VHA Value Framework for virtual care technologies addresses evidence gaps and equity
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Key Takeaway
Consider the VHA Value Framework as a conceptual tool to structure evidence on virtual care technologies.
This article describes the development of a Value Framework for the Veterans Health Administration (VHA) to assess the potential value of virtual care technologies. The framework is based on a synthesis of evidence from 96 prior randomized clinical trials funded by VHA. It organizes value across five domains: Experiences of Care, Access to and Utilization of Quality Healthcare, Population Health, Costs, and Equity.
The authors present this framework as a conceptual tool to support the development of a cumulative evidence base. They do not report pooled effect sizes or trial-level outcomes, as this is not a primary study. The framework is intended for researchers and healthcare organizations within the VHA system.
Key limitations noted include the framework's conceptual nature and its focus on the VHA stakeholder groups. The authors do not report specific safety data, adverse events, or follow-up durations from the underlying trials. Practice relevance is limited to providing a structured approach for evaluating virtual care technologies in the VHA context.
View Original Abstract ↓
Healthcare systems, including the Veterans Health Administration (VHA), are facing tremendous growth in virtual care technologies that are intended to foster connections between patients, informal caregivers, and healthcare team members. The adoption of some of these virtual care technologies was accelerated by the onset of the COVID-19 pandemic, emphasizing the need to more comprehensively and rigorously assess the impacts of such technologies. An encompassing framework that represents the universe of outcomes relevant to virtual care technologies and can inform related measurement is necessary to understand such impacts in depth. Such a framework can inform how, where, and when these technologies may have the most impact, and by extension, contribute the most value. This article describes the participatory and literature-based development of a Value Framework reflecting the potential value of virtual care technologies for VHA healthcare stakeholder groups and the VHA healthcare system.
We pursued a combination of participatory co-design approaches involving key stakeholders representing different domains of expertise in VHA and completed a targeted scoping review of 96 prior randomized clinical trials funded by VHA to identify and describe outcomes related to virtual care technologies. Findings from these activities were synthesized and used to inform the Value Framework's organization.
The Framework is comprised of five primary value categories reflective of healthcare's Quintuple Aim: 1. Experiences of Care, 2. Access to and Utilization of Quality Healthcare, 3. Population Health, 4. Costs, and 5. Equity. Each of these primary value categories includes subcategories and sets of distinct outcomes related to the adoption and use of virtual care technologies.
Since its development, VHA has adopted this Value Framework to inform efforts in evaluating and communicating the impacts of its portfolio of virtual care technologies. The Value Framework may offer researchers and healthcare organizations a tool that can support the development of a cumulative evidence base regarding the value of virtual care technologies.
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