A Qualitative Evaluation of a Telemedicine-Enhanced Emergency Care Program for Older Adults
Objectives To document the experiences of patients, their caregivers, healthcare personnel, and staff members with a program that provides telemedicine‐enhanced emergency care to older adults residing in senior living communities (SLCs) and to delineate perceived barriers and facilitators. Design Qu...
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| Veröffentlicht in: | Journal of the American Geriatrics Society (JAGS) 2013-04, Vol.61 (4), p.571-576 |
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| container_title | Journal of the American Geriatrics Society (JAGS) |
| container_volume | 61 |
| creator | Shah, Manish N. Morris, Dylan Jones, Courtney M. C. Gillespie, Suzanne M. Nelson, Dallas L. McConnochie, Kenneth M. Dozier, Ann |
| description | Objectives
To document the experiences of patients, their caregivers, healthcare personnel, and staff members with a program that provides telemedicine‐enhanced emergency care to older adults residing in senior living communities (SLCs) and to delineate perceived barriers and facilitators.
Design
Qualitative study.
Setting
A primary care geriatric medicine practice.
Participants
Stakeholders associated with telemedicine visits: patients, family caregivers, telemedicine dispatcher, certified telemedicine assistants, telemedicine providers, and SLC staff.
Measurements
Between June and August 2011, telemedicine encounters were observed, and field notes were recorded. After each telemedicine visit, all participants were interviewed using a semistructured guide. Discrete statements from interviews and field notes were coded and arranged into themes. Concordance or discordance in field notes and stakeholder responses were grouped for analysis.
Results
After 10 telemedicine visits and 34 interviews from 21 unique participants, redundancy was achieved. Participants and their families overwhelmingly reported satisfaction with their care, remarking particularly on the convenience, speed, and completeness of the evaluation. Participants reported some unmet expectations regarding provider presence at home and visit length. Providers thought telemedicine made them more efficient overall and improved diagnostic certainty but considered in‐person visits to be superior. All stakeholders, including patients, noted inadequate telemedicine technician training, leading to low confidence levels and performance difficulties. Participants, providers, and telemedicine technicians cited problems with the reliability, weight, and size of the equipment as serious challenges, decreasing their satisfaction and increasing their frustration.
Conclusion
Telemedicine‐enhanced emergency care is an acceptable method of providing emergency care to older adults in SLCs. Stakeholders report a number of advantages. Training and technology barriers require particular attention. |
| doi_str_mv | 10.1111/jgs.12157 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1365982509</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1327725953</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5247-e9c2a15630372100bd75de900c590794e04911080332e54ed7b0ec3920b935413</originalsourceid><addsrcrecordid>eNqN0U1v1DAQBmALgehSOPAHkCWERA9px19xfFxW24W2onwUIcHB8iaTJYuTFDtp2X-Py26LhISEL_bhmbFmXkKeMjhk6RytV_GQcab0PTJhSvBMSabukwkA8KzImdwjj2JcAzAORfGQ7HEhFQcjJ-TrlL4fnW8GNzRXSOdXzo_p2Xe0r6mjF-ixxaopmw6zeffNdSVWdN5iWGFXbujMBaTvQr8KrqV1H-i5rzDQaTX6IT4mD2rnIz7Z3fvk0_H8YvY6OztfvJlNz7JScakzNCV3TOUChOYMYFlpVaEBKJUBbSSCNIxBAUJwVBIrvQQsheGwNCJNKvbJy23fy9D_GDEOtm1iid67DvsxWiZyZQquwPwH5VpzZZRI9PlfdN2PoUuDWCaFKVhe5EVSB1tVhj7GgLW9DE3rwsYysDfh2BSO_R1Oss92HcdlWuqdvE0jgRc74GLpfB3Supv4x2lhJOc3Uxxt3XXjcfPvH-3J4uPt19m2ookD_ryrcOG7zbXQyn5-u7AfTr8cw8mrU7sQvwAnYLDP</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1439816868</pqid></control><display><type>article</type><title>A Qualitative Evaluation of a Telemedicine-Enhanced Emergency Care Program for Older Adults</title><source>MEDLINE</source><source>Wiley Online Library All Journals</source><creator>Shah, Manish N. ; Morris, Dylan ; Jones, Courtney M. C. ; Gillespie, Suzanne M. ; Nelson, Dallas L. ; McConnochie, Kenneth M. ; Dozier, Ann</creator><creatorcontrib>Shah, Manish N. ; Morris, Dylan ; Jones, Courtney M. C. ; Gillespie, Suzanne M. ; Nelson, Dallas L. ; McConnochie, Kenneth M. ; Dozier, Ann</creatorcontrib><description>Objectives
To document the experiences of patients, their caregivers, healthcare personnel, and staff members with a program that provides telemedicine‐enhanced emergency care to older adults residing in senior living communities (SLCs) and to delineate perceived barriers and facilitators.
Design
Qualitative study.
Setting
A primary care geriatric medicine practice.
Participants
Stakeholders associated with telemedicine visits: patients, family caregivers, telemedicine dispatcher, certified telemedicine assistants, telemedicine providers, and SLC staff.
Measurements
Between June and August 2011, telemedicine encounters were observed, and field notes were recorded. After each telemedicine visit, all participants were interviewed using a semistructured guide. Discrete statements from interviews and field notes were coded and arranged into themes. Concordance or discordance in field notes and stakeholder responses were grouped for analysis.
Results
After 10 telemedicine visits and 34 interviews from 21 unique participants, redundancy was achieved. Participants and their families overwhelmingly reported satisfaction with their care, remarking particularly on the convenience, speed, and completeness of the evaluation. Participants reported some unmet expectations regarding provider presence at home and visit length. Providers thought telemedicine made them more efficient overall and improved diagnostic certainty but considered in‐person visits to be superior. All stakeholders, including patients, noted inadequate telemedicine technician training, leading to low confidence levels and performance difficulties. Participants, providers, and telemedicine technicians cited problems with the reliability, weight, and size of the equipment as serious challenges, decreasing their satisfaction and increasing their frustration.
Conclusion
Telemedicine‐enhanced emergency care is an acceptable method of providing emergency care to older adults in SLCs. Stakeholders report a number of advantages. Training and technology barriers require particular attention.</description><identifier>ISSN: 0002-8614</identifier><identifier>EISSN: 1532-5415</identifier><identifier>DOI: 10.1111/jgs.12157</identifier><identifier>PMID: 23452094</identifier><identifier>CODEN: JAGSAF</identifier><language>eng</language><publisher>Hoboken, NJ: Blackwell Publishing Ltd</publisher><subject>Aged ; Aged, 80 and over ; Assisted Living Facilities ; Biological and medical sciences ; elderly ; emergency care ; Emergency medical care ; Emergency Service, Hospital - organization & administration ; Female ; General aspects ; Geriatric Assessment - methods ; Geriatric Assessment - statistics & numerical data ; Humans ; Male ; Medical sciences ; Middle Aged ; Miscellaneous ; Older people ; Outcome and Process Assessment (Health Care) ; Physician-Patient Relations ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Qualitative research ; Referral and Consultation - statistics & numerical data ; Residence Characteristics ; Telemedicine ; Telemedicine - methods ; United States</subject><ispartof>Journal of the American Geriatrics Society (JAGS), 2013-04, Vol.61 (4), p.571-576</ispartof><rights>2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society</rights><rights>2014 INIST-CNRS</rights><rights>2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.</rights><rights>2013 American Geriatrics Society and Wiley Periodicals, Inc</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5247-e9c2a15630372100bd75de900c590794e04911080332e54ed7b0ec3920b935413</citedby><cites>FETCH-LOGICAL-c5247-e9c2a15630372100bd75de900c590794e04911080332e54ed7b0ec3920b935413</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjgs.12157$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjgs.12157$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,27923,27924,45573,45574</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27394229$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23452094$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shah, Manish N.</creatorcontrib><creatorcontrib>Morris, Dylan</creatorcontrib><creatorcontrib>Jones, Courtney M. C.</creatorcontrib><creatorcontrib>Gillespie, Suzanne M.</creatorcontrib><creatorcontrib>Nelson, Dallas L.</creatorcontrib><creatorcontrib>McConnochie, Kenneth M.</creatorcontrib><creatorcontrib>Dozier, Ann</creatorcontrib><title>A Qualitative Evaluation of a Telemedicine-Enhanced Emergency Care Program for Older Adults</title><title>Journal of the American Geriatrics Society (JAGS)</title><addtitle>J Am Geriatr Soc</addtitle><description>Objectives
To document the experiences of patients, their caregivers, healthcare personnel, and staff members with a program that provides telemedicine‐enhanced emergency care to older adults residing in senior living communities (SLCs) and to delineate perceived barriers and facilitators.
Design
Qualitative study.
Setting
A primary care geriatric medicine practice.
Participants
Stakeholders associated with telemedicine visits: patients, family caregivers, telemedicine dispatcher, certified telemedicine assistants, telemedicine providers, and SLC staff.
Measurements
Between June and August 2011, telemedicine encounters were observed, and field notes were recorded. After each telemedicine visit, all participants were interviewed using a semistructured guide. Discrete statements from interviews and field notes were coded and arranged into themes. Concordance or discordance in field notes and stakeholder responses were grouped for analysis.
Results
After 10 telemedicine visits and 34 interviews from 21 unique participants, redundancy was achieved. Participants and their families overwhelmingly reported satisfaction with their care, remarking particularly on the convenience, speed, and completeness of the evaluation. Participants reported some unmet expectations regarding provider presence at home and visit length. Providers thought telemedicine made them more efficient overall and improved diagnostic certainty but considered in‐person visits to be superior. All stakeholders, including patients, noted inadequate telemedicine technician training, leading to low confidence levels and performance difficulties. Participants, providers, and telemedicine technicians cited problems with the reliability, weight, and size of the equipment as serious challenges, decreasing their satisfaction and increasing their frustration.
Conclusion
Telemedicine‐enhanced emergency care is an acceptable method of providing emergency care to older adults in SLCs. Stakeholders report a number of advantages. Training and technology barriers require particular attention.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Assisted Living Facilities</subject><subject>Biological and medical sciences</subject><subject>elderly</subject><subject>emergency care</subject><subject>Emergency medical care</subject><subject>Emergency Service, Hospital - organization & administration</subject><subject>Female</subject><subject>General aspects</subject><subject>Geriatric Assessment - methods</subject><subject>Geriatric Assessment - statistics & numerical data</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Older people</subject><subject>Outcome and Process Assessment (Health Care)</subject><subject>Physician-Patient Relations</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Qualitative research</subject><subject>Referral and Consultation - statistics & numerical data</subject><subject>Residence Characteristics</subject><subject>Telemedicine</subject><subject>Telemedicine - methods</subject><subject>United States</subject><issn>0002-8614</issn><issn>1532-5415</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqN0U1v1DAQBmALgehSOPAHkCWERA9px19xfFxW24W2onwUIcHB8iaTJYuTFDtp2X-Py26LhISEL_bhmbFmXkKeMjhk6RytV_GQcab0PTJhSvBMSabukwkA8KzImdwjj2JcAzAORfGQ7HEhFQcjJ-TrlL4fnW8GNzRXSOdXzo_p2Xe0r6mjF-ixxaopmw6zeffNdSVWdN5iWGFXbujMBaTvQr8KrqV1H-i5rzDQaTX6IT4mD2rnIz7Z3fvk0_H8YvY6OztfvJlNz7JScakzNCV3TOUChOYMYFlpVaEBKJUBbSSCNIxBAUJwVBIrvQQsheGwNCJNKvbJy23fy9D_GDEOtm1iid67DvsxWiZyZQquwPwH5VpzZZRI9PlfdN2PoUuDWCaFKVhe5EVSB1tVhj7GgLW9DE3rwsYysDfh2BSO_R1Oss92HcdlWuqdvE0jgRc74GLpfB3Supv4x2lhJOc3Uxxt3XXjcfPvH-3J4uPt19m2ookD_ryrcOG7zbXQyn5-u7AfTr8cw8mrU7sQvwAnYLDP</recordid><startdate>201304</startdate><enddate>201304</enddate><creator>Shah, Manish N.</creator><creator>Morris, Dylan</creator><creator>Jones, Courtney M. C.</creator><creator>Gillespie, Suzanne M.</creator><creator>Nelson, Dallas L.</creator><creator>McConnochie, Kenneth M.</creator><creator>Dozier, Ann</creator><general>Blackwell Publishing Ltd</general><general>Wiley-Blackwell</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7TK</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope></search><sort><creationdate>201304</creationdate><title>A Qualitative Evaluation of a Telemedicine-Enhanced Emergency Care Program for Older Adults</title><author>Shah, Manish N. ; Morris, Dylan ; Jones, Courtney M. C. ; Gillespie, Suzanne M. ; Nelson, Dallas L. ; McConnochie, Kenneth M. ; Dozier, Ann</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5247-e9c2a15630372100bd75de900c590794e04911080332e54ed7b0ec3920b935413</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Assisted Living Facilities</topic><topic>Biological and medical sciences</topic><topic>elderly</topic><topic>emergency care</topic><topic>Emergency medical care</topic><topic>Emergency Service, Hospital - organization & administration</topic><topic>Female</topic><topic>General aspects</topic><topic>Geriatric Assessment - methods</topic><topic>Geriatric Assessment - statistics & numerical data</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Older people</topic><topic>Outcome and Process Assessment (Health Care)</topic><topic>Physician-Patient Relations</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Qualitative research</topic><topic>Referral and Consultation - statistics & numerical data</topic><topic>Residence Characteristics</topic><topic>Telemedicine</topic><topic>Telemedicine - methods</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shah, Manish N.</creatorcontrib><creatorcontrib>Morris, Dylan</creatorcontrib><creatorcontrib>Jones, Courtney M. C.</creatorcontrib><creatorcontrib>Gillespie, Suzanne M.</creatorcontrib><creatorcontrib>Nelson, Dallas L.</creatorcontrib><creatorcontrib>McConnochie, Kenneth M.</creatorcontrib><creatorcontrib>Dozier, Ann</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><jtitle>Journal of the American Geriatrics Society (JAGS)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shah, Manish N.</au><au>Morris, Dylan</au><au>Jones, Courtney M. C.</au><au>Gillespie, Suzanne M.</au><au>Nelson, Dallas L.</au><au>McConnochie, Kenneth M.</au><au>Dozier, Ann</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Qualitative Evaluation of a Telemedicine-Enhanced Emergency Care Program for Older Adults</atitle><jtitle>Journal of the American Geriatrics Society (JAGS)</jtitle><addtitle>J Am Geriatr Soc</addtitle><date>2013-04</date><risdate>2013</risdate><volume>61</volume><issue>4</issue><spage>571</spage><epage>576</epage><pages>571-576</pages><issn>0002-8614</issn><eissn>1532-5415</eissn><coden>JAGSAF</coden><abstract>Objectives
To document the experiences of patients, their caregivers, healthcare personnel, and staff members with a program that provides telemedicine‐enhanced emergency care to older adults residing in senior living communities (SLCs) and to delineate perceived barriers and facilitators.
Design
Qualitative study.
Setting
A primary care geriatric medicine practice.
Participants
Stakeholders associated with telemedicine visits: patients, family caregivers, telemedicine dispatcher, certified telemedicine assistants, telemedicine providers, and SLC staff.
Measurements
Between June and August 2011, telemedicine encounters were observed, and field notes were recorded. After each telemedicine visit, all participants were interviewed using a semistructured guide. Discrete statements from interviews and field notes were coded and arranged into themes. Concordance or discordance in field notes and stakeholder responses were grouped for analysis.
Results
After 10 telemedicine visits and 34 interviews from 21 unique participants, redundancy was achieved. Participants and their families overwhelmingly reported satisfaction with their care, remarking particularly on the convenience, speed, and completeness of the evaluation. Participants reported some unmet expectations regarding provider presence at home and visit length. Providers thought telemedicine made them more efficient overall and improved diagnostic certainty but considered in‐person visits to be superior. All stakeholders, including patients, noted inadequate telemedicine technician training, leading to low confidence levels and performance difficulties. Participants, providers, and telemedicine technicians cited problems with the reliability, weight, and size of the equipment as serious challenges, decreasing their satisfaction and increasing their frustration.
Conclusion
Telemedicine‐enhanced emergency care is an acceptable method of providing emergency care to older adults in SLCs. Stakeholders report a number of advantages. Training and technology barriers require particular attention.</abstract><cop>Hoboken, NJ</cop><pub>Blackwell Publishing Ltd</pub><pmid>23452094</pmid><doi>10.1111/jgs.12157</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0002-8614 |
| ispartof | Journal of the American Geriatrics Society (JAGS), 2013-04, Vol.61 (4), p.571-576 |
| issn | 0002-8614 1532-5415 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1365982509 |
| source | MEDLINE; Wiley Online Library All Journals |
| subjects | Aged Aged, 80 and over Assisted Living Facilities Biological and medical sciences elderly emergency care Emergency medical care Emergency Service, Hospital - organization & administration Female General aspects Geriatric Assessment - methods Geriatric Assessment - statistics & numerical data Humans Male Medical sciences Middle Aged Miscellaneous Older people Outcome and Process Assessment (Health Care) Physician-Patient Relations Public health. Hygiene Public health. Hygiene-occupational medicine Qualitative research Referral and Consultation - statistics & numerical data Residence Characteristics Telemedicine Telemedicine - methods United States |
| title | A Qualitative Evaluation of a Telemedicine-Enhanced Emergency Care Program for Older Adults |
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