HSR&D Citation Abstract
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How can equitable video visit access be delivered in primary care? A qualitative study among rural primary care teams and patients
Goldstein K, Perry KR, Lewinski A, Walsh CW, Shepherd-Banigan M, Bosworth HB, Weidenbacher HJ, Blalock D, Zullig LL. How can equitable video visit access be delivered in primary care? A qualitative study among rural primary care teams and patients. BMJ (Clinical research ed.). 2022 Aug 5; 12:. doi:10.1136/ bmjopen-2022-062261.
Objective The COVID-19 pandemic sparked exponential growth in video visit use in primary care. The rapid shift
to virtual from in-person care exacerbated digital access disparities across racial groups and rural populations. Moving forward, it is critical to understand when and how
to incorporate video visits equitably into primary care.
We sought to develop a novel clinical algorithm to guide
primary care clinics on how and when to employ video
visits as part of care delivery.
Design Qualitative data collection: one team member
conducted all patient semistructured interviews and led all
focus groups with four other team members taking notes
Setting 3 rural primary care clinics in the USA.
Participants 24 black veterans living in rural areas and
three primary care teams caring for black veterans living
in rural areas.
Primary and secondary outcome measures Findings
from semistructured interviews with patients and focus
groups with primary care teams.
Results Key issues around appropriate use of video visits
for clinical teams included having adequate technical
support, encouraging engagement during video visits
and using video visits for appropriate clinical situations.
Patients reported challenges with broadband access,
inadequate equipment, concerns about the quality of
video care, the importance of visit modality choice, and
preferences for in-person care experience over virtual
care. We developed an algorithm that requires input from
both patients and their care team to assess fit for each
Conclusions Informed matching of patients and clinical
situations to the right visit modality, along with individual
patient technology support could reduce virtual access