Patient and Health Care Provider Perspectives of Virtually Delivered Wound Care: Early Lessons Learned to Optimize Implementation

Background: The TeleWound Practice Program (TWP) is an evidence-based, coordinated national effort to deliver technology-enabled wound care services to Veterans with chronic wounds. To inform implementation across the Veterans Health Administration (VHA), we used the Practical, Robust Implementation and Sustainability Model (PRISM) to examine Veteran and TeleWound health care provider perspectives of the TWP to identify early lessons learned. Methods: We conducted semistructured interviews informed by the PRISM with Veterans who received TWP care and TWP providers, investigating experiences with and perceptions of TeleWound care and the perceived impact of the TWP on patient outcomes. We used PRISM constructs to organize emerging themes to describe patient- and provider-level factors relevant to implementation. Results: Fifteen Veterans and seven providers participated. Both Veterans and providers reported positive experiences, to date, with the TWP and saw many tangible benefits associated with its implementation, including improved Veteran access to high-quality wound care and more efficient, convenient care with fewer costs incurred by both Veterans and the VHA health care system. Both groups suggested that preparing Veterans for TWP encounters was critical. Despite many common themes between Veterans and providers, we learned of several unmet needs and suggestions unique to the Veteran or provider experience. Veterans noted that their unique clinical needs were not always met or easily accounted for through the TWP’s remote modalities, highlighting a need for technical support. Providers reported that increased administrative burden and lack of buy-in among leadership and other providers impeded implementation. Conclusion: Findings suggest that it will be essential to (1) acknowledge and build on patients’ and providers’ positive experiences with TWP; (2) address Veteran-level needs and suggestions, and consider individual clinical needs and preferences when deciding if TWP is the best approach for their wound care; and (3) address unmet provider-level needs (e.g., securing leadership buy-in) to support implementation.