Skilled nursing facilities were able to limit emergency room visits after implementing a more robust telemedicine program, finds a new study led by researchers at the University of Maryland School of Medicine.

UMD scientists and clinicians worked with administrators and providers at three Baltimore-area SNFs to design and implement a telemedicine program between June 2017 through August 2018. The program integrated telemedicine services into standards of care, made it an opt-out service for new residents, helped SNFs acquire telemedicine equipment, trained staff on the equipment, and added more resources for employees. 

When a change in condition was identified, staff conducted an evaluation to determine whether it might warrant an ER visit, was potentially life-threatening, could be handled by internal nursing staff or delayed contact with a physician, or could be assessed through telemedicine. For those fitting telemedicine criteria, visits were scheduled with ER physicians, available 24/7. 

Staff were able to identify changes in resident conditions with telemedicine among 42% of patients requiring further evaluation. Of those, nearly 70% were able to remain at the SNF for treatment while the other 30% were transferred to the emergency room. 

Researchers said the findings revealed that telemedicine visits benefit SNF residents by allowing them to remain in place for treatment, limiting exposure to transport, infectious agents and unnecessary testing that often occurs with an ER visit. 

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

Full results were published in the Journal of Post-Acute and Long-Term Care Medicine.