Telemedicine for Patients with Dementia Can Significantly Decrease ED Visits
Madison, Wisconsin - A study of more than 700 patients with dementia showed the use of telemedicine for those patients in senior living facilities reduced emergency department (ED) visits by 24 percent.
Dr. Manish Shah, principal investigator and professor of emergency medicine at the University of Wisconsin School of Medicine and Public Health, presented the findings at the annual meeting of the Alzheimer’s Association International Conference in Los Angeles.
A total of 731 persons with dementia at 22 senior living centers in the northeastern United States were enrolled in the study, which ran for three and-a-half years. There were 214 intervention subjects and 517 control subjects who did not receive the intervention. Six of the senior living centers were chosen for the telemedicine visits.
Participants were considered to have dementia if they had a diagnosis, were receiving medications for the indication of dementia or had cognitive testing consistent with dementia.
Those in the intervention group had access to patient-to-provider high-intensity telemedicine for acute illnesses. They call this a “high-intensity” model because it is assisted by a technician at the patient’s side and captures much more clinical detail than simple video conferencing, including vital signs, images (e.g., skin, throat), video clips, sounds (e.g., lung, heart, bowel), and diagnostic testing such as electrocardiogram and specimens for laboratory testing (e.g., blood). When a participant felt ill and called the primary-care clinic to obtain care, the clinic would dispatch a technician to travel to the patient with telemedicine equipment to collect information regarding the patient’s condition. This information would then be communicated to the clinic provider, who would video conference with the patient and/or caregivers if needed and make a diagnosis and determine treatment.
The 731 enrolled participants had 1356 ED visits, 287 among intervention and 1069 among control-group participants. There were 201 high-intensity telemedicine visits for acute illnesses for the 214 intervention-group subjects.
“We found that in people with dementia, access to high-intensity telemedicine services is associated with an annualized 24 percent decrease in ED visits,” said Shah.
“More research is needed to understand how to effectively engage patients with dementia and the senior living centers in implementing telemedicine and maximizing the use of the technology.”
The study was funded by the National Institute on Aging of the National Institutes of Health (K24AG054560) and the Agency for Health Care Research and Quality (R01HS018047).
Date Published: 07/14/2019