Implementation and Impact of Tele-Whole Health on Patients: Provider and Patient Perspectives

ABSTRACT

Methods: Semi-structured interviews were conducted with 51 providers and 30 Veterans across 12 VHA Medical Centers (VAMCs). Interviewees included staff delivering and patients participating in tele WH coaching, tele WH educational classes, and tele-complementary and integrative therapies (e.g., acupuncture, chiropractic, yoga, Tai Chi, mindfulness or meditation). Interviews were transcribed and a content analysis was performed using a rapid approach. Results: Participants described a broad range of benefits associated with Veteran participation in teleWH services. These included 1) Improved access to services that previously were not widely offered in-person;2) Increased comfort engaging in services, especially for specific Veteran populations (e.g., Veterans with PTSD, LGBTQ, women, and younger Veterans);3) Greater convenience, including less stress related to travel, length of time required to use services, and integration with workday;and 4) Increased engagement in self-care outside of classes or services. Disadvantages included 1) Decreased socialization and opportunities for group interaction;2) Decreased access to touch-based services (e.g., acupuncture);3) Technological challenges with approved virtual platforms. Facilitator skill and tele health etiquette mattered greatly for satisfaction with tele WH. Background: The Veterans Health Administration (VHA) quickly responded to the COVID-19 pandemic by providing access to care via tele health. This rapid pivot occurred simultaneously with VHA's Whole Health transformation, which includes the integration of complementary and integrative health services, education, and coaching to develop self-care skills. This qualitative study explored providers' and patients' perspectives on the implementation and advantages/ disadvantages of tele-Whole Health services (tele WH). Conclusion: Tele WH is perceived to be a strong complement to in-person services and poses many physical and mental health benefits for patients. Attention to facilitator skills training and ease of virtual platform use is needed to increase engagement and make tele WH a viable patient centered option for care.