Veterans preferences for exchanging information using VA HIT

背景：退伍军人健康管理局(VHA)致力于提供远程和 及时为退伍军人提供医疗信息技术(HIT)服务，改善患者状况 参与度和他们的健康结果。为了支持VHA的使命，电子健康查询 还提出了改善退伍军人访问和有意义地使用HIT的战略目标 资源。到目前为止，包括移动应用程序在内的几个面向患者的平台， Health、MyHealtheVet、Kiosks等已经实现。然而，对于平台， 不断扩大，VHA利益相关者认识到需要培养一名全面的退伍军人- 以创建有用和用户友好的HIT为中心的方法，以确保退伍军人能够 轻松、连续地访问和使用这些服务。然而，尽管年纪较大的退伍军人 慢性疾病(如高血压、糖尿病、慢性阻塞性肺病等)代表大的 VHA的热门用户中，对他们访问和访问的偏好知之甚少 使用VHA Hit平台。这项研究代表了一个独特的机会，利用参与式 研究以补充运营和QUERI努力，以支持VHA的发展 同步的、易于使用的、对目标用户组有用的命中系统，例如 患有慢性共病的老年退伍军人。建议的研究目标是：(1) 基于层次分析的数字健康矩阵决策模型研究 利益相关者的意见；(2)探索患有慢性合并症的老年退伍军人(n=40) 在两个退伍军人管理局(坦帕和贝德福德)使用VHA HIT资源的偏好；(2.1) 开发VHA HIT平台界面可视化建模仿真原型 目标1和目标2的发现；以及(3)开发基于老兵的视觉建模系统，使用 与来自目标2的相同退伍军人的参与式方法。 方法：这项研究将有目的地抽取40名患有慢性并发症的老年退伍军人作为样本。 报告使用电子资源和/或退伍军人管理局管理个人的情况 信息。将对女性和少数族裔进行过度抽样，以确保代表性。混合的- 研究方法将用于进行前瞻性描述性研究设计。数据收集 方法包括加强焦点小组，使用参与性方法，其中退伍军人 使用以下工具开发面向患者的界面的可视化建模原型 基于他们的喜好使用HIT交换信息的模拟软件。数据 分析将包括专题内容分析和描述性统计。 长期目标：目前，业务利益攸关方正在重组 信息学和分析(OIA)和发展一个电子健康小组，以建立一个国家 治理委员会支持这一VHA转型。这项拟议的项目在 直接与内审办内的这些新兴业务活动保持一致。这个项目将引领 涉及到一系列与通过 以老兵为中心的同步打击资源体系。产品将包括数字健康 VHA HIT平台的矩阵决策模型及其特点和使用环境；退伍军人 报告了使用HIT交换信息的首选项；以及可视化建模原型 一个同步命中系统。这些产品将为运营奠定基础 努力增加退伍军人对VHA HIT的采用和持续有意义的使用。

Background: The Veterans Health Administration (VHA) is committed to provide remote and timely health information technology (HIT) services to Veterans to improve patient engagement and their health outcomes. To support the VHA's mission, the eHealth QUERI also set forth a strategic goal to improve Veteran's access and meaningful use of HIT resources. To date, several patient-facing platforms, including mobile applications, tele- health, MyHealtheVet, kiosks, etc. have been implemented. However, with platforms continually expanding, VHA stakeholders recognize the need to develop a holistic Veteran- centered approach to creating useful and user-friendly HIT to ensure that Veterans are able to access and use these services with ease and continuity. Yet, though older Veterans with chronic conditions (e.g. high blood pressure, diabetes, COPD, etc.) represent the large portion of the VHA's HIT users, little is known about their preferences for accessing and using VHA HIT platforms. This study represents a unique opportunity to use participatory research to complement operational and QUERI efforts to support development of a VHA HIT systems that is synchronized, easy to use, and useful for targeted user groups, such as older Veterans with chronic co-morbid conditions. The proposed research aims are: (1) Develop a Digital Health Matrix Decision Model based on an Analytical Hierarchy Process with stakeholder input; (2) Explore older Veterans with chronic co-morbid conditions (n=40) preferences for using VHA HIT resources, at two VA facilities (Tampa & Bedford); (2.1) Develop visual modeling simulation prototypes of VHA HIT platform interfaces based on findings from Aims 1 and 2; and (3) Develop a Veteran-based visual modeling system using participatory methods with the same Veterans from Aim 2. Methods: The study will purposively sample older Veterans (n=40) with chronic co-morbid conditions who report using electronic resources and/or VA HIT to manage personal information. Females and minorities will be over-sampled to ensure representation. Mixed- methods will be used to conduct this prospective descriptive study design. Data collection methods include enhanced focus groups, using participatory methods, in which Veterans inform the development of visual modeling prototypes of patient-facing interfaces using simulation software based on their preferences for exchanging information using HIT. Data analysis will include thematic content analysis and descriptive statistics. Long-term Goals: Currently, operational stakeholders are re-organizing the Office of Informatics and Analytics (OIA) and developing an eHealth group to establish a national governance council to support this VHA HIT transformation. This proposed project is in direct alignment with these emerging operational activities within OIA. This project will lead to a line of implementation research related to enhancing communication through a Veteran-centered synchronized HIT resource system. Products will include Digital Health Matrix Decision Model of VHA HIT platforms, their features, and contexts for use; Veterans' reported preferences for exchanging information using HIT; and visual modeling prototypes of a synchronized HIT system. These products will lay the groundwork for operational efforts to increase Veterans' adoption and sustained meaningful use of VHA HIT.