Perceived benefits of geriatric specialty telemedicine among rural patients and caregivers
Objective Explore the perceived benefits of a Veterans Health Administration (VHA) geriatric specialty telemedicine service (GRECC Connect) among rural, older patients and caregivers to contribute to an assessment of its quality and value. Data Sources In Spring 2021, we interviewed a geographically...
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| Published in: | Health services research Vol. 58; no. 1; pp. 26 - 35 |
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| Main Authors: | , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Oxford, UK
Blackwell Publishing Ltd
01-02-2023
Health Research and Educational Trust |
| Subjects: | |
| Online Access: | Get full text |
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| Summary: | Objective
Explore the perceived benefits of a Veterans Health Administration (VHA) geriatric specialty telemedicine service (GRECC Connect) among rural, older patients and caregivers to contribute to an assessment of its quality and value.
Data Sources
In Spring 2021, we interviewed a geographically diverse sample of rural, older patients and their caregivers who participated in GRECC Connect telemedicine visits.
Study Design
A cross‐sectional qualitative study focused on patient and caregiver experiences with telemedicine, including perceived benefits and challenges.
Data Collection
We conducted 30 semi‐structured qualitative interviews with rural, older (≥65) patients enrolled in the VHA and their caregivers via videoconference or phone. Interviews were recorded, transcribed, and analyzed using a rapid qualitative analysis approach.
Principal Findings
Participants described geriatric specialty telemedicine visits focused on cognitive assessments, tailored physical therapy, medication management, education on disease progression, support for managing multiple comorbidities, and suggestions to improve physical functioning. Participants reported that, in addition to prescribing medications and ordering tests, clinicians expedited referrals, coordinated care, and listened to and validated both patient and caregiver concerns. Perceived benefits included improved patient health; increased patient and caregiver understanding and confidence around symptom management; and greater feelings of empowerment, hopefulness, and support. Challenges included difficulty accessing some recommended programs and services, uncertainty related to instructions or follow‐up, and not receiving as much information or treatment as desired. The content of visits was well aligned with the domains of the Age‐Friendly Health Systems and Geriatric 5Ms frameworks (Medication, Mentation, Mobility, what Matters most, and Multi‐complexity).
Conclusions
Alignment of patient and caregiver experiences with widely‐used models of comprehensive geriatric care indicates that high‐quality geriatric care can be provided through virtual modalities. Additional work is needed to develop strategies to address challenges and optimize and expand access to geriatric specialty telemedicine. |
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| Bibliography: | Funding information Health Services Research and Development, Grant/Award Number: IK2 HS00318; Veterans Health Administration, Office of Rural Health, Grant/Award Number: FY21‐16035 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Funding information Health Services Research and Development, Grant/Award Number: IK2 HS00318; Veterans Health Administration, Office of Rural Health, Grant/Award Number: FY21‐16035 |
| ISSN: | 0017-9124 1475-6773 |
| DOI: | 10.1111/1475-6773.14055 |