Evaluating the Implementation of Home-Based Videoconferencing for Providing Mental Health Services
Open accessAbstract
OBJECTIVE: The Veterans Health Administration (VHA) has recently implemented video-to-home (V2H) telehealth as part of a strategy to improve access to mental health treatment. Implementation research of this modality is needed, given that V2H telehealth transforms the traditional face-to-face delivery of mental health services. To address this need, V2H implementation was evaluated by examining barriers and facilitators that were associated with level of staff V2H experience and factors that differentiated facilities with various levels of V2H performance. METHODS: Semistructured interviews with VHA personnel (N=33) from three facilities were conducted. The facilities were selected by overall number of mental health V2H visits during fiscal year (FY) 2015 as well as by growth in number of visits from FY 2014 through FY 2015. Factors influencing implementation were identified through qualitative analyses that contrasted responses by groups of participants with three different levels of V2H experience (no experience, limited experience, most experience) as well as three facilities that differed in V2H productivity (high visit count, high visit growth, and low visit count and low visit growth). RESULTS: Providers seemed to encounter different barriers and facilitators depending on their level of experience with V2H. Site-level analyses illustrated the importance of logistical support, especially for providers who are newly adopting the technology. Other factors that differentiated the facilities were also identified and described. CONCLUSIONS: Key factors related to implementation of V2H telehealth pertained to provider buy-in and logistical support. Facility-level strategies that address these factors may enhance provider progression from nonuse to sustained use.
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Authors reported that support and high-quality training were necessary to achieve widespread growth.
“Authors reported that support and high-quality training were necessary to achieve widespread growth [2,32-43].”
From Spread, Scale-up, and Sustainability of Video Consulting in Health Care: Systematic Review and Synthesis Guided by the NASSS Framework (2021) · cites this paper as [34]
Spread and scale-up were enabled by an adopter system with engaged and committed staff who were given protected time by the organization to conduct video consultations.
“Spread and scale-up were enabled by an adopter system with engaged and committed staff who were given protected time by the organization to conduct video consultations, as mentioned by Interian et al [34]: “having a team of providers who were detailed solely to provide mental health services by using telehealth technology and had protected time to do so… was rated as having a strong positive”
From Spread, Scale-up, and Sustainability of Video Consulting in Health Care: Systematic Review and Synthesis Guided by the NASSS Framework (2021) · cites this paper as [34]
Interian et al described a video consulting program aimed at improving access to mental health care did not spread successfully in an urban environment compared to other settings because providers did not perceive a local need for the technology.
“Interian et al [34] also described how a video consulting program aimed at improving access to mental health care did not spread successfully in an urban environment compared to other settings, because providers did not perceive a local need for the technology: “A second issue involving provider buy-in pertained to the perceived local need for implementation.””
From Spread, Scale-up, and Sustainability of Video Consulting in Health Care: Systematic Review and Synthesis Guided by the NASSS Framework (2021) · cites this paper as [34]
Challenges to and opportunities for widespread implementation for patients and caregivers were reported in 6 articles.
“Challenges to and opportunities for widespread implementation for patients and caregivers were reported in 6 articles [2,32-34,38,42].”
From Spread, Scale-up, and Sustainability of Video Consulting in Health Care: Systematic Review and Synthesis Guided by the NASSS Framework (2021) · cites this paper as [34]
Of the reviewed articles that reported patient or caregiver challenges, these were primarily clinician perceptions rather than direct reports from patients or caregivers.
“Of the articles that did report patient or caregiver challenges [2,32-34,38,42], these were primarily clinician perceptions, rather than direct reports from patients or caregivers.”
From Spread, Scale-up, and Sustainability of Video Consulting in Health Care: Systematic Review and Synthesis Guided by the NASSS Framework (2021) · cites this paper as [34]
Telehealth champions were typically clinical staff.
“Telehealth champions were typically clinical staff [2,34,36,41-43].”
From Spread, Scale-up, and Sustainability of Video Consulting in Health Care: Systematic Review and Synthesis Guided by the NASSS Framework (2021) · cites this paper as [34]
At least one challenge or opportunity related to political, regulatory, cultural, contextual, or financial factors was reported in all 13 reviewed studies.
“At least one challenge or opportunity related to political, regulatory, cultural, contextual, or financial factors was reported in all studies (n=13) [2,32-43].”
From Spread, Scale-up, and Sustainability of Video Consulting in Health Care: Systematic Review and Synthesis Guided by the NASSS Framework (2021) · cites this paper as [34]
Complexity in the organizational domain was managed more effectively when telehealth champions were available, as reported in 11 reviewed articles.
“Complexity in the organizational domain was managed more effectively when telehealth champions were available, as reported in 11 of the reviewed articles [2,33-37,39-43].”
From Spread, Scale-up, and Sustainability of Video Consulting in Health Care: Systematic Review and Synthesis Guided by the NASSS Framework (2021) · cites this paper as [34]
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- Authors
- Interian, A., King, A. R., St. Hill, L. M., Robinson, C. H., & Damschroder, L. J.
- Affiliations
- Rutgers, The State University of New Jersey (US)
- Dr. Interian and Dr. King are with Mental Health and Behavioral Sciences, U.S. Department of Veterans Affairs (VA) New Jersey Health Care System, Lyons, New Jersey. Dr. Interian is also with the Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, New Jersey. Ms. St. Hill is with the Bloustein School of Planning and Public Policy, Rutgers University, New Brunswick, New Jersey. Ms. Robinson and Ms. Damschroder are with the Center for Clinical Management Research,...
- Venue
- Psychiatric Services
- Published
- 2018-01-01
- Volume
- 69
- Issue
- 1
- Pages
- 69-75
- ISSN
- 0022-1597 (ISSN-L)
- 1075-2730
- 1557-9700
- OpenAlex
- W2752127252
- Cited by
- 41
- References
- 24
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 8 · 2022: 5 · 2021: 13 · 2020: 7 · 2019: 2 · 2018: 1
- FWCI
- 2.58
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Psychiatric Services (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- mental health services, Veterans Health Administration, telehealth implementation, barriers and facilitators, logistics support, employee experience, access to mental health care, veterans
- MeSH terms
- Implementation Science, Adult, Attitude of Health Personnel, Mental Disorders, Home Care Services, Humans, Mental Health Services, United States, United States Department of Veterans Affairs, Telemedicine, Videoconferencing
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