Project Summary

Background: COVID-19 disrupted care for vulnerable patients and accelerated the need for virtual care. In Puerto Rico, telehealth adoption increased, but the incidence of chronic diseases worsened. Patients face many challenges: poor management of chronic conditions, mental health challenges, inadequate broadband access, deteriorating socioeconomic conditions, limited reimbursement and health professional shortages. Access to patient-centered, culturally appropriate virtual health has been identified as an opportunity to reduce health disparities. Many patients are interested in telehealth, but there are barriers to adoption including a lack of consensus among providers, payers and stakeholders, no clear roadmap for action and a dearth of relevant research.

Proposed Solution to the Problem: To address these challenges, the project team will cultivate a community of patients, stakeholders and researchers who are versed in patient-centered comparative clinical effectiveness research (CER) to develop a common understanding of patient, caregiver and stakeholder burdens related to virtual health adoption; alignment around patient-centered outcomes; and a patient-centered CER agenda and research teams to carry it out. This work will enable better patient and stakeholder decisions related to telehealth adoption.

Objectives: This project will build and equip a research community to partner on patient-centered CER with the aim of optimizing virtual care to improve health equity in Puerto Rico.

Activities: Activities include an interactive training and capacity building program to assist and engage Spanish-speaking patients, stakeholders and researchers in patient-centered CER; mediated discussions on patient, caregiver and stakeholder burdens; development of a virtual care patient-centered CER agenda; community/patient partnerships with traditional researchers and stakeholders using the patient-centered CER and Patient/Community Engagement models; and dissemination of the consensus and research agenda around optimizing virtual care to address health disparities in Puerto Rico.

Projected Outcomes and Outputs:  

Short-term outcomes during the project period include participation of 50 or more patients, stakeholders and researchers in a collaborative research community; the establishment of a consensus around barriers to adopting virtual care and patient-centered outcomes that need to be studied; development of patient-centered CER questions for research; at least three research teams committed to carrying out patient-centered CER projects; and engagement of 1,000 or more people with website and social media content.

Medium-term outcomes (0-2 years post-project period) include a clear understanding of current research priorities for Puerto Rico in the adoption of virtual care and patient-centered outcomes. The collaborative research community will be established and trained in PCORI’S Research Fundamentals to pursue new research opportunities. 

Long-term outcomes (3+ years post-project period) include the collaborative research community‘s production of new evidence-based outcomes in virtual care and patient-centered outcomes that could be disseminated and systematized across multiple healthcare organizations in Puerto Rico.

Patient and Stakeholder Engagement Plan: The project team will build upon their network from Impactivo’s research collaboratives and Puerto Rico Telehealth Working Group to engage stakeholders through a structured process of training, mediation and discourse and the documentation and dissemination of proceedings. Patients will be recruited through patient advocacy groups and health facility partners, as well as social media. 

Project Collaborators: Puerto Rico Hospital Association, Puerto Rico Primary Care Association, Citizen’s Agenda, Vaccination and Prevention Coalition of Puerto Rico (VOCES), Harvard Medical School, the Puerto Rico Public Health Trust and other universities in Puerto Rico.

Project Information

Maria Levis, MPA, MPH

Key Dates

May 2025


Project Status
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Last updated: April 3, 2024