Using Qualitative Methods to Support Implementation of Video Telehealth Across a National Health System: A Wholistic Process

Background: The Personalized Implementation of Video Telehealth for Rural Veterans Team facilitated adoption of video telehealth for mental health care in rural facilities within the U.S. Department of Veteran Affairs (VA). It adapted several qualitative methods to support a multisited, multiyear telehealth implementation project. This paper details this work, providing guidance on how qualitative methods can be pragmatically used to support implementation of video telehealth. Methods: Three main qualitative activities were used to support implementation of video telehealth: interviews, integrated periodic reflections, and Rapid Reviews. The qualitative team consisted of two qualitative methodologists. From 2020 to 2023, needs-assessment interviews were conducted with site partners at 17 different VA medical centers. One-year post interviews were conducted with 15 site partners in 2020–2022. Integrated periodic reflections with the implementation team occurred twice a month from 2020 to 2024. From 2020 to 2024, the qualitative team created quarterly Rapid Reviews for active site partners. The number of periodic reflections created each quarter fluctuated from 5 to 12 during this time. Results: The qualitative activities and products presented here were used to support the implementation of video telehealth for mental health across multiple VA facilities. Methods were adapted to reduce burden for partners in rural areas. Qualitative activities supported practical use of information, helping all parties to understand how to continuously improve their activities for better mental health access. Conclusions: The implementation of other innovative technologies for mental health faces many of the same challenges as video telehealth. Qualitative methods can support communication and increase likelihood of successful implementation.