Getting Connected: a Retrospective Cohort Investigation of Video-to-Home Telehealth for Mental Health Care Utilization Among Women Veterans

Jan A Lindsay; Alexandra Caloudas; Julianna Hogan; Anthony H Ecker; Stephanie Day; Giselle Day; Samantha L Connolly; Hilary Touchett; Kendra R Weaver; Amber B Amspoker

doi:10.1007/s11606-022-07594-2

Getting Connected: a Retrospective Cohort Investigation of Video-to-Home Telehealth for Mental Health Care Utilization Among Women Veterans

J Gen Intern Med. 2022 Sep;37(Suppl 3):778-785. doi: 10.1007/s11606-022-07594-2. Epub 2022 Aug 30.

Authors

Jan A Lindsay^{1

2

3}, Alexandra Caloudas⁴, Julianna Hogan^{5

4

6}, Anthony H Ecker^{5

4

6}, Stephanie Day^{5

4

6}, Giselle Day⁴, Samantha L Connolly^{7

8}, Hilary Touchett⁴, Kendra R Weaver⁹, Amber B Amspoker^{5

4

6}

Affiliations

¹ VA South Central Mental Illness Research, Education and Clinical Center, a virtual center, Houston, TX, USA. Jan.Lindsay2@va.gov.
² Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA. Jan.Lindsay2@va.gov.
³ Baylor College of Medicine, Houston, TX, USA. Jan.Lindsay2@va.gov.
⁴ Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA.
⁵ VA South Central Mental Illness Research, Education and Clinical Center, a virtual center, Houston, TX, USA.
⁶ Baylor College of Medicine, Houston, TX, USA.
⁷ Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA, USA.
⁸ Harvard Medical School, Boston, MA, USA.
⁹ Clinical Operations, Veterans Health Administration Office of Mental Health and Suicide Prevention, Washington, DC, USA.

Abstract

Background: Increasingly, women are serving in the military and seeking care at the Veterans Health Administration (VHA). Women veterans face unique challenges and barriers in seeking mental health (MH) care within VHA. VA Video Connect (VVC), which facilitates video-based teleconferencing between patients and providers, can reduce barriers while maintaining clinical effectiveness.

Objective: Primary aims were to examine gender differences in VVC use, describe changes in VVC use over time (including pre-COVID and 6 months following the beginning of COVID), and determine whether changes over time differed by gender.

Design: A retrospective cohort investigation of video-to-home telehealth for MH care utilization among veterans having at least 1 MH visit from October 2019 to September 2020.

Participants: Veterans (236,268 women; 1,318,024 men).

Interventions (if applicable): VVC involves face-to-face, synchronous, video-based teleconferencing between patients and providers, enabling care at home or another private location.

Main measures: Percentage of MH encounters delivered via VA Video Connect.

Key results: Women veterans were more likely than men to have at least 1 VVC encounter and had a greater percentage of MH care delivered via VVC in FY20. There was an increase in the percentage of MH encounters that were VVC over FY20, and this increase was greater for women than men. Women veterans who were younger than 55 (compared to those 55 and older), lived in urban areas (compared to those in rural areas), or were Asian (compared to other races) had a greater percentage of MH encounters that were VVC since the start of the pandemic, controlling for the mean percentage of VVC MH encounters in the 6 months pre-pandemic.

Conclusions: VVC use for MH care is greater in women veterans compared to male veterans and may reduce gender-specific access barriers. Future research and VVC implementation efforts should emphasize maximizing patient choice and satisfaction.

Keywords: health services, women; mental health; telemedicine; veterans.

Publication types

Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

COVID-19* / epidemiology
Female
Humans
Male
Patient Acceptance of Health Care
Retrospective Studies
Telemedicine*
United States / epidemiology
United States Department of Veterans Affairs
Veterans Health
Veterans* / psychology