Table 2.

Research Priorities and Examples of Specific Study Questions That Emerged from Discussions of the Access Workgroup at the 2022 Virtual Care State-of-the-Art Conference

Research priority	Potential research topics
Identify and evaluate opportunities to optimize Veterans’ access to virtual care interventions at the patient, provider, and systems level	Patient level • Are there specific training/teachings that can enhance Veteran’s knowledge, skills, and interest in virtual care? • What type of technical and decision support is needed to improve Veteran’s virtual care access (e.g., Virtual Health Resource Center)? • How do we capitalize on specific clinical events (e.g., an Emergency Department visit or hospitalization) to support a Veteran in gaining access to virtual care?
	Provider level • What interventions work best to train providers to optimally utilize virtual care? • What are the most effective strategies to disseminate best practices? • What is the impact of provider-level incentives on virtual care use?
	Systems level • What structural changes and/or policies are needed to optimize a Veteran’s access to virtual care? • What are specific implementation strategies that can optimize the reach and penetration of virtual care interventions? • How can the VA foster a culture that supports widespread virtual care access?
Create standardized virtual care access metrics with the goal of tracking access expansion and equity	• How can virtual care access metrics help in measuring changes in the digital divide? • How can metrics be used to measure the effectiveness of virtual care access interventions? • Are there quantitative measures of a patient’s virtual access, capability, and/or use that can be used to assess the impact of virtual care on quality and health outcomes?
Customize technology, implementation strategies, and virtual care models to ensure equitable virtual care access	• How could the expansion of virtual care access exacerbate certain disparities?
Examine how the VA can offer access to virtual care that meets a veterans’ dynamic clinical needs and social circumstances	• What is the optimal modality and combination of virtual care and non-virtual care for a given patient given their social, clinical, and economic circumstances? • How does the VA identify and prevent excess, ineffective or inappropriate virtual care access? • How can virtual care encourage Veterans to choose VA care over community care?
Identify implementation strategies that increase patients and clinician adoption of effective virtual care technologies	• How can variations in virtual care access across clinics, facilities, and VISNs offer opportunities to learn from positive outliers and scale those successful interventions rapidly? • How can the VA leverage implementation science to enhance virtual care access (e.g., increase awareness of new and existing virtual care services, interventions, and resources)?
Identify rapid, real-time evaluation methods to optimize virtual care access	• How can the VA leverage its informatics infrastructure to better evaluate virtual care access? • What specific methods can be used to provide rapid, iterative design and evaluations of virtual care interventions?