Developing an approach for virtual care in older adults: A Delphi procedure

COVID-19 exemplified the need to adapt and update ways of seeing patients. Barriers to accessing in-person care during the pandemic challenged older adults' access to quality care and health management. We aim to develop a virtual care pathway to bridge this practice gap, adapted appropriately for this demographic.

Individuals who have used, who knew, or who cared for someone who used virtual care.

We created an approach to providing virtual care for older adults to enhance healthcare provider, patient, and care partner experiences. The online Delphi procedure, hosted on Qualtrics, consisted of two rounds. We used a mixed-methods approach including quantitative (descriptive, frequency, and proportions) and qualitative (feedback themes) analyses. Quantitative analyses were conducted using Microsoft Excel. Responses with a completion rate of ≥80% were used. Statements with a median ≥ 6 on the 7-point Likert scale and ≥75% agreement on multiple choice statements were included in the final pathway. Healthcare providers from various backgrounds, healthcare leadership, patients, and care partners were key contributors throughout the study.

Sixty-three panelists completed round one of which twenty-seven (42.9%) submitted complete responses for round two. The finalized approach consisted of 20 statements across four domains: virtual care principles (n = 7), clinic pre-assessments (n = 4), during each virtual assessment (n = 7), and clinic processes for virtual assessment (n = 2).

This approach highlights the importance of preparation, and benefits of, supporting virtual care for older adults. Virtual care can improve accessibility while complementing, not replacing, in-person care.