Objective: To assess the clinical role of a telemedicine program used to support a specialized geriatric outreach program, and to assay patient attitudes towards teleconsultation.
Design: A regional referral hospital with links to other hospitals and to a tertiary care academic health centre.
Materials and Methods: 53 consecutive telemedicine consultations over two years. Prospective, descriptive study, using standard evaluative instruments, and a patient/caregiver satisfaction questionnaire designed for this study.
Results: Patients seen in teleconsultation comprised 49% 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% “very” satisfied or higher) and 82% said that they were very confident in the diagnostic and therapeutic result. All indicated that they would use teleconsultation again. Important cost savings to patients (CDN $362.31) per visit were estimated from caregiver report.
Conclusion: 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 carers and physicians, and a useful adjunct to the delivery of health care in rural areas.
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