James Alvin Low1, Hui Jin Toh2, Laurence Lean Chin Tan1, Joanne Wee Koon Chia3, Angeline Tian Seah Soek4. 1. GeriCare@North, Khoo Teck Puat Hospital, Singapore; Education Research, Geriatric and Education Research Institute, Singapore; Geriatric Medicine and Palliative Care, Khoo Teck Puat Hospital, Singapore. 2. GeriCare@North, Khoo Teck Puat Hospital, Singapore; Education Research, Geriatric and Education Research Institute, Singapore. Electronic address: huijin87@gmail.com. 3. GeriCare@North, Khoo Teck Puat Hospital, Singapore. 4. Geriatric Medicine and Palliative Care, Khoo Teck Puat Hospital, Singapore.
Abstract
OBJECTIVES: We examined the demographics and the clinical profile of teleconsultations conducted between an acute geriatric medicine department and 8 nursing homes over a period of 6.5 years. DESIGN: This is a prospective, descriptive study. SETTING AND PARTICIPANTS: This study was conducted in 8 nursing homes of Singapore. All nursing home patients referred to the program for teleconsultation between December 2010 and May 2017 were enrolled in the study. MEASURES: The unit observed and studied was the individual telemedicine consultation. Each unique patient contributed 1 or more observation points. The data collected included consultation dates, patient demographics, background medical comorbidities, reasons for referral, physical examination findings, primary diagnoses, and general management plans recommended by the doctors. RESULTS: There were 1673 teleconsultations conducted with 850 unique patients. Most of these patients were categorized as having moderate to severe disability. Ninety-five percent of the consultations were scheduled. The main reasons for referral were for medication review (47.6%) and behavioral problems (22.1%). The 4 commonest comorbidities were hypertension (57.0%), dementia (40.0%), diabetes (39.0%), and hyperlipidemia (38%). The most common primary diagnosis was dementia (21.6%), of which 227 of those diagnosed (62.8%) were referred for behavioral and psychological symptoms of dementia. CONCLUSIONS AND IMPLICATIONS: A telemedicine service for older patients is feasible and could be of a high quality, especially if made available in places where a high density of the latter reside, such as in the care homes and other nursing and rehabilitation facilities.
OBJECTIVES: We examined the demographics and the clinical profile of teleconsultations conducted between an acute geriatric medicine department and 8 nursing homes over a period of 6.5 years. DESIGN: This is a prospective, descriptive study. SETTING AND PARTICIPANTS: This study was conducted in 8 nursing homes of Singapore. All nursing home patients referred to the program for teleconsultation between December 2010 and May 2017 were enrolled in the study. MEASURES: The unit observed and studied was the individual telemedicine consultation. Each unique patient contributed 1 or more observation points. The data collected included consultation dates, patient demographics, background medical comorbidities, reasons for referral, physical examination findings, primary diagnoses, and general management plans recommended by the doctors. RESULTS: There were 1673 teleconsultations conducted with 850 unique patients. Most of these patients were categorized as having moderate to severe disability. Ninety-five percent of the consultations were scheduled. The main reasons for referral were for medication review (47.6%) and behavioral problems (22.1%). The 4 commonest comorbidities were hypertension (57.0%), dementia (40.0%), diabetes (39.0%), and hyperlipidemia (38%). The most common primary diagnosis was dementia (21.6%), of which 227 of those diagnosed (62.8%) were referred for behavioral and psychological symptoms of dementia. CONCLUSIONS AND IMPLICATIONS: A telemedicine service for older patients is feasible and could be of a high quality, especially if made available in places where a high density of the latter reside, such as in the care homes and other nursing and rehabilitation facilities.