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Telehealth for geriatric post-emergency department visits to promote age-friendly care.

Publication ,  Journal Article
McQuown, CM; Snell, KT; Abbate, LM; Jetter, EM; Blatnik, JK; Ragsdale, LC
Published in: Health Serv Res
February 2023

OBJECTIVE: To describe a feasibility pilot study for older adults that addresses the digital divide, unmet health care needs, and the 4Ms of Age-Friendly Health Systems via the emergency department (ED) follow-up home visits supported by telehealth. DATA SOURCES AND STUDY SETTING: Data sources were a pre-implementation site survey and pilot phase individual-level patient data from six US Department of Veterans Affairs (VA) EDs. STUDY DESIGN: A pre-implementation survey assessed existing geriatric ED processes. In the pilot called SCOUTS (Supporting Community Outpatient, Urgent care & Telehealth Services), sites identified high-risk patients during an ED visit. After ED discharge, Intermediate Care Technicians (ICTs, former military medics), performed follow-up telephone, or home visits. During the follow-up visit, ICTs identified "what matters," performed geriatric screens aligned with Age-Friendly Health Systems, observed home safety risks, assisted with video telehealth check-ins with ED providers, and provided care coordination. SCOUTS visit data were recorded in the patient's electronic medical record using a standardized template. DATA COLLECTION/EXTRACTION METHODS: Sites were surveyed via electronic form. Administrative pilot data extracted from VA Corporate Data Warehouse, May-October 2021. PRINCIPLE FINDINGS: Site surveys showed none of the EDs had a formalized way of identifying the 4 M "what matters." During the pilot, ICT performed 56 telephone and 247 home visits. All home visits included a telehealth visit with an ED provider (n = 244) or geriatrician (n = 3). ICTs identified 44 modifiable home fall risks and 99 unmet care needs, recommended 80 pieces of medical equipment, placed 36 specialty care consults, and connected 180 patients to a Patient Aligned Care Team member for follow-up. CONCLUSIONS: A post-ED follow-up program in which former military medics perform geriatric screens and care coordination is feasible. Combining telehealth and home visits allows providers to address what matters and unmet care needs.

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Published In

Health Serv Res

DOI

EISSN

1475-6773

Publication Date

February 2023

Volume

58 Suppl 1

Issue

Suppl 1

Start / End Page

16 / 25

Location

United States

Related Subject Headings

  • Telemedicine
  • Pilot Projects
  • Patient Discharge
  • Humans
  • Health Policy & Services
  • Emergency Service, Hospital
  • Delivery of Health Care
  • Aged
  • 4407 Policy and administration
  • 4203 Health services and systems
 

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McQuown, C. M., Snell, K. T., Abbate, L. M., Jetter, E. M., Blatnik, J. K., & Ragsdale, L. C. (2023). Telehealth for geriatric post-emergency department visits to promote age-friendly care. Health Serv Res, 58 Suppl 1(Suppl 1), 16–25. https://doi.org/10.1111/1475-6773.14058
McQuown, Colleen M., Kristina T. Snell, Lauren M. Abbate, Ethan M. Jetter, Jennifer K. Blatnik, and Luna C. Ragsdale. “Telehealth for geriatric post-emergency department visits to promote age-friendly care.Health Serv Res 58 Suppl 1, no. Suppl 1 (February 2023): 16–25. https://doi.org/10.1111/1475-6773.14058.
McQuown CM, Snell KT, Abbate LM, Jetter EM, Blatnik JK, Ragsdale LC. Telehealth for geriatric post-emergency department visits to promote age-friendly care. Health Serv Res. 2023 Feb;58 Suppl 1(Suppl 1):16–25.
McQuown, Colleen M., et al. “Telehealth for geriatric post-emergency department visits to promote age-friendly care.Health Serv Res, vol. 58 Suppl 1, no. Suppl 1, Feb. 2023, pp. 16–25. Pubmed, doi:10.1111/1475-6773.14058.
McQuown CM, Snell KT, Abbate LM, Jetter EM, Blatnik JK, Ragsdale LC. Telehealth for geriatric post-emergency department visits to promote age-friendly care. Health Serv Res. 2023 Feb;58 Suppl 1(Suppl 1):16–25.
Journal cover image

Published In

Health Serv Res

DOI

EISSN

1475-6773

Publication Date

February 2023

Volume

58 Suppl 1

Issue

Suppl 1

Start / End Page

16 / 25

Location

United States

Related Subject Headings

  • Telemedicine
  • Pilot Projects
  • Patient Discharge
  • Humans
  • Health Policy & Services
  • Emergency Service, Hospital
  • Delivery of Health Care
  • Aged
  • 4407 Policy and administration
  • 4203 Health services and systems