There and back again: the shape of telemedicine in U.S. nursing homes following COVID-19

• Published in: BMC geriatrics 2022-04, Vol.22 (1), p.337-337, Article 337
• Main Authors: Ford, 2nd, James H, Jolles, Sally A, Heller, Dee, Langenstroer, Madeline, Crnich, Christopher
• Format: Article
• Language: English
• Subjects: Content analysis; Coronaviruses; COVID-19; COVID-19 - epidemiology; Data collection; Electronic health records; Epidemics; Forecasts and trends; Geriatrics; Humans; Interviews; Long term health care; Mixed methods; Mixed methods research; Nursing Homes; Older people; Organizational enhancements; Pandemics; Patient safety; Primary care; Providers; Referral and Consultation; SEIPs model; Services; Severe acute respiratory syndrome coronavirus 2; Telemedicine
• ISSN: 1471-2318; 1471-2318
• DOI: 10.1186/s12877-022-03046-y

Telemedicine use in nursing homes (NHs) expanded during the COVID-19 pandemic. The objectives of this study were to characterize plans to continue telemedicine among newly adopting NHs and identify factors limiting its use after COVID-19. Key informants from 9 Wisconsin NHs that adopted telemedicine during COVID-19 were recruited. Semi-structured interviews and surveys were employed to identify participant perceptions about the value of telemedicine, implementation challenges encountered, and plans and barriers to sustaining its delivery after COVID-19. Directed content analysis and a deductive thematic approach using the Systems Engineering Initiative for Patient Safety (SEIPS) model was used during analyses. Quantitative and qualitative data were integrated to identify participant views on the value of telemedicine and the tools and work system enhancements needed to make telemedicine easier and more effective. All participating NHs indicated a preference to continue telemedicine after COVID-19. Urgent assessments of resident change-in-condition and cognitively based sub-specialty consultations were identified as the encounter types most amenable to telemedicine. Reductions in resident off-site encounters and minimization of resident therapy interruptions were identified as major benefits of telemedicine. Twelve work system enhancements needed to better sustain telemedicine were identified, including improvements to: 1) equipment/IT infrastructure; 2) scheduling; 3) information exchange; and 4) telemedicine facilitators. NHs that adopted telemedicine during COVID-19 wish to continue its use. However, interventions that enhance the integration of telemedicine into NH and off-site clinic work systems require changes to existing regulations and reimbursement models to sustain its utilization after COVID-19.