# Provision of high quality telemental health care during COVID-19 and beyond

> **NIH VA IK2** · VA BOSTON HEALTH CARE SYSTEM · 2024 · —

## Abstract

Background: Telemental health (TMH) via videoconferencing or phone can increase Veterans’ access to
mental health (MH) care. TMH can eliminate barriers including travel distance and cost, as well as physical
limitations, caregiving responsibilities, and MH symptoms that can make leaving home difficult. Prior to COVID-
19, rates of TMH in VA were low (~9%). There was a dramatic shift towards TMH during COVID-19 to prevent
infection, with ~50% of care delivered by phone, ~25% by video, and ~25% in-person. Benefits and drawbacks
of phone, video, and in-person care must be considered when choosing a MH care modality. If patients,
providers, and/or leadership believe that phone care is equivalent in quality to video and/or in-person, they may
be more likely to choose this modality as it often has the fewest barriers to use; however, based on limited
evidence, phone care may be lower quality than video and in-person. We need more nuanced analyses
regarding: 1) the relative quality of phone, video, and in-person care (e.g., for more complex patients, for
psychotherapy sessions versus shorter medication management appointments), and 2) patient preferences. As
a clinical psychologist and HSR&D investigator with TMH experience, I am well-positioned to conduct this
research. This proposal will provide key methodological training and advance me toward my goal of becoming
a leading health services researcher and implementation scientist with expertise in telehealth.
Significance/Impact: MH, telehealth, access, and quality of care are all major HSR&D research priorities. The
increased use of TMH during COVID-19 has led to a wealth of untapped data through which we can examine
the relative quality of TMH care as well as patient preferences across modalities, in order to improve care
modality decision-making processes. Results, which will incorporate data from millions of patients and
thousands of providers, have the potential to impact delivery of high-quality MH care on a national scale.
Innovation: To our knowledge, there has been no published research that: 1) compares the quality and patient
preference of phone, video, and in-person MH care, and 2) uses this information to develop and implement
evidenced-based strategies to increase video use when clinically effective and preferred by patients.
Specific Aims: Aim 1: Examine quality outcomes of phone, video, and in-person MH care (e.g., differences in
MH hospitalization rates). Hypothesis: Video care will be equivalent to in-person care and superior to phone
care for more complex patients (e.g., history of MH hospitalization, 3+ MH diagnoses) and for psychotherapy
appointments. Aim 2: Qualitative interviews with MH patients, providers, and leadership. Research question:
What are facilitators/barriers to video use based on stakeholder attitudes, preferences, and decision-making
processes, and how do these factors vary between sites with high levels of phone, video, and in-person care?
Aim 3: Develop/pilot imp...

## Key facts

- **NIH application ID:** 10703248
- **Project number:** 5IK2HX003427-02
- **Recipient organization:** VA BOSTON HEALTH CARE SYSTEM
- **Principal Investigator:** Samantha L Connolly
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2022-10-01 → 2027-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10703248

## Citation

> US National Institutes of Health, RePORTER application 10703248, Provision of high quality telemental health care during COVID-19 and beyond (5IK2HX003427-02). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10703248. Licensed CC0.

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