Telemedicine for Older Adult Nursing Home Residents to Avoid Emergency Department Visits: The Experience of the NHTeleED Project in Maryland

Gruber‐Baldini, Ann L.; Quinn, Charlene C.; Roggio, Anthony; Browne, Brian J.; Magaziner, Jay

doi:10.1016/j.jamda.2022.01.061

Cited by 4 publications

(3 citation statements)

References 7 publications

(8 reference statements)

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“…Especially in rural areas, telemedical consultations can in principle enable faster treatment, while in urban regions a connection with specialists is expected to be more timely ( 42 ). However, potential problems arise from the constant change of nurses, who have to be trained again and again in telemedical consultations or from technically problems during the consultations ( 43 ).…”

Section: Technology Acceptance and Telemedicinementioning

confidence: 99%

“…With regard to acceptance in the nursing home environment, ( 44 ) found that relatives and potential nursing home residents alike consider using telemedical consultations. Physicians and nursing staff who had already been able to carry out telemedical consultations also felt that the consultations were useful and beneficial for the patients being treated ( 43 ).…”

Section: Technology Acceptance and Telemedicinementioning

confidence: 99%

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Everybody hurts sometimes: perceptions of benefits and barriers in telemedical consultations

Rohowsky,

Offermann,

Ziefle

2023

Front. Public Health

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IntroductionShifts in the age structure, rising needs of care and support, and a lack of (in)formal caregivers require innovative solutions to relieve the whole healthcare system. Applying digital approaches, such as telemedicine, has the potential to support people in need of care, to relieve caregivers in families and professional environments, and to assist medical professionals in their working everyday life: e.g., using telemedicine for acute consultations could contribute to avoid hospitalizations of older people, whereas consultations with the general practitioner could reduce efforts and relive medical personnel. Beyond technical opportunities and potential, the acceptance of future users represents a prerequisite for a sustainable adoption of such innovative approaches, especially in sensitive contexts such as life in older age in nursing homes.MethodsThis study aimed at collecting users' perceptions and evaluations of telemedicine in nursing homes. Two scenarios of telemedical consultations were applied which were either carried out by an emergency physician in acute situations or by the attending general practitioner. In a first approach, advantages and disadvantages of telemedicine were collected with the help of a qualitative interview study (N = 12) with laypersons and medical staff. The identified acceptance-relevant factors were then quantified in a second study using an online questionnaire (N = 204).ResultsOutcomes revealed that both types of telemedicial consultations would be gladly used. However, for telemedical consultations in acute situations, the perceived disadvantages outweighed the advantages; for telemedical consultations with the general practitioner, the advantages outweighed the disadvantages. A prominent barrier in both scenarios was perceived impersonality, which limited the willingness to use. Nevertheless, participants indicated that telemedical consultations can be a support for nursing staff.DiscussionOutcomes may help to derive specific implications and recommendations to develop and realize digital technologies tailored to the requirements, needs, and wishes of diverse stakeholders (i.e., patients, medical professionals) as potential future users.

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Section: Technology Acceptance and Telemedicinementioning

confidence: 99%

Section: Technology Acceptance and Telemedicinementioning

confidence: 99%

Everybody hurts sometimes: perceptions of benefits and barriers in telemedical consultations

Rohowsky,

Offermann,

Ziefle

2023

Front. Public Health

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“…This was especially true in nursing homes (NHs) where residents were more susceptible to impacts of the COVID-19 pandemic [1][2][3]. Despite evidence demonstrating its benefits [4][5][6], telemedicine utilization in NHs [7,8] prior to COVID-19 had remained disappointingly low. Research suggests that prior to the COVID-19 pandemic that the adoption of telemedicine in Nursing Homes ranged from 13 to 39% [9,10].…”

Section: Introductionmentioning

confidence: 99%

Characteristics of telemedicine workflows in nursing homes during the COVID-19 pandemic

Ford

Jolles

Heller

et al. 2023

BMC Health Serv Res

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Background The use of telemedicine increased dramatically in nursing homes (NHs) during the COVID-19 pandemic. However, little is known about the actual process of conducting a telemedicine encounter in NHs. The objective of this study was to identify and document the work processes associated with different types of telemedicine encounters conducted in NHs during the COVID-19 pandemic. Methods A mixed methods convergent study was utilized. The study was conducted in a convenience sample of two NHs that had newly adopted telemedicine during the COVID-19 pandemic. Participants included NH staff and providers involved in telemedicine encounters conducted in the study NHs. The study involved semi-structured interviews and direct observation of telemedicine encounters and post-encounter interviews with staff and providers involved in telemedicine encounters observed by research staff. The semi-structured interviews were structured using the Systems Engineering Initiative for Patient Safety (SEIPS) model to collect information about telemedicine workflows. A structured checklist was utilized to document steps performed during direct observations of telemedicine encounters. Information from interviews and observations informed the creation of a process map of the NH telemedicine encounter. Results A total of 17 individuals participated in semi-structured interviews. Fifteen unique telemedicine encounters were observed. A total of 18 post-encounter interviews with 7 unique providers (15 interviews in total) and three NH staff were performed. A 9-step process map of the telemedicine encounter, along with two microprocess maps related to encounter preparation and activities within the telemedicine encounter, were created. Six main processes were identified: encounter planning, family or healthcare authority notification, pre-encounter preparation, pre-encounter huddle, conducting the encounter, and post-encounter follow-up. Conclusion The COVID-19 pandemic changed the delivery of care in NHs and increased reliance on telemedicine services in these facilities. Workflow mapping using the SEIPS model revealed that the NH telemedicine encounter is a complex multi-step process and identified weaknesses related to scheduling, electronic health record interoperability, pre-encounter planning, and post-encounter information exchange, which represent opportunities to improve and enhance the telemedicine encounter process in NHs. Given public acceptance of telemedicine as a care delivery model, expanding the use of telemedicine beyond the COVID-19 pandemic, especially for certain NH telemedicine encounters, could improve quality of care.

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The Geriatric-Focused Emergency Department: Opportunities and Challenges

Sloane

2022

Journal of the American Medical Directors Association

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Telemedicine for Older Adult Nursing Home Residents to Avoid Emergency Department Visits: The Experience of the NHTeleED Project in Maryland

Cited by 4 publications

References 7 publications

Everybody hurts sometimes: perceptions of benefits and barriers in telemedical consultations

Everybody hurts sometimes: perceptions of benefits and barriers in telemedical consultations

Characteristics of telemedicine workflows in nursing homes during the COVID-19 pandemic

The Geriatric-Focused Emergency Department: Opportunities and Challenges

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