Teleconsultation in geriatrics: impact on professional practice.

Area of Science:

• Geriatric Medicine
• Health Services Research
• Medical Informatics

Background:

• Teleconsultations are encouraged to improve access to specialist care for isolated elderly patients.
• Implementing teleconsultations can alter established clinical practices and may face non-technical barriers.
• Qualitative research is essential to understand the organizational and practice impacts of teleconsultation.

Purpose of the Study:

• To analyze the impact of a teleconsultation system on professional work practices and care organization.
• To explore changes in interactions and knowledge sharing between geriatricians and specialists.
• To identify factors facilitating or hindering the routine use of teleconsultations in geriatric care.

Main Methods:

• Qualitative analysis of an established teleconsultation system between a geriatric and a tertiary care hospital.
• Observation of 66 teleconsultations (experimental and routine phases).
• Semi-structured interviews with 10 key stakeholders involved in teleconsultations.

Main Results:

• Teleconsultation use altered work practices for both geriatricians and specialists.
• Effective patient examination via teleconsultation depended on cooperation and trust.
• New professional relationships fostered knowledge sharing and created alliances, though requiring geriatrician humility.
• Organizational adaptations, including schedule changes and telemedicine support, were necessary for routine use.

Conclusions:

• The teleconsultation system was suitable for specialists, with collaboration being a key advantage.
• Improved elderly patient care resulted from enhanced professional relationships.
• Successful adaptation required project management support during the experimental phase.
• Teleconsultations are not universally applicable across all specialties or situations and necessitate new organizational models.