Telemedicine and telehealth consults were effective and well received in nursing homes during the pandemic — especially in certain care areas, according to researchers from the New York University Rory Meyers College of Nursing.
Investigators aimed to explore how these modalities promote access to specialty care, modernize care models and improve patient outcomes in skilled nursing and other post-acute care facilities. In an analysis of 16 studies conducted between 2014 and 2020, they found measurable clinical effects on residents, including reduced emergency and hospital admissions, reductions in physical restraints, and improved vital signs.
Process improvements from tele-consults also were observed, along with cost savings. Quick access to specialists was a notable benefit, and on-call healthcare providers could evaluate residents from home, wrote lead author Lisa Groom, MSN, RN, a Ph.D. candidate. There was no negative effect on resident outcomes or signs of excessive cost burden, she added.
Certain kinds of diagnostics support are better suited to remote settings than others, the study confirmed. Geriatric, wound care, psychiatric and palliative specialist tele-consults were among the most effective. But some nursing home clinicians specifically preferred in-person wound care nurse practitioners and palliative care providers over telemedicine providers, the researchers noted.
The consensus throughout the studies was that telehealth and telemedicine benefitted patient/resident care, and researchers found enthusiasm “or at least curiosity” about its use from providers, older adults and their families, Groom and colleagues reported.
On the other hand, the evidence is not comprehensive and the quality of the studies was relatively low, preventing the researchers from making overarching evidence-based recommendations, they added. This is likely due to the newness of the modalities in the nursing home setting, and highlights the potential for further study, the authors concluded.
The review did not include all aspects of telemedicine in nursing home settings, such as telepharmacy, teledentistry and telerehabilitation, due to the researchers’ focus on the modality’s medical-nursing link.
Full findings were published in JAMDA.
