Telemedicine found to reduce ED visits among senior living residents
Manish Shah, M.D., M.P.H.
The use of “high-intensity” telemedicine at senior living communities significantly reduces visits to emergency departments, according to research published Jan. 7 by Telemedicine and e-Health.
“Acute illness among senior living community residents often leads to emergency department visits,” said Manish Shah, M.D., M.P.H., associate professor of emergency medicine, public health sciences and medicine (geriatrics/aging) at the University of Rochester in New York. “We found that these virtual doctors' visits reduced the rate of ED use by 18% over the course of a year.”
And that 18% reduction was conservative, added Shah, who also is associate chairman for research in the Department of Emergency Medicine. “We provided telemedicine services only during limited weekday hours,” he said. “So intervention group subjects would have to go to the ED for care during weekends and evenings, reducing the effect on the rate of ED use compared with an always-available telemedicine model.”
Shah and his research team offered the option of high-intensity telemedicine to residents of six senior living communities in Rochester, NY. High intensity means that the telemedicine visits were assisted by a clinical technician at each resident's side, using equipment found in an ED that allow physicians to perform detailed clinical exams.
Results in the intervention group were compared with those of 16 senior living communities that did not offer a telemedicine option. At the intervention sites, residents with acute illnesses were offered telephone consultations, outpatient visits, ED referrals or telemedicine consultations.
More than 1,200 residents were followed from May 2010 to November 2013. During that time, 479 patients in the intervention group were provided care 503 times for illnesses. In 465 cases (90%), all services were delivered via telemedicine — no further immediate care, such as ED visits, was necessary.