Table 3.
Changes in national healthcare system and study sites in operational metrics and health technology utilization metrics over initial year and a half of implementation phase
| National | Site A (St. Cloud, MN) | Site B (San Diego, CA) | Site C (New Orleans, LA) | Site D (Tampa, FL) | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Operational metrics | |||||||||||||||||||||||||||||||
| Time point* | 1* | 2* | % difference | 1 | 2 | % difference | 1 | 2 | % difference | 1 | 2 | % difference | 1 | 2 | % difference | ||||||||||||||||
| Facility complexity categorization | n/a | n/a | n/a | 3 | 3 | n/a | 1A | 1A | n/a | 1B | 1B | n/a | 1A | 1A | n/a | ||||||||||||||||
| # of facilities included | 1255 | 1299 | n/a | 4 | 4 | n/a | 7 | 7 | n/a | 9 | 9 | n/a | 15 | 15 | n/a | ||||||||||||||||
| # enrollees | 9,100,000 + | 9,093,691 | 2.2% | 38,944 | 32,046 | (− 17.7%) | 86,140 | 72,931 | (− 15.3%) | 46,743 | 43,478 | (− 7.0%) | 100,329 | 95,836 | (− 4.5%) | ||||||||||||||||
| Operating beds | 20,354 | 35,681 | 75.3% | 388 | 389 | 0.3% | 272 | 272 | n/a | 150 | 168 | 12.0% | 499 | 499 | n/a | ||||||||||||||||
| Outpatient visits | 81,305,962 | 45,965,521 | (− 43.5%) | 440,059 | 216,676 | (− 50.8%) | 993,457 | 522,244 | (− 47.3%) | 694,783 | 367,013 | (− 94.7%) | 1,437,900 | 863,301 | (− 40.0% | ||||||||||||||||
| Unique inpatient admissions | 487,600 | 237,075 | (− 51.4) | 2491 | 576 | (− 76.9%) | 6642 | 3133 | (− 52.8%) | 2927 | 1783 | (− 39.1%) | 10,753 | 4368 | (− 59.4%) | ||||||||||||||||
| % Rural/highly rural | 29.3% | 32.5% | 10.9% | 75.3% | 76.0% | 0.9% | 5.1% | 4.7% | (− 7.8%) | 19.4% | 18.4% | (− 5.2%) | 8.4% | 9.5% | 13.1% | ||||||||||||||||
| Health technology utilization metrics | |||||||||||||||||||||||||||||||
| Synchronous video telehealth | Primary care providers using VA Video Connect | 63.7% | 93.6% | 46.9% | 87.8% | 98.8% | 12.5% | 61.9% | 96.8% | 56.4% | 53.7% | 99.1% | 84.5% | 94.7% | 99.1% | 4.6% | |||||||||||||||
| Mental health providers using VA Video Connect | 62.4% | 97.0% | 55.4% | 60.7% | 91.6% | 50.9% | 58.4% | 97.6% | 67.1% | 55.2% | 93.2% | 68.8% | 90.1% | 95.3% | 5.8% | ||||||||||||||||
| Online patient health portal | My HealtheVet (% premium accounts) | 41.1% | 46.2% | 12.4% | 47.1% | 51.3% | 8.9% | 48.5% | 55.2% | 13.8% | 45.1% | 45.8% | 1.6% | 48.6% | 53.2% | 9.5% | |||||||||||||||
| Automated text message platform | Annie (# (%) unique veterans) | 5247 | 30,342 | 478.3% | 472 | 729 | 54.4% | 86 | 589 | 584.9% | 19 | 248 | 1205.3% | 42 | 582 | 1285.7% | |||||||||||||||
| Mobile health apps | PTSD Coach (# lifetime downloads) | 473,283 | 770,282 | 62.8% | No user authentication is required for these mobile health apps, so utilization metrics are not available by any specific site or individual | ||||||||||||||||||||||||||
| Mindfulness Coach | 376,242 | 836,386 | 122.3% | ||||||||||||||||||||||||||||
| CBT-i Coach | 399,163 | 714,243 | 78.9% | ||||||||||||||||||||||||||||
| Insomnia Coach | 0** | 72,563 | n/a | ||||||||||||||||||||||||||||
| COVID Coach | 0** | 199,310 | n/a | ||||||||||||||||||||||||||||
Timepoint 1: end of pre-implementation phase = September 2019 (end of quarter 4, fiscal year (FY) 2019); timepoint 2: one-and-a-half years after implementation phase began = end of quarter 2, FY2021