# Enhancing Veterans' Access to Care through Video Telehealth Tablets

> **NIH VA I50** · VETERANS ADMIN PALO ALTO HEALTH CARE SYS · 2021 · —

## Abstract

Background. In 2016, VA’s Offices of Rural Health (ORH) and Connected Care (OCC) began distributing
video-enabled tablets to Veterans with geographic, clinical, and social barriers to in-person care. In an
ORH-funded evaluation of the first 5,000 VA-issued tablets, we found that many tablet recipients were high-
need (e.g., rural, socially isolated Veterans with mental health conditions). However, the tablet initiative’s
reach, adoption, and implementation varied across facilities. Furthermore, approximately 20% of tablet
recipients did not use their tablets, suggesting an opportunity to evaluate implementation strategies that will
optimize the impact of this limited resource. In 2017, VA transitioned from early tablet models to lower cost,
user-friendly iPads, a shift that may facilitate tablet adoption and use. We propose to build on our existing
collaboration with ORH and OCC to conduct a Partnered Evaluation Initiative that examines the
effectiveness and implementation of tablet distribution to high-need Veterans with access barriers.
Objectives. The objectives of this partnered evaluation are to: 1) evaluate the effectiveness and
implementation of VA’s initiative to distribute video telehealth tablets to high-need Veterans with access
barriers, and 2) test how an enhanced patient assessment tool influences tablet reach and effectiveness.
Methods. We will conduct a Hybrid II trial guided by the PRISM framework, focusing on the following aims:
▪ Aim 1 will focus on Reach, Adoption, and Implementation of tablets. In Aim 1.1, we will identify patient
characteristics that could be the focus of future interventions to enhance the tablet initiative’s reach among
high-need patients. In Aim 1.2, we will survey facility telehealth coordinators to examine how adoption (i.e.,
tablet distribution volume) is influenced by facility characteristics (e.g. rurality, telehealth staffing, leadership
engagement) and implementation strategies. In Aim 1.3, we will interview facility leadership, telehealth
coordinators, providers, and Veterans to identify implementation strategies with potential to enhance tablet
distribution and use. In Aim 1.4 we will design and pilot test an enhanced patient assessment tool that
draws on Aim 1 findings and that will be evaluated in a random sample of facilities in Aim 2.
▪ In Aim 2, we will evaluate the Effectiveness of tablets on patient access, clinical outcomes, and
experience, and assess the enhanced patient assessment tool (developed in Aim 1.4) at randomly-selected
facilities. Aim 2 analyses will incorporate administrative data (Aim 2.1), and a patient survey (Aim 2.2). Our
partnership with OCC offers an opportunity to rigorously evaluate whether the enhanced patient
assessment tool increases tablet distribution and use among high-need patients. First, we will compare all
tablet recipients to a propensity score matched comparison group of patients who did not receive tablets.
Then, among tablet recipients, we will compare ...

## Key facts

- **NIH application ID:** 10181055
- **Project number:** 5I50HX002782-02
- **Recipient organization:** VETERANS ADMIN PALO ALTO HEALTH CARE SYS
- **Principal Investigator:** Donna Michelle Zulman
- **Activity code:** I50 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2019-10-01 → 2022-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10181055

## Citation

> US National Institutes of Health, RePORTER application 10181055, Enhancing Veterans' Access to Care through Video Telehealth Tablets (5I50HX002782-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10181055. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*