Factors Influencing How Providers Assess the Appropriateness of Video Visits: Interview Study With Primary and Specialty Health Care Providers

BackgroundThe rapid implementation of virtual care (ie, telephone or video-based clinic appointments) during the COVID-19 pandemic resulted in many providers offering virtual care with little or no formal training and without clinical guidelines and tools to assist with decis...

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Main Authors: Caroline Gray, Charlie Wray, Rebecca Tisdale, Camila Chaudary, Cindie Slightam, Donna Zulman
Format: Article
Language:English
Published: JMIR Publications 2022-08-01
Series:Journal of Medical Internet Research
Online Access:https://www.jmir.org/2022/8/e38826
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author Caroline Gray
Charlie Wray
Rebecca Tisdale
Camila Chaudary
Cindie Slightam
Donna Zulman
author_facet Caroline Gray
Charlie Wray
Rebecca Tisdale
Camila Chaudary
Cindie Slightam
Donna Zulman
author_sort Caroline Gray
collection DOAJ
description BackgroundThe rapid implementation of virtual care (ie, telephone or video-based clinic appointments) during the COVID-19 pandemic resulted in many providers offering virtual care with little or no formal training and without clinical guidelines and tools to assist with decision-making. As new guidelines for virtual care provision take shape, it is critical that they are informed by an in-depth understanding of how providers make decisions about virtual care in their clinical practices. ObjectiveIn this paper, we sought to identify the most salient factors that influence how providers decide when to offer patients video appointments instead of or in conjunction with in-person care. MethodsWe conducted semistructured interviews with 28 purposefully selected primary and specialty health care providers from the US Department of Veteran’s Affairs health care system. We used an inductive approach to identify factors that impact provider decision-making. ResultsQualitative analysis revealed distinct clinical, patient, and provider factors that influence provider decisions to initiate or continue with virtual visits. Clinical factors include patient acuity, the need for additional tests or labs, changes in patients’ health status, and whether the patient is new or has no recent visit. Patient factors include patients’ ability to articulate symptoms or needs, availability and accessibility of technology, preferences for or against virtual visits, and access to caregiver assistance. Provider factors include provider comfort with and acceptance of virtual technology as well as virtual physical exam skills and training. ConclusionsProviders within the US Department of Veterans Affairs health administration system consider a complex set of factors when deciding whether to offer or continue a video or telephone visit. These factors can inform the development and further refinement of decision tools, guides, and other policies to ensure that virtual care expands access to high-quality care.
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spelling doaj.art-d27dc778632b4239b3a66f50b43b8f482023-08-28T22:56:56ZengJMIR PublicationsJournal of Medical Internet Research1438-88712022-08-01248e3882610.2196/38826Factors Influencing How Providers Assess the Appropriateness of Video Visits: Interview Study With Primary and Specialty Health Care ProvidersCaroline Grayhttps://orcid.org/0000-0002-8987-6142Charlie Wrayhttps://orcid.org/0000-0001-9203-2031Rebecca Tisdalehttps://orcid.org/0000-0003-2749-6889Camila Chaudaryhttps://orcid.org/0000-0003-0864-8445Cindie Slightamhttps://orcid.org/0000-0001-9211-2285Donna Zulmanhttps://orcid.org/0000-0001-8904-2810 BackgroundThe rapid implementation of virtual care (ie, telephone or video-based clinic appointments) during the COVID-19 pandemic resulted in many providers offering virtual care with little or no formal training and without clinical guidelines and tools to assist with decision-making. As new guidelines for virtual care provision take shape, it is critical that they are informed by an in-depth understanding of how providers make decisions about virtual care in their clinical practices. ObjectiveIn this paper, we sought to identify the most salient factors that influence how providers decide when to offer patients video appointments instead of or in conjunction with in-person care. MethodsWe conducted semistructured interviews with 28 purposefully selected primary and specialty health care providers from the US Department of Veteran’s Affairs health care system. We used an inductive approach to identify factors that impact provider decision-making. ResultsQualitative analysis revealed distinct clinical, patient, and provider factors that influence provider decisions to initiate or continue with virtual visits. Clinical factors include patient acuity, the need for additional tests or labs, changes in patients’ health status, and whether the patient is new or has no recent visit. Patient factors include patients’ ability to articulate symptoms or needs, availability and accessibility of technology, preferences for or against virtual visits, and access to caregiver assistance. Provider factors include provider comfort with and acceptance of virtual technology as well as virtual physical exam skills and training. ConclusionsProviders within the US Department of Veterans Affairs health administration system consider a complex set of factors when deciding whether to offer or continue a video or telephone visit. These factors can inform the development and further refinement of decision tools, guides, and other policies to ensure that virtual care expands access to high-quality care.https://www.jmir.org/2022/8/e38826
spellingShingle Caroline Gray
Charlie Wray
Rebecca Tisdale
Camila Chaudary
Cindie Slightam
Donna Zulman
Factors Influencing How Providers Assess the Appropriateness of Video Visits: Interview Study With Primary and Specialty Health Care Providers
Journal of Medical Internet Research
title Factors Influencing How Providers Assess the Appropriateness of Video Visits: Interview Study With Primary and Specialty Health Care Providers
title_full Factors Influencing How Providers Assess the Appropriateness of Video Visits: Interview Study With Primary and Specialty Health Care Providers
title_fullStr Factors Influencing How Providers Assess the Appropriateness of Video Visits: Interview Study With Primary and Specialty Health Care Providers
title_full_unstemmed Factors Influencing How Providers Assess the Appropriateness of Video Visits: Interview Study With Primary and Specialty Health Care Providers
title_short Factors Influencing How Providers Assess the Appropriateness of Video Visits: Interview Study With Primary and Specialty Health Care Providers
title_sort factors influencing how providers assess the appropriateness of video visits interview study with primary and specialty health care providers
url https://www.jmir.org/2022/8/e38826
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