Empowering Veterans With Telehealth, Technology and Health Communication: A Quality Improvement Pilot Project

Theoretical Background and research questions/hypothesis: With 1,700 healthcare facilities and 8.7 million Veterans enrolled, the Department of Veterans Affairs (VA) operates the Nation’s largest integrated healthcare system. To provide exceptional healthcare for Veterans, VA developed a number of healthcare tools, including My HealtheVet, VA’s online Personal Health Record that offers Veterans online access to their self-entered and VA medical history, prescription refills and health goals. While many Veterans use My HealtheVet to review/print health records, features that allow Veterans to take a more active role in their healthcare were relatively unknown and under-utilized. To promote these features, VA piloted a program in June 2012 to increase enrollment in Secure Messaging, a secure and convenient tool for Veterans to communicate with their healthcare team between visits. VA’s Office of Informatics and Analytics (OIA) developed a communications program to increase Veteran participation by encouraging existing users to upgrade to Secure Messaging and enrolling non-users in My HealtheVet and Secure Messaging.

Methods: First, OIA conducted research, including literature reviews, questionnaires and interviews with VA healthcare providers and stakeholders, to better understand the patient community and current perception of My HealtheVet. Research revealed that Veterans were eager for more My HealtheVet features, particularly if features gave them greater control of their healthcare. Interviews with onsite My HealtheVet coordinators indicated that Veterans often signed up for My HealtheVet at their appointments at VA medical facilities, rather than at their home computer, positioning the facility healthcare providers to serve as primary message carriers and advocates. With these findings, OIA developed and executed a communications plan to deliver messages to Veterans at their point of care, increase awareness of Secure Messaging and supply materials to providers. Development/Training: Engaged staff through educational offerings, including workbooks, online videos and training sessions. Drafted copy and designed materials, including letters, posters and phone tents. Production/Awareness: Worked with healthcare providers to refine and revise program messages. Prepared, printed professionally and made 508 compliant and several translated into Spanish. Distribution/Deployment:By June 1, all sites received printed materials. The internal VA SharePoint page was posted, allowing providers to download and print materials. The external eHealth website, was updated and internal blog posts/e-news blasts were distributed to increase awareness and pave the way for the national campaign.

Results: The campaign resulted in greater My HealtheVet/Secure Messaging enrollment rates at all pilot sites. Overall, enrollment increased 42 percent over Fiscal Year (FY) 2011 and upgrades to Secure Messaging increased 271 percent over FY11. The pilot program exceeded VA expectations and OIA deployed a national campaign in the fall 2012.

Conclusions: This campaign used existing content, successfully impacted VA performance metrics and far exceeded expectations, while foundationally adhering to core public relations principals and foundational research, the project proved that “My HealtheVet and Secure Messaging put health care in the hands of Veteran patients."

Implications for research and/or practice: Lessons learned will help participants peel away the layers of centralized, traditional patient outreach and uncover the core of strong, action-oriented, engaging messages that focus on point of care communication, but also include other vehicles essential to diffusing key messages.