Benefits of Telemedicine for Older Adult Nursing Home Residents

With telehealth on the rise in skilled nursing facilities (SNFs), researchers found SNF residents benefited from telemedicine visits that allowed them to remain in place for treatment.

According to study authors, when residents remained in SNFs there was “limited exposure to transport, exposure to infectious agents, and additional tests in the emergency department (ED).”

“Telemedicine services may be one solution to address need for rapid evaluation and treatment of resident acute conditions and access limitations during outbreaks of infections,” stated study authors.

From June 2017 through August 2018, The University of Maryland (UM) School of Medicine (UMSOM) and Medical System (UMMS) designed and pilot tested the implementation of the Nursing Home Telemedicine-Emergency Department (NHTeleEd). The goal of the pilot test was to determine whether telemedicine services provided earlier detection and improvement management of treatable problems.

Researchers from UM worked with SNF administrators and providers to: “(1) revise SNF admission policies so that incoming residents had to opt-out of potential telemedicine visits; (2) create SNF staff telemedicine scope of practice; (3) credential ED physicians to provide telemedicine consults; (4) integrate telemedicine service into SNF Standards of Care; (5) conduct training on telemedicine equipment; (6) create telemedicine visit forms; and (7) assist in acquiring telemedicine equipment.”

During the study period, 3 Balitmore SNFs chose single staff members to collect monthly data and test telemedicine equipment weekly.

To test the pilot, SNF clinical staff would identify changes in resident conditions and determine whether the condition warranted an ED visit, was life-threating, could be handled by internal staff, or could be handled via telehealth.

Results of the pilot showed that in 466 residents there was a change in condition that needed further evaluation, and 144 (31%) were identified for potential telemedicine visits.

Providing the option of a telemedicine visit resulted in 68.9% (n=42 of 61) of evaluated residents remaining at their SNF for treatment as opposed to being transported to the ED.

“After each telemedicine visit, SNF nurses and ED physicians completed satisfaction measures through an online portal (n=50 nurses and 45 physicians across the 61 telemedicine visits),” stated researchers. “Both groups agreed that patients were satisfied with the visit (6.0 on 7-point scale); overall satisfaction with the telemedicine visit was similar for nurses (5.8) and physicians (5.6).”

“With the post-pandemic changes in Medicare and Medicaid reimbursement for telemedicine SNF visits, telemedicine may improve access and quality of care for SNF residents,” concluded study authors.

Reference:
Gruber-Baldini AL, Quinn CC, Roggio AX, Browne BJ, Magaziner JS. Telemedicine for older adult nursing home residents to avoid emergency department visits: the experience of the NHTeleED project in Maryland. JAMDA. February 26, 2022. doi:10.1016/j.jamda.2022.01.061