Telehealth for older patients: the Hong Kong experience

We studied the feasibility, acceptability and cost-effectiveness of using telemedicine to provide geriatric services to residents of nursing homes. A local 200-bed nursing home supported by the community geriatric assessment team (CGAT) participated in a one-year study, during which videoconferencing was used to replace conventional outreach or clinic-based geriatric care. The feasibility of telemedicine was evaluated by participating specialists in a total of 1001 consultations. Other outcome measures included productivity gains, utilization of hospital emergency and inpatient services, and user satisfaction. Telemedicine was adequate for patient care in 60-99% of cases in seven different disciplines. The CGAT was able serve more patients and see them earlier and more frequently. Telemedicine was cheaper than conventional care, and well accepted by health-care professionals as well as clients. Substantial savings were achieved in the study period through a 9% reduction in visits to the hospital emergency department and 11% fewer hospital bed-days. Telemedicine was a feasible means of care delivery to a nursing home and resulted in enhanced productivity and cost-savings. Linking more such institutions to care providers would further increase cost-effectiveness.