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Incorporating TechQuity in Virtual Care Within the Veterans Health Administration: Identifying Future Research and Operations Priorities.
Walsh, Conor; Sullivan, Caitlin; Bosworth, Hayden B; Wilson, Sarah; Gierisch, Jennifer M; Goodwin, Kaitlyn B; Mccant, Felicia; Hoenig, Helen; Heyworth, Leonie; Zulman, Donna M; Turvey, Carolyn; Moy, Ernest; Lewinski, Allison A.
  • Walsh C; Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, NC, USA. conor.walsh@va.gov.
  • Sullivan C; Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC, USA. conor.walsh@va.gov.
  • Bosworth HB; Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, NC, USA.
  • Wilson S; Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, NC, USA.
  • Gierisch JM; Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
  • Goodwin KB; School of Nursing, Duke University, Durham, NC, USA.
  • Mccant F; Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.
  • Hoenig H; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
  • Heyworth L; Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, NC, USA.
  • Zulman DM; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
  • Turvey C; Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, NC, USA.
  • Moy E; Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
  • Lewinski AA; Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.
J Gen Intern Med ; 2023 Jan 17.
Article in English | MEDLINE | ID: covidwho-2174898
ABSTRACT

BACKGROUND:

The Covid-19 pandemic dramatically changed healthcare delivery, driving rapid expansion of synchronous (i.e., real-time) audio-only and video telehealth, otherwise known as virtual care. Yet evidence describes significant inequities in virtual care utilization, with certain populations more dependent on audio-only virtual care than video-based care. Research is needed to inform virtual care policies and processes to counteract current inequities in access and health outcomes.

OBJECTIVE:

Given the importance of incorporating equity into virtual care within the Veterans Health Administration (VHA), we convened a Think Tank to identify priorities for future research and virtual care operations focused on achieving equitable implementation of virtual care within the VHA.

METHODS:

We used participatory activities to engage clinicians, researchers, and operational partners from across the VHA to develop priorities for equitable implementation of virtual care. We refined priorities through group discussion and force-ranked prioritization and outlined next steps for selected priorities. KEY

RESULTS:

Think Tank participants included 43 individuals from the VHA who represented diverse geographical regions, offices, and backgrounds. Attendees self-identified their associations primarily as operations (n = 9), research (n = 28), or both (n = 6). We identified an initial list of 63 potential priorities for future research and virtual care operations. Following discussion, we narrowed the list to four priority areas (1) measure inequities in virtual care, (2) address emerging inequities in virtual care, (3) deploy virtual care equitably to accommodate differently abled veterans, and (4) measure and address potential adverse consequences of expanded virtual care. We discuss related information, data, key partners, and outline potential next steps.

CONCLUSIONS:

This Think Tank of research and operational partners from across the VHA identified promising opportunities to incorporate equity into the design and implementation of virtual care. Although much work remains, the priorities identified represent important steps toward achieving this vital goal.
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Full text: Available Collection: International databases Database: MEDLINE Language: English Journal subject: Internal Medicine Year: 2023 Document Type: Article Affiliation country: S11606-023-08029-2

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Full text: Available Collection: International databases Database: MEDLINE Language: English Journal subject: Internal Medicine Year: 2023 Document Type: Article Affiliation country: S11606-023-08029-2