How Telehealth Addresses the Needs of Vulnerable Elders

Background: One of the most vulnerable groups is older persons who seek medical care (patients), especially those who are cognitively impaired with limited access to technology or knowledge of its use.

Intervention: Cuyahoga County Adult Protective Services (APS) partnered with the geriatricians who work at Cleveland Clinic to arrange for clients to be seen virtually in their home environment. Once a patient was identified as having cognitive concerns or an unaddressed medical issue, an appointment was scheduled for a concurrent in-home nurse and virtual visit with a geriatrician.The APS nurse visited the patient's residence to perform an in-home assessment followed by the virtual portion of the visit concurrent with the geriatrician using a Health Insurance Portability and Accountability Act (HIPAA)-compliant electronic platform.

Outcomes: Fifty-six patients were seen and evaluated in-home by a nurse and then simultaneously virtually by a geriatrician over a 12-month period. Among these patients, 53% had a guardian assigned, 55% were able to stay in their home, and 55% lacked regular health care before the visit, but afterward, 74% started primary medical care.

Conclusion: Physicians working collaboratively with community agencies for in-home technology-enhanced visits led to positive outcomes for this vulnerable older population.