Avoid common mistakes on your manuscript.
Three years after the invention of the telephone in 1876, physicians first used the telephone to reduce unnecessary office visits. By the early 1900s telephone communication between physicians and patients was becoming not uncommon. In 1924 the cover of Radio News showed a picture of a visionary radio doctor who was connected to his patient by a live picture and audio. Later in the 1920s Dr. Hugo Gernsback created the concept of “teledactyl” where the physician could not only hear and see their patient, but also examine them with robotic arms. At the end of the 1920s radio communication was used to provide medical care in remote areas such as Australia and to ships to care for sick passengers. By the end of the 1940s radiographs were being transmitted by telegraph. In 1964 the first telelink was established in Nebraska to provide psychiatric and neurological services. In 1967, the Massachusetts General Hospital established a telehealth link to provide care to persons at Boston’s Logan Airport (1, 2). In the 1960s with the advent of space travel, NASA established systems to collect biometric data and to provide medical care to astronauts.
In 1977 the Veterans Administration developed its telehealth outreach system to veterans in the USA who predominantly lived in rural areas. The GRECC Connect was established in 2008 to provide geriatric services to older veterans in rural centers (3).
In the last decade telehealth has become established in the USA, particularly in the Veterans Administration (4). Much data now suggests that video conference health professional visits are comparable to in person visits (5). This has been particularly true in dermatology, chronic heart failure, hypertension and diabetes mellitus. The major advantage of telemedicine for older persons is that it allows most of their medical visits to be at home rather than in a physician’s office. It also means that when an older person is developing a problem, they can rapidly interact with a health professional. The disadvantage is the problems an older person may have with using the technology, but as many older persons visit their health professional with a family member this can solve the problem. Over the past year the Saint Louis University geriatrics team has successfully done complex geriatric consults, predominantly in persons with moderate dementia, successfully over Zoom.
Besides regular visits for persons who are stable with chronic diseases, telehealth is an excellent way to manage geriatric syndromes. We have developed the Rapid Geriatric Assessment (RGA) which is an excellent approach to diagnose and follow frailty, sarcopenia, anorexia of aging and cognitive dysfunction (6, 7). We have also developed a computer assisted program that can identify and suggest management approaches for the syndromes (8). The RGA also asks that older person what matters to them and explores their approach to advance directives. At Saint Louis University, we have developed a computer based annual wellness visit which can be completed annually with the assistance of a caregiver. For persons with sarcopenia exercises can be delivered by the telehealth “geroton”. For persons with dysphoria, we have used the Finnish “Circle of Friends” approach by telehealth (9). Cognitive Stimulation Therapy (CST) is an excellent approach to slow cognitive decline and can be delivered by telehealth (10). Provided technical glitches can be solved, caregivers and patients are happy with video telehealth (11). It is important to health professionals delivering telehealth that they be aware that there are many unique factors involved to do this successfully and they be able to adapt to them (12).
A home telehealth program can enhance an older person’s quality of life and in addition telehealth can be used to deliver rehabilitation programs in the home. Telemedicine is a reasonable alternative for older persons with cognitive problems in comparison to in person visits (13). Telemedicine can decrease emergency department visits in community dwelling seniors (14). Telemedicine can decrease emergency department visits in community dwelling seniors (14).
References
Bashur R, Lovett J. Assessment of telemedicine: Results of the initial experience. Aviat Space Environ ed 1977;Jan;48(1):65–70.
Zundel KM. Telemedicine: History, applications, and impact on librarianship. Bull Med Libr Assoc 1996;84(1):71–75.
Pimentel CB, Gately M, Barczi SR, et al. GRECC Connect: Geriatrics telehealth to empower health care providers and improve management of older veterans in rural communities. Federal Practitioner 2019;Oct:464–470.
Merrell RC. Geriatric telemedicine: Background and evidence for telemedicine as a way to address the challenges of geriatrics. Healthc Inform Res 2015;21:223–229.
Bashshur RL, Shannon GW. History of telemedicine: evolution, context, and transformation. New Rochelle (NY): Mary Ann Liebert; 2009
Merchant RA, Hui RJY, Kwek SC, et al. Rapid Geriatric Assessment using mobile app in primary care: Prevalence of geriatric syndromes and review of its feasibility. Front Med (Lausanne). 2020;7:261. eCollection 2020.
Sanford AM, Morley JE, Berg-Weger M, et al. High prevalence of geriatric syndromes in older adults. PLoS One 2020;15(6):e0233857. eCollection 2020.
Morley JE. Rapid Geriatric Assessment: Secondary prevention to stop age-associated disability. Clin Geriatr Med 2017;33:431–440.
Zubatsky M. Virtual groups to address the health of homebound adults during COVID-19: A biopsychosocial network. J Nutr Health Aging 2021;25:281–283.
Zubatsky M, Berg-Weger M, Morley J. Using telehealth groups to combat loneliness in older adults through COVID-19. J Am Geriatr Soc 2020;68:1678–1679.
Gately ME, Tickle-Degnen L, Trudeau SA, et al. Caregiver satisfaction with a video telehealth home safety evaluation for dementia. Int J Telerehabil 2020;8:12(2):35–42.
Weiss EF, Malik R, Santos T, et al. Telehealth for the cognitively impaired older adult and their caregivers: Lessons from a coordinated approach. Neurodegener Dis Manag 2021;11:83–89.
Poon P, Hu E, Dai D, et al. Cognitive intervention for community-dwelling older persons with memory problems: Telemedicine versus face-to-face treatment. Int J Geriatr Psychiatry 2005;20:285–286.
Gillespie SM, Shah MN, Wasserman EB, et al. Reducing emergency department utilization through engagement in telemedicine by senior living communities. Telemed j E Health 2016;22:489–496.
Hui E, Woo J. Telehealth for older patients: The Hong Kong experience. J Telemed Telecare 2002.8 Suppl 3:53:39–41.
Zulfiqar AA, Hajjam A, Talha S, et al. Telemedicine and geriatrics in France: Inventory of experiments. Current Gerontol Geriatr Res 2018; DOI.https://doi.org/10.1155/2018/9042180.
Groom LL, McCarthy MM, Stipfel AW, Brody AA. Telemedicine and telehealth in nursing homes; An integrative review. J Am Med Dir Assoc 2021;Apr 2;S1525-8610(21)00258-09.
Inyer S, Mehta P, Weith J, et al. Converting a geriatrics clinic to virtual visits during COVID-19: A case study. J Prim Care Community Health 2021;12: DOI: https://doi.org/10.1177/21501327211000235.
Hawley CE, Genovese N, Owsiany MT, et al. Rapid integration of home telehealth visits amidst COVID-19: What do older adults need to succeed? J Am Geriatr Soc 2020;68:2431–2439.
Doraiswamy S, Jithesh A, Mamtani R, et al. Telehealth use in geriatrics during the COVID-19 pandemic—A scope review and evidence synthesis. Int J Environ Res Public Health. 2021;18:1755. DOI:https://doi.org/10.3390/ijerph18041755.
Acknowledgement
The work in this editorial was funded by the Geriatric Workforce Enhancement Program (GWEP).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest: The author declares there are no conflicts.
Rights and permissions
About this article
Cite this article
Morley, J.E. Telehealth and Geriatrics. J Nutr Health Aging 25, 712–713 (2021). https://doi.org/10.1007/s12603-021-1643-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12603-021-1643-1