Willingness for video visits for non-emergent health issues, mental health, or specialty visits

Importance While there is growing evidence for the benefits of, and individual facilitators to, telemedicine use, few studies evaluate factors influencing willingness to engage with video telemedicine. Objective To assess factors associated with willingness to participate in video telemedicine for non-emergent health issues in outpatient settings. Design Survey study using quantitative and qualitative data collected through categorical and open-ended questions via a computer-assisted telephone interview conducted from April to October 2022. Setting The Veterans Health Administration (VHA) Participants 350 veterans with a VHA primary care visit in March 2022 Exposures The survey asked veterans about their internet access, phone, and internet-capable devices, overall telemedicine (i.e., medical visits by telephone or video) experience and preferences. Demographics, financial resources, living situation, transportation, and basic needs were also reported. Main outcomes The primary outcome was self-reported willingness to participate in an outpatient video visit with a doctor for a non-emergent: health issue, mental health outpatient visit, or health issue requiring a specialty physician. Outcomes were assessed using sample weighted ordinal logistic regression and thematic analysis for the open-ended questions. Results Overall, 264 (76.1%) of survey respondents were willing to use video telemedicine for a non-emergent health issue. In mental health or specialty care settings, respectively, 241 (70.7%), and 212 (61.6%) of survey respondents were willing to use video telemedicine. Though many Veterans reported telemedicine benefits (i.e., convenience, reduced travel burden, easy medication renewal), others were reluctant or unable to use the technology (i.e., digital literacy, insufficient internet). In adjusted analyses, willingness to participate in video telemedicine was associated with a differentially higher probability of expressing interest in telemedicine but not knowing how to use it in each setting [health care issue: 12.0%; 95% CI = (1.3%, 22.8%); mental health: 16.6%; 95% CI = (5.3%, 28.0%); specialty care: 21.1%; 95% CI = (5.9%, 36.4%)]. Conclusions and relevance While willingness to choose video telemedicine is influenced by multiple factors and was dependent on the setting, knowing how to use the technology was a barrier in all three clinical settings for those interested in telemedicine. Training opportunities to improve know-how with video telemedicine technologies should be considered.