Feasibility of telemedicine for specialized geriatric care at a regional referral hospital

Purpose: To assess whether telemedicine is a feasible adjunct to a specialized geriatric outreach program at a regional referral hospital and to assay patient attitudes towards teleconsultation. Design and methods: Prospective, descriptive study, using standard evaluative instruments, and a patient/caregiver satisfaction questionnaire designed for this study, of 53 consecutive telemedicine consultations during two years at a regional referral hospital. Results: Teleconsultation comprised 49 per cent of all patient visits for tertiary geriatric referral during the study period. Most patients were elderly women, seen for assessment of cognitive impairment. None were seen exclusively by teleconsultation, which fulfilled the roles of follow-up and second opinion. No patient required an additional in-person assessment to achieve a diagnosis. Patients expressed a high level of satisfaction with teleconsultation (80 per cent "very" satisfied or higher) and 82 per cent said they were very confident in the diagnostic and therapeutic result. All indicated they would use teleconsultation again. Important cost savings to patients ($362.31) per visit were estimated from caregiver report. Discussion: In the roles of follow-up and for diagnostic review, teleconsultation was a worthwhile support to specialized geriatric services in a rural area, rather than substituting for it. Teleconsultation appears to be feasible for older patients, their caregivers and physicians, and a useful adjunct to the delivery of health care in rural areas.