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Title page

Contents

Highlights 2

Letter 5

Background 9

VHA's Programs Have Assisted Veterans in Addressing Barriers to Telehealth, but VHA Does Not Measure ATLAS Program Effectiveness 12

VHA's Digital Divide Consult and ATLAS Programs Have Assisted Veterans in Accessing Video Telehealth 12

VHA Is Making Changes to the ATLAS Program to Improve Telehealth Access, Including Transitioning to a Grant Program 20

VHA Does Not Measure ATLAS Program Effectiveness on an Ongoing Basis 22

VA Surveys and Other Assessments Indicate That Veterans Are Generally Satisfied with the VHA Health Care They Receive via Telehealth 25

VHA Has Processes in Place to Monitor the Quality of Its Telehealth Services and Is Developing a Framework to Assess Veterans' Health Outcomes 29

VHA Assesses the Quality of Video Telehealth by Regularly Monitoring Its VISNs 29

VHA Has Additional Efforts Underway to Assess Veterans' Health Outcomes Associated with Telehealth 34

Conclusions 36

Recommendations for Executive Action 36

Agency Comments 37

Appendix I: Department of Veterans Affairs Veterans Integrated Service Networks and Medical Centers Selected for Interviews 38

Appendix II: Additional Department of Veterans Affairs Actions to Address Barriers to Veterans' Telehealth Access 39

Appendix III: Office of Connected Care Conditions of Participation Standards and Virtual Care Scorecard Measures 41

Appendix IV: Comments from the Department of Veterans Affairs 46

Appendix V: GAO Contact and Staff Acknowledgments 48

Tables

Table 1. Digital Divide Consult Tablet Loan Data, Fiscal Years 2022 through 2023 13

Table 2. Location, Hosts, and Visits for the ATLAS Program Sites, Fiscal Years (FY) 2022 through 2023 17

Table 3. Selected VISNs and VA Medical Centers 38

Table 4. Examples of VA and VHA Actions to Address Barriers to Veterans' Telehealth Access, as of April 2024 39

Table 5. Office of Connected Care Conditions of Participation Standards with Examples of Criteria and Evidence, Fiscal Year 2023 41

Table 6. Office of Connected Care Virtual Care Scorecard Measures and Veterans Integrated Service Networks Performance Rates for Veterans Health... 43

Figures

Figure 1. Veterans' Options for Real-Time, Remote Health Care from the Veterans Health Administration 10

Figure 2. Number and Percentage of Veterans Health Administration Visits by Type, Fiscal Years 2022 through 2023 11

Figure 3. Example of an Accessing Telehealth through Local Area Stations (ATLAS) Site 16

Figure 4. Veterans' Satisfaction with Video Telehealth, by Selected Survey Questions, Calendar Years 2022 through 2023 26

Figure 5. Office of Connected Care's Collaborative Approach to Telehealth Quality Management Activities 32

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