and administered a survey to them over the telephone. The majority of participants (N=2727) were male (2268/2727, 83.2%), White (2226/2727, 81.6%), living in their own apartment or house (2519/2696, 93.4%), and had completed some college (1176/2701, 43.5%) or an advanced degree (1178/2701, 43.6%). Cohort members were 59.9 years old, on average. The majority self-reported their health status as being good (1055/2725, 38.7%) or very good (524/2725, 19.2%). Most cohort members owned a personal computer (2609/2725, 95.7%), tablet computer (1616/2716, 59.5%), and/or smartphone (2438/2722, 89.6%). The Veterans Engagement with Technology Collaborative cohort is an example of a VHA learning health care system initiative designed to support the data-driven implementation of patient-facing technologies into practice and measurement of their impacts. With this initiative, VHA is building capacity for future, rapid, rigorous evaluation and quality improvement efforts to enhance understanding of the adoption, use, and impact of patient-facing technologies.