title: Perspectives from the Veterans Health Administration about opportunities and barriers in telemedicine.
abstract: We used qualitative interviews to examine the perceptions of direct providers of telemedicine services, primary care providers (PCPs) and hospital administrators about opportunities and barriers to the implementation of telemedicine services in a network of Veterans Health Administration hospitals. A total of 37 interviews were conducted (response rate of 28%) with 17 direct telemedicine providers, nine PCPs and 11 administrators. The overall inter-coder reliability across all themes was high (Scott's pi = 0.94). Direct telemedicine providers generally agreed that telemedicine improved rapport with patients, and respondents in all three groups generally agreed that telemedicine improves access, productivity, and the quality and coordination of care. Respondents mentioned several benefits to home telemedicine, including the ability to better manage chronic diseases, provide frequent clinician contact, facilitate quick responses to patient needs and provide care in patient's homes. Most respondents anticipated future growth in telemedicine services. Barriers to telemedicine implementation included technical challenges, the need for more education and training for patients and staff, preferences for in-person care, the need for programme improvement and the need for additional staff time to provide telemedicine services.
authors.affiliation: VA HSR&D Center for Practice Management and Outcomes Research, VA Ann Arbor Health Care System, Ann Arbor, Michigan, USA. Faithhopp@wayne.edu
authors.forename: Faith
authors.initials: F
authors.lastname: Hopp
authors.forename: Pamela
authors.initials: P
authors.lastname: Whitten
authors.forename: Usha
authors.initials: U
authors.lastname: Subramanian
authors.forename: Peter
authors.initials: P
authors.lastname: Woodbridge
authors.forename: Michael
authors.initials: M
authors.lastname: Mackert
authors.forename: Julie
authors.initials: J
authors.lastname: Lowery
mesh_terms: D001291:Attitude of Health Personnel; D003695:Delivery of Health Care / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D011369:Professional-Patient Relations; D011787:Quality of Health Care / Q000592:standards; D017216:Telemedicine / Q000458:organization & administration* / Q000592:standards; D014481:United States; D014493:United States Department of Veterans Affairs