Hise Nicholas, Buckner Jacob, Ince Spencer, Quint Clay
University of Texas Health Science Center San Antonio, 7703 Floyd Curl Dr, San Antonio, TX 78229, United States.
South Texas Veterans Healthcare System, 7400 Merton Minter, San Antonio, TX 78229, United States.
Ann Vasc Surg Brief Rep Innov. 2022 Dec;2(4):100147. doi: 10.1016/j.avsurg.2022.100147. Epub 2022 Nov 10.
Telemedicine usage has accelerated as a result of the COVID-19 pandemic, raising concerns those without the necessary technology and digital literacy to participate may face increasing health disparities. In this study, we examined the rates at which veterans are able to connect to two common telemedicine applications: VA Video Connect (VVC) and Doximity Dialer Video (DV).
Participants were selected from a pool of vascular surgery patients seen from August 2020 to October 2021 at a single Veterans Affairs medical center. Participants had to be >50 years old and not previously participated in a video visit. Eligible veterans were asked their interest participating in video visits and if they owned a smartphone. Those who met the eligibility requirements were tested on their ability to connect to both VVC and DV with minimal assistance. The connectivity rate for both platforms was recorded, and basic demographic and medical history information was collected.
One-hundred-four veterans participated in the study, with an average age of 70 ± 7 years. Seventy-four participants (71%) expressed interest in video visits, and 52 (70%) owned a smartphone. Forty-five smartphone owners (87%) successfully connected to DV, whereas 19 (37%) successfully connected to VVC ( < 0.001). VVC connectivity decreased with increasing age-group: 50-59 = 80%, 60-69 = 44%, ≥70 = 18% ( = 0.02).
Older veterans demonstrate difficulty connecting to VVC. The VHA is taking important steps to streamline usability of VVC, however continued expansion of support programs is necessary to improve access and reduce healthcare disparities in this population.
由于新冠疫情，远程医疗的使用加速，这引发了人们对那些没有必要技术和数字素养来参与的人可能面临健康差距不断扩大的担忧。在本研究中，我们调查了退伍军人连接两种常见远程医疗应用程序的比率：退伍军人事务部视频连接（VVC）和多西美蒂拨号视频（DV）。
参与者从2020年8月至2021年10月在一家退伍军人事务医疗中心就诊的血管外科患者中选取。参与者必须年龄大于50岁且此前未参加过视频就诊。符合条件的退伍军人被询问他们参与视频就诊的兴趣以及是否拥有智能手机。那些符合资格要求的人在最少协助下接受连接VVC和DV的能力测试。记录两个平台的连接率，并收集基本人口统计学和病史信息。
104名退伍军人参与了研究，平均年龄为70±7岁。74名参与者（71%）表示对视频就诊感兴趣，52名（70%）拥有智能手机。45名智能手机拥有者（87%）成功连接到DV，而19名（37%）成功连接到VVC（P<0.001）。VVC的连接率随着年龄组的增加而下降：50 - 59岁 = 80%，60 - 69岁 = 44%，≥70岁 = 18%（P = 0.02）。
老年退伍军人在连接VVC方面存在困难。退伍军人健康管理局正在采取重要措施简化VVC的可用性，然而，持续扩大支持项目对于改善这一人群的就医机会和减少医疗差距是必要的。
