In a survey by University of Missouri School of Nursing, the move to telehealth treatment in nursing homes brings a mix of benefits and challenges.
Telehealth has widely been used to help give high-risk patients and rural communities access to quality care via video or phone calls. These calls reduce the risk of spreading infection by visiting a medical facility, and bring care to patients who might otherwise drive hours to access quality care. The pandemic, greater access to video conferencing apps via the internet, and increased media and medical outreach on these options has increased telehealth’s quality and expanded access.
Benefits for patients are wide-ranging
The study found that by using telehealth to diagnose and build a treatment plan for minor medical needs, nursing home patients avoided the added stress of transportation to a hospital, which may cause intense stress for the patient. Kimberly Powell, one of the study’s authors and an assistant professor at University of Missouri School of Nursing, said in a statement, “Whether it’s a fall in the middle of the night or a sudden change in vitals, if a nurse can quickly hop on a Zoom call with a resident and make an assessment, perhaps an intervention plan can be developed that allows the resident to be treated in the nursing home, which saves time, money and an unnecessary transfer to the hospital.”
In addition to the reduced stress and use of nursing home resources, the study also identified improved access to care and enhanced communication among medical professionals and their patients.
Challenges for patients remain
But the study also identified some significant challenges for patients. Those patients who were struggling with cognitive difficulties or the effects of isolation — exacerbated by the forced seclusion of the pandemic — often felt confused by the new format, preferred a face-to-face visit, or struggled to use the technology. “For some nursing home residents, going to a doctor’s office for a consultation or follow-up appointment can be a fun social event, as it may be their only chance each month to get fresh air and go out in the community, so taking that opportunity away can be difficult for some,” Powell said. “Or for those with cognitive impairments, they might not understand on a telehealth call why or how their doctor is talking to them through a computer screen.”
In addition, the use of telehealth puts a greater burden on the nursing home staff, who are asked to treat more conditions in-house and act as tech support for their patients. The resources that the nursing home may save on transport to hospitals can quickly be reallocated to direct patient care.
Telehealth use increases, but hurdles remain
The pandemic has been an interesting test case in our ability to pivot to telehealth as an option that opens access to populations that have typically been underserved due to location, risk factors, or mobility issues. The increased use of video calls amongst people of all ages, increased access to internet service, and widespread campaigns to normalize these tools and similar technology like wearable health devices have done their part as well. This study reminds us that while many of us spend hours a day on video conferences, the technology is not fully intuitive for everyone.
As the study concludes, nursing homes and medical facilities hoping to further implementation of telehealth programs should be aware of the possible side effects and build plans to mitigate those issues.
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