Telemedicine for specialist geriatric care in small rural hospitals: preliminary data

Gray, Leonard C., Fatehi, Farhad, Martin-Khan, Melinda, Peel, Nancye M. and Smith, Anthony C. (2016) Telemedicine for specialist geriatric care in small rural hospitals: preliminary data. Journal of the American Geriatrics Society, 64 6: 1347-1351. doi:10.1111/jgs.14139


Author Gray, Leonard C.
Fatehi, Farhad
Martin-Khan, Melinda
Peel, Nancye M.
Smith, Anthony C.
Title Telemedicine for specialist geriatric care in small rural hospitals: preliminary data
Journal name Journal of the American Geriatrics Society   Check publisher's open access policy
ISSN 0002-8614
1532-5415
Publication date 2016-06-22
Year available 2016
Sub-type Article (original research)
DOI 10.1111/jgs.14139
Open Access Status Not Open Access
Volume 64
Issue 6
Start page 1347
End page 1351
Total pages 5
Place of publication Malden, MA United States
Publisher Wiley-Blackwell Publishing
Collection year 2017
Language eng
Abstract Small rural hospitals admit and manage older adults who, in city hospitals, would usually be offered geriatrician-supported comprehensive geriatric assessment and coordinated subacute care if required. Distance and diseconomies of scale prohibit access to the conventional in-person approach. A telegeriatric service model involving a geriatrician consulting remotely using wireless, mobile, high-definition videoconferencing; a trained host nurse at the rural site; structured geriatric assessment configured on a web-based clinical decision support system; routine weekly virtual rounds; and support from a local multidisciplinary team was established to overcome these barriers. This was a prospective observational study to examine the feasibility and sustainability of the model. Patient characteristics were recorded using the interRAI Acute Care assessment system. Usage patterns were derived from health service data sets and a service statistics database. Patients had characteristics that are consistent with characteristics of individuals typically referred for geriatric assessment. Overall, 53% of patients had cognitive impairment, 75% had limitations with activities of daily living, and the average Frailty Index was 0.44 ± 0.12. Stable patterns of consultation occurred within 6 months of start-up and continued uninterrupted for the remainder of the 24-month observation period. The estimated overall rate of initial consultation was 1.83 cases per occupied bed per year and 2.66 review cases per occupied bed per year. The findings indicate that the model was feasible and was sustained throughout and beyond the study period. This telegeriatric service model appears suitable for use in small rural hospitals.
Keyword Telemedicine
Videoconferencing
Remote consultation
Telegeriatrics
Geriatrics
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
Centre for Research in Geriatric Medicine Publications
Centre for Online Health Publications
 
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Created: Wed, 22 Jun 2016, 12:11:13 EST by Burke, Eliza on behalf of Centre for On-Line Health