Nursing Home Provider Perceptions of Telemedicine for Reducing Potentially Avoidable Hospitalizations

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• 作者：Julia Driessen ; PhD^a ; ^b ; Andro Bonhomme ; MD^c ; Woody Chang ; MD^d ; David A. Nace ; MD ; MPH^e ; Dio Kavalieratos ; PhD^f ; Subashan Perera ; PhD^e ; ^g ; Steven M. Handler ; MD ; PhD^b ; ^e ; ^{handlersm@upmc.edu" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Nursing homes ; telemedicine ; telehealth ; hospitalization ; hospital readmission
• 刊名：Journal of the American Medical Directors Association
• 出版年：2016
• 出版时间：1 June 2016
• 年：2016
• 卷：17
• 期：6
• 页码：519-524
• 全文大小：258 K

文摘

Potentially avoidable hospitalizations (PAHs) of nursing home (NH) residents are common, costly, and can have significant economic consequences. Telemedicine has been shown to reduce emergency department and hospitalization of NH residents, yet adoption has been limited and little is known about provider's perceptions and desired functionality for a telemedicine program. The goal of this study was to survey a nationally representative sample of NH physicians and advanced practice providers to quantify provider perceptions and desired functionality of telemedicine in NHs to reduce PAHs.

Design/Setting/Participants/Measurement

We surveyed physicians and advanced practice providers who attended the 2015 AMDA–The Society for Post-Acute and Long-Term Care Medicine Annual Conference about their perceptions of telemedicine and desired attributes of a telemedicine program for managing acute changes of condition associated with PAHs.

Results

We received surveys from 435 of the 947 conference attendees for a 45.9% response rate. Providers indicated strong agreement with the potential for telemedicine to improve timeliness of care and fill existing service gaps, while disagreeing most with the ideas that telemedicine would reduce care effectiveness and jeopardize resident privacy. Responses indicated clear preferences for the technical requirements of such a program, such as high-quality audio and video and inclusion of an electronic stethoscope, but with varying opinions about who should be performing the consults.

Conclusion

Among NH providers, there is a high degree of confidence in the potential for a telemedicine solution to PAHs in NHs, as well as concrete views about features of such a solution. Such consensus could be used to drive an approach to telemedicine for PAHs in NHs that retains the theoretical strengths of telemedicine and reflects the needs of facilities, providers, and patients. Further research is needed to objectively study the impact of successful telemedicine implementations on patient, provider, and economic outcomes.