eHealth Partnered Evaluation Initiative
Condition: Non-secure Message Senders
Study type: Interventional

Summary: 
      On October 1, 2016, the VHA Office of Telehealth and the Connected Health Office will merge
      to create a single entity that will be responsible for the implementation and evaluation of
      eHealth technologies across the healthcare system. In an effort to successfully fulfill its
      mission, the new combined Connected Health/Telehealth Office is pledging $1,100,000 for an
      eHealth Partnered Evaluation Initiative (PEI) to support the further implementation of
      eHealth technologies across VHA, and to measure their impacts on dimensions of access and
      other outcomes. Developed in close consultation with leadership of the new office, the
      proposed objectives of the eHealth PEI are to (1) implement a patient-level "supported
      adoption intervention" for secure messaging and evaluate the impact of secure messaging use
      through a rapid, one-year randomized trial; and (2) evaluate the initial rollout of VHA's
      automated telehealth text messaging system to Veterans and clinical team members.
    

Detailed description: 
      eHealth is a model for the delivery and receipt of healthcare services with an expanding
      evidence base that suggests great potential to increase access and support the transition
      from episodic to continuous care. In this model, patients, their families, and clinical team
      members use eHealth technologies that support functions (e.g., communication, behavior
      support, transactions) that are critical to disease prevention and health management which in
      turn influences behaviors, processes and outcomes.

      In October 2016, the existing Office of Telehealth and the Connected Health Office will merge
      to create a single Office to oversee the implementation and evaluation of eHealth
      technologies across VHA. The new combined Connected Health/Telehealth Office will manage the
      full spectrum of technologies included in the current Offices of Telehealth (e.g., clinical
      video telehealth, home telehealth, tele-ICU) and Connected Health (e.g., patient portal,
      secure messaging, mobile apps), as well as new technologies that span these offices (such as
      the new Automated Telehealth Texting System). Recognizing the importance of rigorous
      evaluation to its mission, the Connected Health/Telehealth Office is pledging funds for an
      eHealth Partnered Evaluation Initiative (PEI) to support the further implementation of
      eHealth technologies across VHA, and to measure their impacts on dimensions of access, as
      well as Veteran and clinical team experiences, healthcare processes, and Veteran health
      outcomes.

      Developed in close consultation with Connected Health/Telehealth Office leadership, the
      proposed objectives of the eHealth PEI are to (1) implement a patient-level "supported
      adoption intervention" for secure messaging and evaluate the impact of secure messaging use
      through a rapid, one-year randomized trial; and (2) evaluate the initial rollout of VHA's
      automated telehealth text messaging system to Veterans and clinical team members. The
      evaluation work associated with each of these two objectives will be guided by the Practical,
      Robust Implementation and Sustainability Model (PRISM).

      The implementation and evaluation of eHealth technologies is not just the mission of the new
      Connected Health/Telehealth Office, it is also the vision of VHA. In addition to addressing
      the needs of the investigators' operational partner, the aforementioned objectives map to key
      strategies and transformational actions detailed in the Blueprint for Excellence, and align
      with a recently developed Virtual Access Strategy Document intended to guide the efforts of
      the Connected Health/Telehealth Office. The proposed eHealth PEI team includes leadership and
      investigators from the eHealth Quality Enhancement Research Initiative (QUERI) who are
      recognized authorities in informatics, implementation science, and mixed methods evaluation,
      and have longstanding, collaborative relationships with constituents in the Connected
      Health/Telehealth Office.
    

Intervention name(s): Supported adoption intervention; Active comparator control
Intervention type(s): Behavioral; Behavioral
Intervention description(s): An intervention where a healthcare system implements quality improvement by sending patients proactive reminders, motivational messages, and educational support to encourage use of a new service (i.e., secure messaging); The investigators will use an attention control (a control intended to balance the attention Veterans receive from the facility mailings and to enhance masking of intervention versus control). As an attention control must not have information about the intended intervention, the investigators will mail out general wellness information available on the VHA National Center for Prevention
Other intervention name(s): SAI; General wellness information
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Health Services Research
Keywords: Supported adoption; Secure messaging; Patient aligned care team (PACT); My HealtheVet Coordinator