Telehealth essential for geriatric medicine under COVID-19

Amid the novel coronavirus disease (COVID-19) pandemic, telehealth was an indispensable method of delivering quality medical care to older adults, a recent study has found. However, as cases declined, and to better suit patient needs, telehealth use subsequently declined in the later phases of the pandemic.

Researchers conducted 30-minute, semi-structured, audio-recorded interviews including 48 US-based physicians across different specialties. Framework analysis was used to detect major themes and subthemes.

Of the participants, 18 were geriatricians, 15 were primary care physicians, and 15 were emergency medicine (EM) doctors. Before March 2020, only 29 percent of respondents had reported using video visits. This proportion jumped during the pandemic, with only two EM participants reporting no uptake despite the outbreak.

Five themes emerged from the interviews. First, physicians noted that telehealth uptake was rapid, disorganized, and iterative. Video consultations were initially driven by the sudden need to migrate digitally and had to settle for a “chaotic” adoption of such platforms before organizations underwent iterative improvements.

However, telehealth proved to be a safe way to continue health visits for older patients while also protecting healthcare workers, participants said. Physicians also noted differences in telehealth uptake according to specialties: it could substitute for in-person visits in primary and geriatric care, but EM physicians preferred it as a supplement to in-person presentation.

Nevertheless, telehealth posed unique challenges for older patients, as reported by physicians. These include socioeconomic limitations, limited knowledge and comfort with technology, and poor internet access.

Finally, once cases started declining, so did telehealth visits, the participants reported. This was mostly due to patient preferences and their inability to cope with the aforementioned challenges.

“Our results highlight promising areas where telehealth can facilitate care delivery; however, investments in infrastructure, payment policies, and training are needed to ensure telehealth viability, after COVID-19,” the researchers said.