• Charlie M Wray, Jacqueline M Ferguson, Liberty Greene, Ashley Griffin, James Van Campen, Amy Mj O'Shea, Cindie Slightam, and Donna M Zulman.
• Department of Medicine, University of California, San Francisco, San Francisco, CA, USA. Charlie.Wray@ucsf.edu.
• J Gen Intern Med. 2024 Mar 1; 39 (4): 549556549-556.

IntroductionThe Veterans Health Administration (VHA) distributes video-enabled tablets to individuals with barriers to accessing care. Data suggests that many tablets are under-used. We surveyed Veterans who received a tablet to identify barriers that are associated with lower use, and evaluated the impact of a telephone-based orientation call on reported barriers and future video use.MethodsWe used a national survey to assess for the presence of 13 barriers to accessing video-based care, and then calculated the prevalence of the barriers stratified by video care utilization in the 6 months after survey administration. We used multivariable modeling to examine the association between each barrier and video-based care use and evaluated whether a telephone-based orientation modified this association.ResultsThe most prevalent patient-reported barriers to video-based care were not knowing how to schedule a visit, prior video care being rescheduled/canceled, and past problems using video care. Following adjustment, individuals who reported vision or hearing difficulties and those who reported that video care does not provide high-quality care had a 19% and 12% lower probability of future video care use, respectively. Individuals who reported no interest in video care, or did not know how to schedule a video care visit, had an 11% and 10% lower probability of being a video care user, respectively. A telephone-based orientation following device receipt did not improve the probability of being a video care user.DiscussionBarriers to engaging in virtual care persist despite access to video-enabled devices. Targeted interventions beyond telephone-based orientation are needed to facilitate adoption and engagement in video visits.© 2023. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.

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