Lisa L Groom1, Margaret M McCarthy2, Amy Witkoski Stimpfel2, Abraham A Brody3. 1. New York University Rory Meyers College of Nursing, New York, NY, USA. Electronic address: llg322@nyu.edu. 2. New York University Rory Meyers College of Nursing, New York, NY, USA. 3. New York University Rory Meyers College of Nursing, New York, NY, USA; Hartford Institute for Geriatric Nursing, New York, NY, USA; Division of Geriatric Medicine and Palliative Care, Department of Internal Medicine, NYU Grossman School of Medicine, New York, NY, USA.
Abstract
OBJECTIVES: Telemedicine and telehealth are increasingly used in nursing homes (NHs). Their use was accelerated further by the COVID-19 pandemic, but their impact on patients and outcomes has not been adequately investigated. These technologies offer promising avenues to detect clinical deterioration early, increasing clinician's ability to treat patients in place. A review of literature was executed to further explore the modalities' ability to maximize access to specialty care, modernize care models, and improve patient outcomes. DESIGN: Whittemore and Knafl's integrative review methodology was used to analyze quantitative and qualitative studies. SETTING AND PARTICIPANTS: Primary research conducted in NH settings or focused on NH residents was included. Participants included clinicians, NH residents, subacute patients, and families. METHODS: PubMed, Web of Science, CINAHL, Embase, PsycNET, and JSTOR were searched, yielding 16 studies exploring telemedicine and telehealth in NH settings between 2014 and 2020. RESULTS: Measurable impacts such as reduced emergency and hospital admissions, financial savings, reduced physical restraints, and improved vital signs were found along with process improvements, such as expedient access to specialists. Clinician, resident, and family perspectives were also discovered to be roundly positive. Studies showed wide methodologic heterogeneity and low generalizability owing to small sample sizes and incomplete study designs. CONCLUSIONS AND IMPLICATIONS: Preliminary evidence was found to support geriatrician, psychiatric, and palliative care consults through telemedicine. Financial and clinical incentives such as Medicare savings and reduced admissions to hospitals were also supported. NHs are met with increased challenges as a result of the COVID-19 pandemic, which telemedicine and telehealth may help to mitigate. Additional research is needed to explore resident and family opinions of telemedicine and telehealth use in nursing homes, as well as remote monitoring costs and workflow changes incurred with its use.
OBJECTIVES: Telemedicine and telehealth are increasingly used in nursing homes (NHs). Their use was accelerated further by the COVID-19 pandemic, but their impact on patients and outcomes has not been adequately investigated. These technologies offer promising avenues to detect clinical deterioration early, increasing clinician's ability to treat patients in place. A review of literature was executed to further explore the modalities' ability to maximize access to specialty care, modernize care models, and improve patient outcomes. DESIGN: Whittemore and Knafl's integrative review methodology was used to analyze quantitative and qualitative studies. SETTING AND PARTICIPANTS: Primary research conducted in NH settings or focused on NH residents was included. Participants included clinicians, NH residents, subacute patients, and families. METHODS: PubMed, Web of Science, CINAHL, Embase, PsycNET, and JSTOR were searched, yielding 16 studies exploring telemedicine and telehealth in NH settings between 2014 and 2020. RESULTS: Measurable impacts such as reduced emergency and hospital admissions, financial savings, reduced physical restraints, and improved vital signs were found along with process improvements, such as expedient access to specialists. Clinician, resident, and family perspectives were also discovered to be roundly positive. Studies showed wide methodologic heterogeneity and low generalizability owing to small sample sizes and incomplete study designs. CONCLUSIONS AND IMPLICATIONS: Preliminary evidence was found to support geriatrician, psychiatric, and palliative care consults through telemedicine. Financial and clinical incentives such as Medicare savings and reduced admissions to hospitals were also supported. NHs are met with increased challenges as a result of the COVID-19 pandemic, which telemedicine and telehealth may help to mitigate. Additional research is needed to explore resident and family opinions of telemedicine and telehealth use in nursing homes, as well as remote monitoring costs and workflow changes incurred with its use.
Authors: Suhui Evelyn Li; Mynti Hossain; Boyd Gilman; Lauren V Forrow; Katie M Lee; Randall Brown Journal: Health Serv Res Date: 2022-02-21 Impact factor: 3.734
Authors: Petra Plunger; Magdalena Eitenberger; Maria Kletecka-Pulker; Thomas Wochele-Thoma; Elisabeth Klager; Ann Kathrin Ruf; Fabian Eibensteiner Journal: Nurs Open Date: 2021-12-16
Authors: James H Ford; Sally A Jolles; Dee Heller; Madeline Langenstroer; Christopher Crnich Journal: BMC Geriatr Date: 2022-04-19 Impact factor: 4.070
Authors: Adam H Dyer; Aoife Fallon; Claire Noonan; Helena Dolphin; Cliona O'Farrelly; Nollaig M Bourke; Desmond O'Neill; Sean P Kennelly Journal: J Am Med Dir Assoc Date: 2022-07-04 Impact factor: 7.802
Authors: Jonas Behnke; Philipp Friedrich Arndt; Michael John Cekay; Daniel Berthold; Birgit Herentin; Rio Dumitrascu; Ulf Sibelius; Bastian Eul Journal: BMC Palliat Care Date: 2022-08-12 Impact factor: 3.113