Online Program

335097
Health information technologies to support management of treatment regimes: Perspectives of veterans and their caregivers in VHA


Tuesday, November 3, 2015

Rendelle E. Bolton, MPH, MSW, MA, Center for Evaluating Patient-Centered Care in VA, Center for Healthcare Organization and Implementation Research, HIV/HCV Quality Enhancement Research Initiative, US Department of Veterans Affairs, Bedford, MA
Jack Clark, PhD, Center for Healthcare Organization and Implementation Research, HIV/HCV Quality Enhancement Research Initiative, US Department of Veterans Affairs, Bedford, MA
Jeffrey Solomon, PhD, Center for Evaluating Patient-Centered Care in VA, Center for Healthcare Organization and Implementation Research, HIV/HCV Quality Enhancement Research Initiative, US Department of Veterans Affairs, Bedford, MA
Eric Dieperink, MD, Department of Psychiatry, US Department of Veterans Affairs, Minneapolis, MN
Karen Steinhauser, PhD, US Department of Veterans Affairs, Durham, NC
D Keith McInnes, ScD, MSc, Health Law, Policy, and Management, Boston University School of Public Health & Department of Veterans Affairs, Bedford, MA
Health Information Technology (HIT) has vast potential to support patients and informal caregivers in managing health conditions and complex treatment regimens. VA has invested heavily in HIT including an electronic personal health record (PHR) and secure messaging (SM) system. However, uptake depends on alignment of HIT design with users’ views of their needs and practices. While caregivers often provide informational support, little is known about how these activities map onto HIT usage in Veteran-caregiver dyads. We report results on informational support provision and HIT uptake from a qualitative study examining caregiver and Veteran experiences of treatment for Hepatitis C (HCV).

Methods

Semi-structured interviews were conducted with 16 Veteran-caregiver dyads (n=32) from two VAMCs. Interview transcripts were coded line-by-line, with codes developed inductively, and then organized into broader thematic categories. Analysis focused on content relating to informational support and HIT usage.

Results

Caregivers searched online for information related to HCV, its treatment, and unresolved questions from clinical appointments. While appointments, lab results, and medications were tracked electronically and on paper, few dyads used the PHR for these tasks. Despite in-person and phone communication with clinicians, no dyads utilized SM. Nevertheless, Veterans and caregivers desired greater access to clinical information on disease status throughout treatment, were interested in using the PHR, and endorsed granting caregivers access to the Veteran’s PHR.

Conclusions

Informational support provided by caregivers aligns with VAs HIT features. Allowing caregivers’ access is well received by caregivers and Veterans, and should be considered by healthcare systems to better support care.

Learning Areas:

Chronic disease management and prevention
Communication and informatics
Implementation of health education strategies, interventions and programs

Learning Objectives:
Describe how Health Information Technologies can support Veterans and their caregivers in managing complex treatment regimens.

Keyword(s): Veterans' Health, Information Technology

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been a qualitative researcher on multiple federally funded grants and evaluation projects related to Veterans health concerns and healthcare delivery in the VA. My scientific interests include qualitative health research, patient-centered care, patient-provider communication, and Veterans health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.