Improving Video Visit Adoption by Surgeons

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PROJECT SUMMARY/ABSTRACT Dr. Chad Ellimoottil is a surgical specialist whose long-term career goal is to improve patient outcomes through fostering the adoption of video visits. Current research demonstrates that surgical video visits can 1) reduce travel burdens for rural patients, 2) reduce medical costs for patients and caregivers, and 3) increase patient satisfaction without compromising quality of care. Despite these advantages, less than 1% of surgeons use video visits. Research plan: This proposal directly responds to AHRQ’s Special Emphasis Notice which intends to support career development grants (K08) focusing on health information technology implementation (NOT- HS-13-011). It leverages mentors with expertise in health economics, implementation science, and telehealth to generate an understanding of the role of monetary and non-monetary barriers on surgical video visit adoption and how these barriers can be mitigated through interventions designed to drive behavior change. This proposal has three research aims: 1) Evaluate the impact of payment reform on video visit use by surgical patients; 2) Define non-monetary barriers to surgical video visit adoption; 3) Design and pilot an implementation intervention to facilitate video visit adoption. Candidate: Dr. Ellimoottil is Assistant Professor of Urology at the University of Michigan, where he completed a two-year health services research fellowship. Dr. Ellimoottil has clinical, administrative, and research experience with telehealth through his virtual clinic, his participation in Michigan Medicine's Virtual Care team, and his role leading a telehealth research collaboration. Career development plan: Dr. Ellimoottil's career development plan builds upon his training and career experience to: 1) To learn advanced quantitative methods (linked to Research Aim 1); 2) To learn survey design and qualitative methods (linked to Research Aim 2), and 3) To learn principles of implementation science relevant to telehealth adoption (linked to Research Aim 3). Mentorship team: Primary mentor Dr. David Miller is a Chief Clinical Officer at Michigan Medicine. He is currently a principal investigator on an R01 grant related to healthcare delivery reform. Co-mentor Dr. Sarah Krein has 20 years of experience in survey design, qualitative methods, and implementation science. Co-mentor Dr. Andy Ryan is a health economist with expertise in advanced quantitative methods, including econometrics. Dr. Ellimoottil’s advisory board includes two nationally recognized telehealth experts (Drs. Rashid Bashshur and Judd Hollander) and an R01-funded implementation science expert (Dr. Ted Skolarus). This study will benefit patients, practitioners, and policymakers through the development of evidence-based methods to advance telehealth adoption. It will produce the training, research experience, and preliminary data necessary for Dr. Ellimoottil to conduct an effectiveness-implementation hybrid trial assessing the clinical and implementation outcomes from his proposed implementation intervention. The overarching goal is to advance video visit adoption in order to improve healthcare access, experience, and outcomes for patients undergoing surgical care.