Provider reported value and use of virtual resources in extended primary care prior to and during COVID-19

Jolie N Haun; Vanessa Panaite; Bridget A Cotner; Christine Melillo; Hari H Venkatachalam; Christopher A Fowler; Brian Zilka; William Messina

doi:10.1186/s12913-022-08752-2

Provider reported value and use of virtual resources in extended primary care prior to and during COVID-19

BMC Health Serv Res. 2022 Nov 15;22(1):1353. doi: 10.1186/s12913-022-08752-2.

Authors

Jolie N Haun^{1

2}, Vanessa Panaite^{1

3}, Bridget A Cotner^{1

4}, Christine Melillo⁵, Hari H Venkatachalam¹, Christopher A Fowler^{1

6}, Brian Zilka⁷, William Messina⁸

Affiliations

¹ Research and Development Service, James A. Haley Veterans' Hospital and Clinics, 8900 Grand Oak Circle, Tampa, FL, 33637, USA.
² College of Public Health, University of South Florida, 4202 E. Fowler Avenue, Tampa, FL, 33620, USA.
³ Department of Psychology, University of South Florida, 4202 E. Fowler Avenue, Tampa, FL, 33620, USA.
⁴ Department of Anthropology, University of South Florida, 4202 E. Fowler Avenue, Tampa, FL, 33620, USA.
⁵ Research and Development Service, James A. Haley Veterans' Hospital and Clinics, 8900 Grand Oak Circle, Tampa, FL, 33637, USA. Christine.Melillo@va.gov.
⁶ Department of Psychiatry and Behavioral Neurosciences, University of South Florida, 4202 E. Fowler Avenue, Tampa, FL, 33620, USA.
⁷ Primary Care, James A. Haley Veterans' Hospital and Clinics, 13000 Bruce B. Downs Boulevard, Tampa, FL, 33612, USA.
⁸ Ambulatory Care, James A. Haley Veterans' Hospital and Clinics, 13000 Bruce B. Downs Boulevard, Tampa, FL, 33612, USA.

Abstract

Background: A proactive approach to delivering care using virtual resources, while reducing in-person contact, is needed during the COVID-19 pandemic.

Objective: In the current study we describe pre- to post- COVID-19 pandemic onset related changes in electronic delivery of primary care.

Methods: A longitudinal, pre-post within-subjects design was used. Patient-aligned care team providers from one VA medical center, a primary care annex, and four affiliated community-based outpatient clinics completed both a baseline and follow up survey (N = 62) or the follow-up survey only (N = 85). The follow-up survey contained questions about COVID-19.

Results: The majority of providers (88%) reported they would continue virtual care once pandemic restrictions were lifted. Most (83%) felt prepared to transition to virtual care when pandemic restrictions began. Use of My HealtheVet, Telehealth, and mobile apps showed a significant increase (22.7%; 31.1%; 48.5%). Barriers to virtual care included (1) internet connectivity; (2) patients' lack of technology comfort and skills; and (3) technical issues. Main supports to provide virtual care to patients were (1) peers/ colleagues; (2) technology support through help desk; (3) equipment such as laptops and dual screens; (4) being able to use doximety and virtual care manager, and (5) training.

Conclusions: Overall, provider-use and perceptions related to using virtual care improved over time. Providers adapted quickly to providing virtual care during COVID-19 and planned to provide virtual care long-term.

Keywords: Primary care; Technology; Veteran; Virtual healthcare resources.

MeSH terms

Ambulatory Care Facilities
COVID-19* / epidemiology
Humans
Pandemics
Primary Health Care
Telemedicine*