The Diagnostic Accuracy of Telegeriatrics for the Diagnosis of Dementia via Video Conferencing

Martin‐Khan, Melinda; Flicker, Leon; Wootton, Richard; Loh, Poh-kooi; Edwards, Helen; Varghese, Paul; Byrne, Gerard; Klein, Kerenaftali; Gray, Leonard C.

doi:10.1016/j.jamda.2012.03.004

Cited by 81 publications

(73 citation statements)

References 31 publications

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“…Another strategy may be involving practice nurses in the dementia diagnosis and management so that persons with dementia and families get the time they need within the financial reimbursements available. f) Ensuring that specialist dementia diagnosis services are accessible in all geographical areas, rural areas could be serviced through telehealth which has been shown to provide valid diagnosis (Martin-Khan et al, 2012) g) A dementia registry may encourage diagnosis by tracking performance against standards (Religa et al, 2015) A caveat in designing an intervention is that this review only takes into account the viewpoints of health practitioners; the viewpoints of persons with dementia and their carers also need to be considered (e.g. (Low et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

Communicating a diagnosis of dementia: A systematic mixed studies review of attitudes and practices of health practitioners

Low¹,

McGrath

Swaffer

et al. 2018

Dementia

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The aim of this study is to systematically review practitioners' practices and attitudes in regards to communicating a diagnosis of dementia. A systematic search was conducted of Scopus, Web of Science and PubMed for English language original empirical papers. A sequential explanatory mixed studies analysis approach was used. Twenty-five quantitative descriptive, two intervention, six mixed methods descriptive and 21 qualitative studies were included. Pooled analysis showed that 34% of GPs and 48% of specialists usually/ routinely tell the person with dementia their diagnosis, and 89% of GPs and 97% specialists usually/routinely tell the family the diagnosis. Euphemistic terms such as 'memory problems' are more often used to describe dementia than medical terms. Practitioners' decision to diagnose and communicate the diagnosis of dementia are influenced by (a) their own beliefs regarding dementia and treatment efficacy and their confidence in diagnosis and communication; (b) patient circumstances including level of awareness, level of severity and family support; (c) the health and social care system including access to specialist and diagnostic services, reimbursement for diagnosis/management and availability of services and (d) cultural norms in relation to dementia including stigma, labels, and common clinical practice. The diagnosis and communication of diagnosis of dementia are intertwined processes and should be concurrently addressed in interventions. Multicomponent approaches to address these practices could include guideline development, practitioner education, anti-stigma public health campaigns, offering post-diagnosis treatments and support and sufficient reimbursement for practitioners for time spent managing dementia.

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Section: Discussionmentioning

confidence: 99%

Communicating a diagnosis of dementia: A systematic mixed studies review of attitudes and practices of health practitioners

Low¹,

McGrath

Swaffer

et al. 2018

Dementia

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“…Comparative studies have found agreement between face-to-face (FTF) and telemedicine assessments using the Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Katz assessment of Activities of Daily Living, Instrumental ADL assessment, and Informant Questionnaire for Cognitive Decline in the Elderly (30, 31). Mild cognitive impairment (MCI) and AD can be diagnosed by telemedicine as studies have found that the accuracy of diagnosis via telemedicine was not inferior to FTF assessment (32, 33). …”

Section: Telemedicine In Dementia Carementioning

confidence: 99%

A Multidisciplinary Model of Dementia Care in an Underserved Retirement Community, Made Possible by Telemedicine

et al. 2016

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The need for memory specialists is increasing as the incidence of dementia rapidly rises across the globe. In rural areas, demand for these specialists far outstrips supply. It is increasingly difficulty for patients to receive care in a timely manner. In this paper, we document our experience using videoconference telemedicine to bring a multidisciplinary model of care to a rural retirement community in Southern California. To our knowledge, we are one of the first to integrate telemedicine into dementia care on this large a scale. Given the relatively remote location, patients and neurologists have previously had to travel great distances and bear with long wait times. With neurological consultation by telemedicine and a local team consisting of a geriatrician, a neuropsychologist, and a case manager, we have been able to provide comprehensive dementia care in this underserved area, comparable to university-affiliated California Alzheimer’s Disease Centers, typically found only in major metropolitan areas. We have shown that telemedicine can be very effective in improving access and quality of dementia care.

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“…Studies of telemedicine in NHs have evaluated the use of technology to improve access to services such palliative care through remote consults, 45 teledermatology, 46-50 telepsychiatry 51-55 and potentially other specialties such as cardiology, pulmonary and neurology. Thus, telemedicine could be leveraged more broadly as a platform for providing other services, such as enhanced access to other specialty care, elevating the technology to a ‘horizontal,’ cross-cutting intervention within a NH and potentially increasing the associated clinical and financial benefits.…”

Section: Discussionmentioning

confidence: 99%

Nursing Home Provider Perceptions of Telemedicine for Reducing Potentially Avoidable Hospitalizations

Driessen

Bonhomme

Chang

et al. 2016

Journal of the American Medical Directors Association

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Objective Potentially avoidable hospitalizations (PAHs) of nursing home (NH) residents are common, costly, and can have significant economic consequences. Telemedicine has been shown to reduce emergency department and hospitalization of NH residents, yet adoption has been limited and little is known about provider's perceptions and desired functionality for a telemedicine program. The goal of this study was to survey a nationally representative sample of NH physicians and advanced practice providers to quantify provider perceptions and desired functionality of telemedicine in NHs to reduce PAHs. Design/Setting/Participants/Measurement We surveyed physician and advanced practice providers who attended the 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine Annual Conference about their perceptions of telemedicine and desired attributes of a telemedicine program for managing acute changes of condition associated with PAHs. Results We received surveys from 435 of the 947 conference attendees for a 45.6% response rate. Providers indicated strong agreement with the potential for telemedicine to improve timeliness of care and fill existing service gaps, while disagreeing most with the ideas that telemedicine would reduce care effectiveness and jeopardize resident privacy. Responses indicated clear preferences for the technical requirements of such a program, such as high-quality audio and video and inclusion of an electronic stethoscope, but without strong opinions about who should be performing the consults. Conclusion Among NH providers, there is a high degree of confidence in the potential for a telemedicine solution to PAHs in NHs, as well as concrete views about features of such a solution. Such consensus could be used to drive an approach to telemedicine for PAHs in NHs that retains the theoretical strengths of telemedicine and reflects the needs of facilities, providers, and patients. Further research is needed to objectively study the impact of successful telemedicine implementations on patient, provider, and economic outcomes.

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The Diagnostic Accuracy of Telegeriatrics for the Diagnosis of Dementia via Video Conferencing

Cited by 81 publications

References 31 publications

Communicating a diagnosis of dementia: A systematic mixed studies review of attitudes and practices of health practitioners

Communicating a diagnosis of dementia: A systematic mixed studies review of attitudes and practices of health practitioners

A Multidisciplinary Model of Dementia Care in an Underserved Retirement Community, Made Possible by Telemedicine

Nursing Home Provider Perceptions of Telemedicine for Reducing Potentially Avoidable Hospitalizations

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