A Pilot Program of Virtual Healthcare Delivery to Older Veterans

TL;DR

A new telemedicine program called TeleGEM provides comprehensive geriatric assessments to older Veterans who lack access to specialized care.

Contribution

The TeleGEM program introduces a novel interdisciplinary telemedicine model for delivering Comprehensive Geriatric Assessments to underserved Veterans.

Findings

Thirty-three Veterans aged 65 and older were evaluated using telemedicine technologies including carts, home devices, and E-consults.

The TeleGEM model uses the 5M framework to assess Veterans and reduces the need for travel to tertiary care centers.

The program demonstrates potential to improve quality of life and reduce travel burdens for frail older Veterans.

Abstract

Telemedicine and ECHO® programs have successfully assisted in delivering specialized medical care as part of outreach efforts to rural and underserved areas. We describe a new pilot, Tele Geriatric Evaluation & Management program (TeleGEM) undertaken by our GRECC (Geriatric Research Education and Clinical Center) using telemedicine to deliver an interdisciplinary team-based model of Comprehensive Geriatric Assessment to Veterans in the network who lacked access to this service. Our team included a geriatrician, registered nurse, pharmacist, and administrative assistant with rehab services and neuropsychology available on a consultative basis. Thirty-three frail Veterans,65y & older (average 77y) were referred to our program for evaluation during a 10-month period starting January 2024. Telemedicine technologies used to provide this service from the tertiary care facility included the use of telemedicine carts available at the local VA medical centers (67%), in Veterans’ homes using audiovisual digital devices and/or audio visits by telephone (24%), in addition to E-consults (9%) completed by chart reviews. Veterans were assessed using the 5M framework: what Matters, Mind, Multicomplexity, Medications, and Mobility. Other measures included mileage saved by avoiding travel to the geriatric clinics located at the tertiary care facility. The Tele GEM platform can serve as a novel and valuable healthcare delivery model of care providing comprehensive geriatric assessments which can help improve function and quality of life for frail older Veterans, thus reducing the burden of travel to tertiary care centers.