Veterans Experiences Using Secure Messaging

Deployment of Secure Messaging (SM) in primary care and women's clinics throughout the Veteran Health System by 2011 was an implementation priority for the Secretary and Under Secretary for Health for FY11 under the VHA T21 initiative. Secure Messaging is in early phases of implementation, this eHealth tool requires thoughtful evaluation to promote the successful implementation and dissemination of this tool. The primary aim of this project is to describe Veterans' experiences when using the SM feature on MyHealtheVet (MHV). This project has local, VISN, and national impact on the implementation and sustainability of the SM feature on MHV through its qualitative and quantitative examination of users' experiences. Findings from this research explores why Veterans choose to, or not to, use the SM feature on MHV, identify facilitators and barriers, and examine if experiences differ by health literacy or computer literacy. In addition to the interview data, findings from the usability testing and the quantitative survey findings build knowledge about Veterans' experiences using the SM feature on MyHealtheVet. These data will inform systems improvements, educational approaches, and marketing strategies to increase adoption and long-term utilization among Veterans.

Project Background:

Secure Messaging is a VHA implementation priority to improve Veteran access to care. Successful deployment of Secure Messaging will support improved access to care, and improved healthcare outcomes in the Veteran population. To support these initiatives, and the successful implementation of this health informatics tools in the VHA, this project is exploring Veterans' perspectives' about adopting Secure Messaging and their experiences using Secure Messaging to inform systems improvements, educational approaches, and marketing strategies.

Objectives:

The primary aim of this project is to describe Veterans' experiences when using the Secure Messaging feature on My HealtheVet (MHV). This research is designed to explore why Veterans choose to, or not to, use the Secure Messaging feature on MHV, identify facilitators and barriers, and examine if experiences differ by health literacy or computer literacy. In addition to the interview data, findings from the usability testing provide user data about Veterans' skills and patterns when using Secure Messaging. This study was extended to conduct a mail-in quantitative survey evaluation of Veterans experiences, preferences, purposes and perceived facilitators and barriers for using, or not using Secure Messaging.

Methods:

This is a prospective mixed-methods descriptive study.

In Phase One: A purposive sampling was used to identify the sample of Veterans who have been Personally Authenticated for the Secure Messaging feature on My HealtheVet. Participants were recruited from two sites (Tampa n=18, Boston n=15). Phase 1 data collection procedures included: (1) surveys; (2) In-person interviews; (3) usability testing; (4) Secure Messaging secondary data collection; and (5) telephone interviews to complete study objectives.

In Phase Two: Random sampling was used to collect mail-in survey data from up to 1,000 Veteran participants who have been personally authenticated to use secure messaging. Quantitative data will be summarized using descriptive statistics to describe sample characteristics, frequency counts and proportions.

Study Status: The project team has completed data collection and analysis for Phase 1 and 2. Team is currently working on publications for dissemination.

Eligibility Criteria:
Inclusion Criteria:

* Individuals who have been Personally Authenticated for the SM feature on MHV and
* who use SM independent of other caregivers, and
* cognitive impairment that prevents use of a personal computer.

Exclusion Criteria:

* Unable or unwilling to provide informed consent.