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Student-Facilitated, Enhanced Telehealth Home Care for Older Adults and People with Disabilities
Kelly Goo1,2, Nicole Schindler3,4, Dana Rubenstein3,5
1Duke University School of Medicine, Durham, NC, USA. kellygoo526@gmail.com.
Background:
Primary care home visits benefit older adults and adults with disabilities but are often challenging to sustain. While telehealth is less costly and time-intensive, potential limitations include access, assessment adequacy, and patient satisfaction.
Aim:
To improve patient access to effective telehealth encounters as a component of home-based care while educating medical students via home visits.
Setting:
Home-based primary care program partnership between a federally qualified health center and a tertiary academic center in the Southeast US from November 2022 to June 2023.
Participants:
Eight medical students and eight patients.
Program Description:
Student pairs facilitated video telehealth encounters with patients in their homes supervised by an off-site clinician. Outcome measures included clinical activities conducted, patient satisfaction, and medical student reflections.
Program Evaluation:
Students facilitated 28 enhanced telehealth visits. In total, 287 clinical activities were performed. Of the 238 activities evaluated for clinical utility, 13.2% warranted an intervention. All patient participants were satisfied and interested in continuing. Student reflection themes included valuing longitudinal relationships, home-based care, and social determinants of health.
Discussion:
This novel program may improve patient access to home-based care via telehealth encounters facilitated by medical students and, concurrently, provide a model for student participation in home visits.
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