University of Massachusetts Medical School Faculty Publications

UMMS Affiliation

Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences

Publication Date


Document Type

Article Postprint


Health Communication | Military and Veterans Studies | Nervous System Diseases | Telemedicine


BACKGROUND: Individuals with spinal cord injuries and disorders (SCI/D) require frequent interdisciplinary health care to address impairments in mobility, autonomic functions, and secondary complications. Telehealth has the capacity to substantially transform healthcare delivery and improve care by increasing access and communication. However, relatively little is known about telehealth use in this specific population. Here, we attempt to fill part of this gap.

OBJECTIVE: To investigate the frequency and characteristics associated with telehealth use in Veterans with SCI/D.

DESIGN: Cross-sectional, descriptive project

SETTING: Veterans Health Administration (VHA) facilities.

Participants: 15,028 Veterans living with SCI/D whom received services from the VHA SCI/D System of Care.

Intervention: Not applicable

Outcome Measures: Frequency and characteristics associated with VHA telehealth utilization.

Results: Of the 15,028 Veterans with SCI/D included in the evaluation, 17% used some form of telehealth in VHA Fiscal Year (FY)2017. Veterans over the age of 65 had lower odds (OR = 0.88, p < 0.05, CI: 0.80-0.98) of using telehealth. Being Caucasian (OR = 1.29, p < 0.01, CI: 1.09-1.52), living in rural areas (OR =1.16, p < 0.01, CI: 1.05-1.28), living greater distances away from the VHA (p < 0.01 for all distances), and being in priority group 8, meaning that Veterans have higher copayment requirements (OR=1.46, p < 0.001, CI: 1.19-1.81), were all significantly associated with greater odds of telehealth use. The most frequent types of telehealth used were real-time clinical video and store-and-forward between a provider and patient within the same hub network.

Conclusion: There are opportunities to increase telehealth adoption in the SCI/D arena. The findings from this project highlight which Veterans are currently using telehealth services, as well as gaps regarding telehealth adoption in this population.


Spinal Cord Injuries and Disorders, Spinal Cord Injury, Telehealth, Veterans

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© 2020. This article is protected by copyright. This is a PDF file of an accepted manuscript that has been accepted for publication and posted with a 12-month embargo as allowed by the publisher’s author rights policy at This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.

DOI of Published Version



Hatch MN, Martinez RN, Etingen B, Cotner B, Hogan TP, Wickremasinghe IM, Sippel J, Smith BM. Characterization of Telehealth Use in Veterans with Spinal Cord Injuries and Disorders. PM R. 2020 Oct 24. doi: 10.1002/pmrj.12515. Epub ahead of print. PMID: 33098620. Link to article on publisher's site

Related Resources

Link to Article in PubMed

Journal/Book/Conference Title

PM and R : the journal of injury, function, and rehabilitation

PubMed ID


Available for download on Sunday, October 24, 2021