Pandemic prompts digital shift in care for older patients

Amid the novel coronavirus disease (COVID-19) pandemic, transitional care management (TCM) visits have undergone a sustained digital shift, with such services increasingly delivered through telehealth, a recent study has shown.

This online migration has helped reduce barriers to high-value services for older adults, especially during a vulnerable transition period, the researchers said.

The cross-sectional analysis included 44,681 patients receiving TCM services whose electronic health data were accessed. Weekly rates of in-person and virtual TCM visits were compared among three periods: before the pandemic was declared a national emergency (30 December 2019 to 15 March 2020), during the initial pandemic period (16 March to 12 April 2020), and after (12 April 2020 to 3 January 2021).

The average weekly TCM visits during the first period of observation was 927, nearly all of which were in-person. During the initial pandemic period, the number of TCM visits declined while the proportion of telehealth TCM increased, accounting for 15.4 percent of total visits.

In the latter part of the pandemic, TCM visits rebounded, reaching a weekly average of 841, 14.0 percent of which were conducted virtually. Older adults accounted for 70.4 percent and 66.4 percent of all TCM visits during the second and third periods, respectively.

“Further study will be necessary to determine if telehealth TCM visits are associated with the same improvements in clinical outcomes and cost savings as in-person visits, whether differences in outcomes exist between visits delivered by video or phone, and older adults' perspectives on the acceptability of telehealth TCM visits,” the researchers said.

“Ultimately, it is likely that a mix of telehealth and in-person options for postdischarge care may be best suited to meet patient needs,” they added.