LAUSR

Background: In response to COVID-19, the Department of Veterans Affairs (VA) adopted social distancing to slowthe spread of the virus and minimize the risk of viral transmission to its high-risk patients To help protect veteransand VA providers while ensuring that veterans continue to receive high-quality care, the VA embraced telehealthplatforms such as VVC, where the provider conducts a real-time video visit through a secure connection to thepatients' computer, smart phone, or e-pad While this platform is touted to be fast and easy, it still requires notabletechnical, skills, and knowledge components to be successful, which can be challenging in an older rural population The Hematology-Oncology service of the Overton Brooks VA Medical Center embarked on a survey to explore theacceptability and the barriers to VVC care among our cancer patients Methodology: A phone survey of a random sample was conducted across five Hematology-Oncology clinics askingthe veterans to consent for VVC visits and, if the veteran declined, to indicate the reason behind this decision Itspecifically asked the veteran to categorize the reason as related to Equipment, Connectivity, Literacy, Privacy, Financial, or Other/Explain Age, sex, and race characteristics were captured for each participant Descriptivestatistics and logistic regression were carried out Results: The sample consisted of 101 veterans from Arkansas, Texas, and Louisiana The median age was 71 withthe majority between ages 61-85 years The participants were 96% male vs 4% female and 45% Black vs 55%White Only 13% consented to VVC care Among the veterans who declined, the reasons were related to lack of theappropriate equipment (53%), lack of adequate connection (14%), literacy (14%), and concerns with privacy (9%) No one cited financial issues Among those who provided other reasons (10%), the majority did not see theadvantage of VVC over a regular phone call Except for “Other,” which consisted of 78% White, the rest of thecategories' racial breakdown mirrored the whole sample Stepwise logistic regression revealed age (p=0 03) to bethe only statistically significant factor that is inversely related to VVC acceptability Conclusion: These results confirm our experience that the older the veteran, the less the acceptability of VVC care However, our survey indicates that 86% of the barriers to VVC use can be potentially overcome by providing theappropriate equipment along with education and training Still, 14% of our veterans lack access to the internet Withappropriate funding and veteran training, VVC has the potential to play a major role in rural veteran cancer careduring the COVID19 pandemic