RT Journal Article
SR Electronic
T1 Evaluating the Effectiveness of Routine Screening for Digital Needs Among Rural Veterans
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 4101
DO 10.1370/afm.21.s1.4101
VO 21
IS Supplement 1
A1 Cohen, Alicia
A1 Russell, Lauren
A1 Kennedy, Meaghan
A1 Cornell, Portia
A1 Mitchell, Kathleen
A1 Moy, Ernest
A1 Silva, Jennifer
A1 heyworth, leonie
YR 2023
UL http://www.annfammed.org/content/21/Supplement_1/4101.abstract
AB Context: To facilitate access to telehealth services among Veterans enrolled in Veterans Health Administration (VHA) care during the COVID-19 pandemic, in August 2020 VHA implemented a national Digital Divide (DD) Consult. Through this consult, Veterans without reliable internet access or video-capable devices can receive a loaned internet-connected device and/or assistance applying for federal internet subsidies. VHA lacks a way, however, to systematically identify Veterans who would benefit from a DD Consult.Objective: To develop and integrate digital needs screening questions into an existing VHA social risk screening and referral program, “Assessing Circumstances & Offering Resources for Needs” (ACORN).Study Design: Cross-sectional pilot.Setting: Two rural VA primary care clinics.Population Studied: Veterans seen by primary care social work between July-September 2021.Intervention: Digital needs screening questions were developed with input from an interprofessional group of clinicians and subject matter experts, and refined through cognitive testing with Veterans. Questions assessed access to a phone, tablet, and/or computer; access to reliable and affordable internet; running out of phone minutes and/or data before the end of the month; interest in assistance setting up a telehealth visit; and need for help learning to use a device for a telehealth visit. Social workers routinely administered the expanded ACORN screening tool to Veterans as part of an intake assessment.Outcome Measures: 1) prevalence of reported digital needs and 2) DD Consult placed in the prior 12 months (y/n).Results: Of 156 Veterans screened, 45% reported >=1 digital need. Twenty-two percent reported not having access to a device, 13% lacked reliable and affordable internet, and 3% reported often or sometimes running out of phone minutes and/or data. Thirteen percent of Veterans were interested in help setting up a telehealth visit; of those, 55% needed help learning to use a device. Among Veterans with a digital need, only 4% had a DD Consult placed in the prior 12 months.Conclusions: Nearly half of rural Veterans in our pilot screened positive for >=1 digital need. The vast majority of Veterans identified as having a digital need had not previously had a DD Consult placed. Routine screening for digital needs is a critical step towards connecting Veterans with needed technology resources and informing future resource allocation in VHA.