Abstract
Background: As the use of telemental health—mental health care delivered through video or phone—has increased in the era of COVID, it is important to understand patients' preferences and perspectives regarding the use of video for telehealth visits. A new web-based treatment program for veterans uses video visits with mental health experts to supplement its online cognitive behavioral therapy to treat clinically significant symptoms of depression and/or post-traumatic stress disorder.Objective: As part of the program evaluation, Veterans were asked, “How important was it for you to be able to physically see your provider through video telehealth?” to understand whether they thought using video was important and why it may or may not be important.Materials and Methods: The study uses data from the program's exit survey and exit interview. The surveys and interviews were conducted over a 19-month period. Surveys and interviews were conducted over the phone with note taking. Matrix and content analyses were used to analyze the qualitative data—predetermined themes and emergent themes were analyzed and inform findings.Results: Seventy-three veterans completed a survey. Of these, 64 completed an interview. The majority of veterans surveyed (75%) said that it was “very important” to physically see their provider through video telehealth, 23% said that it was at least “somewhat important” or “not at all important.” This study highlights three main themes found in the qualitative data: patients discuss (1) advantages of using video, (2) why they dislike video, and (3) technological barriers to using video.Conclusions: Being able to visually see a provider, and be seen by a provider, has distinct benefits for care and relationship building that are difficult to achieve over the phone. This has important implications for the future delivery of telemental health care and deserves consideration as patients and providers decide whether to use phone or video for remotely delivered care.
Highlights
While telehealth has been available since the 1960s1 and deployed in a variety of health and treatment contexts,[2,3,4] its use has surged across the country as the era of COVID has quickened telehealth’s reach and adoption.[5,6] Reflecting broader trends, the U.S Department of Veteran Affairs (VA) has actively sought to promote and implement video telehealth since 2013.7 Before the pandemic, only 2% of mental health encounters within the VA health care system were through the VA’s video telehealth to home platform, VA Video Connect
Background: As the use of telemental health—mental health care delivered through video or phone—has increased in the era of COVID, it is important to understand patients’ preferences and perspectives regarding the use of video for telehealth visits
A closer analysis of these VA telemental health encounters shows a mix of modalities being used—with a majority of care delivered through telephone
Summary
The majority of veterans surveyed (75%) said that it was ‘‘very important’’ to physically see their provider through video telehealth, 23% said that it was at least ‘‘somewhat important’’ or ‘‘not at all important.’’ This study highlights three main themes found in the qualitative data: patients discuss (1) advantages of using video, (2) why they dislike video, and (3) technological barriers to using video. Conclusions: Being able to visually see a provider, and be seen by a provider, has distinct benefits for care and relationship building that are difficult to achieve over the phone This has important implications for the future delivery of telemental health care and deserves consideration as patients and providers decide whether to use phone or video for remotely delivered care
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