# Understanding and Improving Video-Based Primary Care Delivery to Veterans

> **NIH VA I21** · VA GREATER LOS ANGELES HEALTHCARE SYSTEM · 2024 · —

## Abstract

Background: [With the onset of the COVID-19 pandemic, VA primary care (PC) experienced a substantial
increase in video-based encounters, nationwide. This rapid uptake of video-based care in PC clinics, however,
varied by site. Given that the VA is committed to continue expanding VA Video Connect (VVC), which is the main
videoconferencing platform at the VA, more research is needed to comprehensively examine why and how VVC
was successfully adopted at some sites and understand why VVC expansion was limited at other sites.]
Significance/Impact: [Barriers and facilitators to video-based care are many and multifaceted. This study will
examine patient, provider, and site-level characteristics of VVC use in PC at high and low VVC sites, and identify
patient-centered, provider-recommended, and leadership supported VVC guidelines that are context-specific for
PC clinics. This study will contribute more generally to our understanding of what is needed to achieve
acceptance of video technology. Such knowledge will be helpful for VA, as well as the delivery of healthcare in
general. In-depth understanding about challenges and successes of VVC use will inform future improvements of
VVC policies, processes, and procedures for all Veterans, across all VA facilities.]
Innovation: This study will examine Veterans’ perspectives about how VVC in PC can be improved to better
meet their needs when using video-based care. This is an understudied topic. Furthermore, by learning about
the providers’ and leadership’s perspectives on how VVC can be implemented more effectively, we will better
understand the full context of VA video care. [This 18-month pilot study will create context-specific VVC playbook
for high and low VVC using sites that will be patient-centered, provider-recommended, and leadership
supported. This will help improve delivery of video-based primary care and patient outcomes at the VA.]
Specific Aims: This pilot study’s overall objective is to identify strategies to improve VVC use for all Veterans.
1) Identify PC clinic sites in the top 5% and bottom 5% of VVC use nationally by examining patient, provider,
and site-level variations in VVC use since the onset of COVID-19 (March 2020-March 2024, aka study period).
2) Characterize patient-, provider-, site-specific factors associated with VVC use in PC, nationwide, during the
study period.
3) Evaluate barriers and facilitators to using VVC in PC from patients, providers, and leadership
(VISN/VAMC/CBOC) perspectives at 3 high and 3 low VVC using sites in PC (identified in Aims 1 & 2).
Methodology: [The non-adoption, abandonment, scale-up, spread, and sustainability (NASSS) framework will
be used for all aspects of the proposed study (data collection, analyses, synthesis of quantitative and qualitative
findings). Two sequential, mixed methods approaches will be used, where quantitative analyses (Aims 1 & 2) will
first inform the sampling and data collection for the qualitative interviews (Aim 3, n=60) at ...

## Key facts

- **NIH application ID:** 10849681
- **Project number:** 5I21HX003503-02
- **Recipient organization:** VA GREATER LOS ANGELES HEALTHCARE SYSTEM
- **Principal Investigator:** Danielle Elise Rose
- **Activity code:** I21 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2023-09-01 → 2025-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10849681

## Citation

> US National Institutes of Health, RePORTER application 10849681, Understanding and Improving Video-Based Primary Care Delivery to Veterans (5I21HX003503-02). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10849681. Licensed CC0.

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