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. 2021 Oct 25;7(1):81–99. doi: 10.1007/s41347-021-00227-1

Table 2.

Change in facilitator and site capacity across first year-and-a-half of implementation phase

Facilitator or site focused Knowledge area Item Sub-item Across sites Site A (St. Cloud, MN)
Pre (N = 11) Post (N = 8) 6-month Post (N = 7) Pre (N = 2) Post (N = 2) 6-month Post (N = 2)
Questions to facilitator regarding their own knowledge and readiness Knowledge base of target audience (% rated high or very high level of knowledge) Rate your current level of knowledge on VA health care: (response options: very high, high, moderate, low, very low) Veteran Health Needs 72.7% 87.5% 100.0% 50.0% 50.0% 100.0%
VHA System 63.6% 87.5% 100.0% 50.0% 100.0% 100.0%
Knowledge base of virtual care core competencies (% rated high or very high) Rate how strongly you agree/disagree with the following statements regarding adoption of virtual care tools and program in clinical practice at your facility (response options: very high, high, moderate, low, very low) Clinical Integration of Virtual Care 72.7% 100.0% 100.0% 50.0% 100.0% 100.0%
Evidence Base for Virtual Care 63.6% 100.0% 100.0% 50.0% 100.0% 100.0%
Security and Privacy of Virtual Care 63.6% 100.0% 100.0% 50.0% 100.0% 100.0%
Ethical Issues with Virtual Care 72.7% 75.0% 100.0% 50.0% 50.0% 100.0%
Cultural Considerations with Virtual Care 63.6% 75.0% 100.0% 50.0% 50.0% 100.0%
Readiness to use virtual care (% in action or maintenance stage) Please select the item below that best describes where you are in terms of integration of virtual health technologies into clinical care I do not intend on integrating virtual health technologies into my clinical practice (precontemplation) 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
I am intending to begin integration virtual health technologies into my clinical practice in the next 6 months (contemplation) 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
I am planning on integrating virtual health technologies into my clinical practice next month (preparation) 9.1% 0.0% 0.0% 0.0% 0.0% 0.0%
I started integrating virtual health technologies into my clinical practice within the past 6 months (action) 18.2% 37.5% 0.0% 50.0% 0.0% 0.0%
I started integrating virtual health technologies into my clinical practice more 6 months ago (sustainment) 72.7% 62.5% 100.0% 50.0% 100.0% 100.0%
Product knowledge (% that had either used the product, prescribed, or recommended the product in clinical care, or trained others on how to use the product) Average rate of product knowledge across suite of 56 virtual care products and programs (% that had either used the product, prescribed, or recommended the product in clinical care, or trained others on how to use the product) 21.8% 34.7% 42.4% 21.4% 34.1% 41.5%
Product knowledge on key products (% that had either used the product, prescribed, or recommended the product in clinical care, or trained others on how to use the product) Annie (VHA's automated health text messaging web platform) 36.7% 62.5% 85.7% 50.0% 100.0% 50.0%
Mindfulness Coach (iOS and Android app) 36.7% 50.0% 57.1% 0.0% 50.0% 50.0%
My HealtheVet (VHA's patient web portal) 63.6% 75.0% 100.0% 50.0% 50.0% 100.0%
PTSD Coach (iOS and Android app) 36.7% 50.0% 71.4% 50.0% 50.0% 50.0%
Rx Refill (iOS and Android app) 27.3% 37.5% 42.9% 0.0% 0.0% 0.0%
VA Video Connect (live video telehealth) 72.7% 87.5% 100.0% 50.0% 50.0% 100.0%
Questions to facilitator regarding perceptions of site capacity Quality of facility climate and support regarding virtual care implementation (% agree or strongly agree) Rate how strongly you agree/disagree with the following statements regarding adoption of virtual care adoption in clinical practice at your facility (response options: strongly agree, agree, neither agree nor disagree, disagree, strongly disagree) Virtual care can be integrated into care at your site 81.8% 100.0% 100.0% 50.0% 100.0% 100.0%
Virtual care is supported by scientific evidence 72.7% 100.0% 100.0% 50.0% 100.0% 100.0%
Virtual care implementation is supported by your facility leadership 72.7% 75.0% 85.7% 50.0% 50.0% 100.0%
Site barriers to implementation (% rated barrier as moderate, high, or very high) Time constraints/too busy 100.0% 87.5% 85.7% 100.0% 100.0% 100.0%
Don’t know virtual care tools enough 81.8% 62.5% 57.1% 100.0% 50.0% 50.0%
Need more training 72.7% 62.5% 57.1% 50.0% 50.0% 50.0%
Unclear policies regarding use 72.7% 50.0% 42.9% 50.0% 50.0% 0.0%
Concerns about security and privacy 72.7% 62.5% 57.1% 50.0% 50.0% 50.0%
Need more evidence that proves effectiveness of virtual care 63.6% 37.5% 28.6% 50.0% 50.0% 50.0%
Don’t know how to choose which virtual care tool to use 63.6% 50.0% 42.9% 50.0% 50.0% 50.0%
Virtual care will interfere with the patient/client relationship 45.5% 37.5% 28.6% 50.0% 50.0% 0.0%
No compensation for use of virtual care with patients 36.7% 37.5% 42.9% 50.0% 50.0% 50.0%
Lack of connectivity in the clinic 36.7% 25.0% 28.6% 50.0% 50.0% 50.0%
Employer restrictions/lack of employer support 27.3% 25.0% 14.3% 50.0% 0.0% 0.0%
Cost or resources associated with use 18.2% 25.0% 14.3% 50.0% 50.0% 50.0%
Don’t think that virtual care will work 18.2% 12.5% 14.3% 0.0% 0.0% 0.0%
Facilitator or site focused Site B (San Diego, CA) Site C (New Orleans, LA) Site D (Tampa, FL)
Pre (N = 3) Post (N = 2) 6-month Post (N = 2) Pre (N = 3) Post (N = 2) 6-month Post (N = 2) Pre (N = 3) Post (N = 2) 6-month Post (N = 1)
Questions to facilitator regarding their own knowledge and readiness 66.7% 100.0% 100.0%  100.0%  100.0%  100.0%  66.7%  100.0%  100.0% 
33.3%  100.0%  100.0%  66.7%  100.0%  100.0%  100.0%  100.0%  100.0% 
66.7%  100.0%  100.0%  66.7%  100.0%  100.0%  100.0%  100.0%  100.0% 
66.7%  100.0%  100.0%  66.7%  100.0%  100.0%  66.7%  100.0%  100.0% 
66.7%  100.0%  100.0%  66.7%  100.0%  100.0%  66.7%  100.0%  100.0% 
66.7%  50.0%  100.0%  66.7%  100.0%  100.0%  100.0%  100.0%  100.0% 
66.7%  50.0%  100.0%  66.7%  100.0%  100.0%  66.7%  100.0%  100.0% 
0.0%  0.0%  0.0%  0.0%  0.0%  0.00%  0.0%  0.0%  0.0% 
0.0%  0.0%  0.0%  0.0%  0.0%  0.0%  0.0%  0.0%  0.0% 
33.3%  0.0%  0.0%  0.0%  0.0%  0.00%  0.0%  0.0%  0.0% 
33.3%  50.0%  0.0%  33.3%  0.0%  0.0%  0.0%  0.0%  0.0% 
33.3%  50.0%  100.0%  66.7%  100.0%  100.0%  100.0%  100.0%  100.0% 
22.0%  35.1%  42.8%  20.7%  32.9%  40.3%  22.5%  35.2%  43.8% 
33.3%  50.0%  100.0%  33.3%  50.0%  100.0%  33.3%  50.0%  100.0% 
0.0%  50.0%  50.0%  33.3%  50.0%  50.0%  33.3%  50.0%  100.0% 
66.7%  33.3%  100.0%  66.7%  33.3%  100.0%  66.7%  33.3%  100.0% 
33.3%  33.3%  50.0%  33.3%  33.3%  100.0%  33.3%  50.0%  100.0% 
33.3%  33.3%  50.0%  33.3%  33.3%  50.0%  33.3%  33.3%  100.0% 
66.7%  66.7%  100.0%  100.0%  100.0%  100.0%  66.7%  100.0%  100.0% 
Questions to facilitator regarding perceptions of site capacity 100.0%  100.0%  100.0%  66.7%  100.0%  100.0%  100.0%  100.0%  100.0% 
66.7%  100.0%  100.0%  66.7%  100.0%  50.0%  66.7%  100.0%  100.0% 
66.7%  100.0%  100.0%  66.7%  50.0%  50.0%  100.0%  100.0%  100.0% 
100.0%  50.0%  100.0%  100.0%  50.0%  50.0%  100.0%  50.0%  100.0% 
100.0%  50.0%  50.0%  66.7%  50.0%  50.0%  66.7%  50.0%  100.0% 
100.0%  50.0%  50.0%  66.7%  50.0%  50.0%  66.7%  50.0%  100.0% 
66.7%  50.0%  50.0%  100.0%  50.0%  50.0%  66.7%  50.0%  100.0% 
100.0%  50.0%  50.0%  66.7%  50.0%  50.0%  66.7%  100.0%  100.0% 
66.7%  50.0%  50.0%  66.7%  0.0%  50.0%  66.7%  50.0%  100.0% 
66.7%  50.0%  50.0%  66.7%  50.0%  50.0%  66.7%  50.0%  0.0% 
0.0%  50.0%  50.0%  33.3%  50.0%  50.0%  33.3%  0.0%  0.0% 
0.0%  0.0%  50.0%  66.7%  50.0%  50.0%  66.7%  50.0%  100.0% 
33.3%  50.0%  50.0%  33.3%  0.0%  0.0%  33.3%  0.0%  0.0% 
33.3%  50.0%  50.0%  33.3%  50.0%  0.0%  0.0%  0.0%  0.0% 
0.0%  0.0%  0.0%  33.3%  50.0%  50.0%  0.0%  0.0%  100.0% 
33.3%  0.0%  0.0%  33.3%  50.0%  50.0%  0.0%  0.0%  0.0%