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Health Services Research & Development

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2012 HSR&D/QUERI National Conference Abstract

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2012 National Meeting

3114 — Developing a Conceptual Framework for Understanding Veterans' Experiences Using Secure Messaging on MyHealtheVet

Haun JNLuther SL, and Powell-Cope GM, Tampa Center of Excellence; Simon SR, VA Boston Healthcare System; Shimada SL, Bedford Center of Excellence & eHealth QUERI; Lind JD, Tampa Center of Excellence;

Objectives:
The objective of this research was to develop a conceptual model using Theory of Planned Behavior and the Technology Acceptance Model to guide the implementation of a mixed-methods research protocol to examine and understand Veterans’ experiences using the Secure Messaging feature on My HealtheVet.

Methods:
The Theory of Planned Behavior and the Technology Acceptance Model provide a comprehensive conceptual framework for implementing mixed-methods to triangulate data. To triangulate data findings about beliefs, attitudes, and perceptions (Theory of Planned Behavior), and the ease of use and usefulness (Technology Acceptance Model), the proposed mixed-methods include: (1) in-person interviews, (2) usability testing, (3) secondary data collection (full-text abstracts of Secure Messages), and (4) three-month follow-up telephone interviews.

Results:
This conceptual framework and mixed methods of data collection expand upon previous research evaluating user experiences to explore why Veterans choose to, or choose not to use the Secure Messaging, identify facilitators and barriers, and examine if experiences differ by health literacy or computer literacy. Preliminary findings, lessons learned, and methodological implementation issues will be presented.

Implications:
Results from this research will guide systems improvements, educational approaches, and marketing strategies to increase adoption and long-term utilization among Veterans to promote the successful evaluation and implementation of the Secure Messaging tool nationally. These findings will also support the development of subsequent research to address how Secure Messaging affects quality of communication and changes in workflow, effects on bricks and mortar, as well as intervention studies to examine health care effectiveness factors and quality of communication between patients and their healthcare providers.

Impacts:
Secure Messaging is an implementation priority for the VHA T21 initiative to promote transformational change, as well as a goal of the eHealth QUERI strategic plan. This research is a successful collaboration between the Tampa and Boston VA Centers of Excellence, eHealth QUERI, and My HealtheVet. In partnership, these groups will use this data to support adoption and sustainability of the Secure Messaging tool. Developing a conceptual framework to model findings will facilitate understanding of Veterans’ experiences using Secure Messaging and will have local, VISN, and national impact on the implementation and sustainability of this communication tool.


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