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User Testing of the Veteran Delegation Tool: Qualitative Inquiry

BACKGROUND: Informal caregivers, or care partners, provide critical support to care recipients when managing health care. Veterans Health Administration (VHA) priorities identify care partners as vital in supporting veterans’ care management. The Veteran Delegation Tool (VDT) is VHA’s Health Insuran...

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Autores principales: Haun, Jolie N, Melillo, Christine, Schneider, Tali, Merzier, Marie M, Klanchar, S Angelina, Fowler, Christopher A, Benzinger, Rachel C
Formato: Online Artículo Texto
Lenguaje:English
Publicado: JMIR Publications 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9999259/
https://www.ncbi.nlm.nih.gov/pubmed/36821364
http://dx.doi.org/10.2196/40634
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author Haun, Jolie N
Melillo, Christine
Schneider, Tali
Merzier, Marie M
Klanchar, S Angelina
Fowler, Christopher A
Benzinger, Rachel C
author_facet Haun, Jolie N
Melillo, Christine
Schneider, Tali
Merzier, Marie M
Klanchar, S Angelina
Fowler, Christopher A
Benzinger, Rachel C
author_sort Haun, Jolie N
collection PubMed
description BACKGROUND: Informal caregivers, or care partners, provide critical support to care recipients when managing health care. Veterans Health Administration (VHA) priorities identify care partners as vital in supporting veterans’ care management. The Veteran Delegation Tool (VDT) is VHA’s Health Insurance Portability and Accountability Act–compliant solution for care partners to comanage veterans’ care through VHA’s electronic health portal. Human-centered design approaches in VDT development are needed to inform enhancements aimed at promoting uptake and sustained use. OBJECTIVE: The objective of this prospective descriptive quality improvement project was to use a human-centered design approach to examine VDT use perceptions and practical experiences. METHODS: This project was conducted using a 4-phase approach: frame, discover, design, and deliver. The frame phase designed the protocol and prepared the VDT system for testing. This paper reports on the discover phase, which used semistructured and follow-up interviews and user testing to examine VDT’s benefits, facilitators, and barriers. The discover phase data informed the design and deliver phases, which are underway. RESULTS: Veterans (24/54, 44%), care partners (21/54, 39%), and individuals who represented dual roles (9/54, 17%)—namely veteran care partner (4/54, 7%), veteran clinical provider (2/54, 4%), and care partner provider (3/54, 6%)—participated in semistructured interviews in the discover phase. A subsample of these participants (3/54, 6%) participated in the follow-up interviews and user testing. Analysis of the semistructured interviews indicated convergence on the respondents’ perceptions of VDT’s benefits, facilitators, and barriers and recommendations for improving VDT. The perceived benefits were authorized access, comanagement of care needs on the web, communication with the clinical team, access to resources, and ease of burden. Perceived barriers were nonrecognition of the benefits of VDT, technical literacy access issues, increased stress in or burden on care partners, and personal health information security. Participant experiences across 4 VDT activity domains were upgrade to My HealtheVet Premium account, registration, sign-in, and use. User testing demonstrated users’ challenges to register, navigate, and use VDT. Findings informed VDT development enhancements and recommendations. CONCLUSIONS: Care partners need Health Insurance Portability and Accountability Act–compliant access to electronic health portals to assist with care management. VDT is VHA’s solution, allowing communication among delegates, veterans, and clinical care teams. Users value VDT’s potential use and benefits, while access and navigation improvements to ensure uptake and sustained use are needed. Future efforts need to iteratively evaluate the human-centered phases, design and deliver, of VDT to target audiences. Continued efforts to understand and respond to care partners’ needs are warranted.
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spelling pubmed-99992592023-03-11 User Testing of the Veteran Delegation Tool: Qualitative Inquiry Haun, Jolie N Melillo, Christine Schneider, Tali Merzier, Marie M Klanchar, S Angelina Fowler, Christopher A Benzinger, Rachel C J Med Internet Res Original Paper BACKGROUND: Informal caregivers, or care partners, provide critical support to care recipients when managing health care. Veterans Health Administration (VHA) priorities identify care partners as vital in supporting veterans’ care management. The Veteran Delegation Tool (VDT) is VHA’s Health Insurance Portability and Accountability Act–compliant solution for care partners to comanage veterans’ care through VHA’s electronic health portal. Human-centered design approaches in VDT development are needed to inform enhancements aimed at promoting uptake and sustained use. OBJECTIVE: The objective of this prospective descriptive quality improvement project was to use a human-centered design approach to examine VDT use perceptions and practical experiences. METHODS: This project was conducted using a 4-phase approach: frame, discover, design, and deliver. The frame phase designed the protocol and prepared the VDT system for testing. This paper reports on the discover phase, which used semistructured and follow-up interviews and user testing to examine VDT’s benefits, facilitators, and barriers. The discover phase data informed the design and deliver phases, which are underway. RESULTS: Veterans (24/54, 44%), care partners (21/54, 39%), and individuals who represented dual roles (9/54, 17%)—namely veteran care partner (4/54, 7%), veteran clinical provider (2/54, 4%), and care partner provider (3/54, 6%)—participated in semistructured interviews in the discover phase. A subsample of these participants (3/54, 6%) participated in the follow-up interviews and user testing. Analysis of the semistructured interviews indicated convergence on the respondents’ perceptions of VDT’s benefits, facilitators, and barriers and recommendations for improving VDT. The perceived benefits were authorized access, comanagement of care needs on the web, communication with the clinical team, access to resources, and ease of burden. Perceived barriers were nonrecognition of the benefits of VDT, technical literacy access issues, increased stress in or burden on care partners, and personal health information security. Participant experiences across 4 VDT activity domains were upgrade to My HealtheVet Premium account, registration, sign-in, and use. User testing demonstrated users’ challenges to register, navigate, and use VDT. Findings informed VDT development enhancements and recommendations. CONCLUSIONS: Care partners need Health Insurance Portability and Accountability Act–compliant access to electronic health portals to assist with care management. VDT is VHA’s solution, allowing communication among delegates, veterans, and clinical care teams. Users value VDT’s potential use and benefits, while access and navigation improvements to ensure uptake and sustained use are needed. Future efforts need to iteratively evaluate the human-centered phases, design and deliver, of VDT to target audiences. Continued efforts to understand and respond to care partners’ needs are warranted. JMIR Publications 2023-02-23 /pmc/articles/PMC9999259/ /pubmed/36821364 http://dx.doi.org/10.2196/40634 Text en ©Jolie N Haun, Christine Melillo, Tali Schneider, Marie M Merzier, S Angelina Klanchar, Christopher A Fowler, Rachel C Benzinger. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 23.02.2023. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.
spellingShingle Original Paper
Haun, Jolie N
Melillo, Christine
Schneider, Tali
Merzier, Marie M
Klanchar, S Angelina
Fowler, Christopher A
Benzinger, Rachel C
User Testing of the Veteran Delegation Tool: Qualitative Inquiry
title User Testing of the Veteran Delegation Tool: Qualitative Inquiry
title_full User Testing of the Veteran Delegation Tool: Qualitative Inquiry
title_fullStr User Testing of the Veteran Delegation Tool: Qualitative Inquiry
title_full_unstemmed User Testing of the Veteran Delegation Tool: Qualitative Inquiry
title_short User Testing of the Veteran Delegation Tool: Qualitative Inquiry
title_sort user testing of the veteran delegation tool: qualitative inquiry
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9999259/
https://www.ncbi.nlm.nih.gov/pubmed/36821364
http://dx.doi.org/10.2196/40634
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