Abstract
Due to the lack of expert clinical involvement in the nursing homes of Singapore, frail and older nursing home residents become frequent unnecessary users of acute care services. Telegeriatrics, a pilot programme implemented by an acute hospital in Singapore used videoconferencing to provide timelier geriatric care, which could reduce transfers to the acute hospital. We assess the impact of the level of engagement with Telegeriatrics has on nursing home to hospital transfer rates. From December 2010 to March 2015, a total of 579 telemedicine consultation episodes were conducted in two nursing homes. Hospital admission rates were monitored over a 2-year period and compared against the nursing home’s level of engagement with Telegeriatrics. The findings show a reduction in hospital admission rate for both nursing homes. There was a significant decrease of 33 % in hospital admission rates in the more-engaged nursing home while the less-engaged nursing home reported a 2 % increase. The results show that, by improving the availability of specialist support and with increased engagement in Telegeriatrics, unnecessary hospitalizations could be reduced. This leads to elimination of stress and disruption for the resident, as well as reduced costs and quicker medical care.
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References
Kim, H., et al.: Potentially preventable hospitalizations among older adults with diabetes. Am. J. Managed Care 17(1), 419–426 (2001)
Wolff, J.L., et al.: Prevalence, expenditures, and complications of multiple chronic conditions in the elderly. Arch. Intern. Med. 162, 2269–2276 (2002)
Cheah, J., Heng, B.H.: Implementing chronic disease management in the public healthcare sector in Singapore: the role of hospitals. World Hosp. Health Serv., 37(3), 19–23, 40–3 (2001)
Cheah, J.: Chronic disease management: a Singapore perspective. BMJ 323(7319), 990–993 (2001)
Tan, J.: Hospital-Acquired Infections. The New Paper, p. 7, 19 February 2013
Tinetti, M.E., et al.: A multifactorial intervention to reduce the risk of falling among elderly people living in the community. N. Engl. J. Med. 331, 821–827 (1994)
Burgio, K.L., et al.: Behavioral vs drug treatment for urge urinary incontinence in older women: a randomized controlled trial. J. Am. Med. Assoc. 280, 1995–2000 (1998)
Inouye, S.K., et al.: A multicomponent intervention to prevent delirium in hospitalized older patients. N. Engl. J. Med. 340, 669–676 (1999)
Day, P., Rasmussen, P.: What is the evidence for the effectiveness of specialist geriatric services in acute, post-acute and sub-acute settings? A critical appraisal of the literature. New Zealand Health Technology (NZHTA) Report, vol. 7, no. 3, pp. 1–169 (2004)
Ellis, G., et al.: Comprehensive geriatric assessment for older adults admitted to hospital: metaanalysis of randomised controlled trials. BMJ 343, d6553 (2011)
Ouslander, J.G.: Reducing potentially avoidable hospitalizations of nursing home residents: the INTERACT II project. Florida Medical Directors Association (FMDA) Progress Report (2009)
Moehr, J.R., et al.: Video conferencing-based telehealth–its implications for health promotion and health care. Methods Inf. Med. 44(2), 334–341 (2005)
Casavant, D.W., et al.: Trial of telemedicine for patients on home ventilator support: feasibility, confidence in clinical management and use in medical decision-making. J. Telemedicine Telecare 20(8), 441–449 (2014)
Graham, A.R.: Tele-education in medicine: why and how. Riv Med Lab – JLM 3(1), 24–26 (2002)
Pedley, D., et al.: A role for tele-education in the centralization of accident and emergency services. J. Telemedicine Telecare 9(1), 33–34 (2003)
Our Healthcare System, 30 October 2013. https://www.moh.gov.sg/content/moh_web/home/our_healthcare_system.html
Mamun, K., et al.: Polypharmacy and inappropriate medication use in Singapore nursing homes. Ann. Acad. Med. Singapore 33(1), 49–52 (2004)
Finkers, F., et al.: A study of medication reviews to identify drug-related problems of polypharmacy patients in the Dutch nursing home setting. J. Clin. Pharm. Ther. 32(5), 469–476 (2007)
Walsh, E.K., Cussen, K.: “Take ten minutes”: a dedicated ten minute medication review reduces polypharmacy in the elderly. Ir. Med. J. 103(8), 236–238 (2010)
Special issue on healthcare: healthy ageing and the future of public healthcare systems. European Commission (2009). http://ec.europa.eu/research/social-sciences/pdf/efmn-special-issue-on-healthcare_en.pdf. Accessed 22 November 2011
Vander Werf, M.: Ten critical steps for a successful telemedicine program. Stud. Health Technol. Inform. 104, 60–68 (2004)
Smart, N.: Exercise training for heart failure patients with and without systolic dysfunction: an evidence-based analysis of how patients benefit. Cardiol. Res. Pract., 2011 (2011). Article ID: 837238. http://doi.org/10.4061/2011/837238
Taylor, J., et al.: Examining the use of telehealth in community nursing: identifying the factors affecting frontline staff acceptance and telehealth adoption. J. Adv. Nurs. 71(2), 326–337 (2014)
McLean, S., et al.: Telehealthcare for chronic obstructive pulmonary disease. Cochrane Review and meta-analysis. Br. J. Gen. Pract. 62(604), 739–749 (2012)
Ellis, D.G., et al.: A telemedicine model for emergency care in a short-term correctional facility. Telemedicine J. e-health 7(2), 87–92 (2001)
Chaiyachati, K.H., et al.: Continuity in a VA Patient-Centered Medical Home Reduces Emergency Department Visits. PLoS ONE 9(5), e96356 (2014)
Grabowski, D.C., O’Malley, A.J.: Use of telemedicine can reduce hospitalizations of nursing home residents and generate savings for medicare. Health Aff. (Millwood) 33(2), 244–250 (2014)
Murray, E., Burns, J., May, C., Finch, T., O’Donnell, C., Wallace, P., Mair, F.: Why is it difficult to implement e-health initiatives? A qualitative study. Implementation Sci. ?: IS, 6, 6 (2011). http://doi.org/10.1186/1748-5908-6-6
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Toh, H. et al. (2015). Increased Engagement in Telegeriatrics Reduces Unnecessary Hospital Admissions of Nursing Home Residents. In: Helfert, M., Holzinger, A., Ziefle, M., Fred, A., O'Donoghue, J., Röcker, C. (eds) Information and Communication Technologies for Ageing Well and e-Health. ICT4AWE 2015. Communications in Computer and Information Science, vol 578. Springer, Cham. https://doi.org/10.1007/978-3-319-27695-3_5
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