Interactive video specialty consultations in long-term care

OBJECTIVES: To assess provider and resident satisfaction with and outcomes of specialist physician consultations provided via interactive video to residents of a long-term care (LTC) center. DESIGN: Cross-sectional survey. SETTING: Two Veterans Affairs Medical Centers (VAMC) and a state LTC center. PARTICIPANTS: Physicians (n=12) at the VAMC and nurses (n=30) and residents (n=62) at the LTC center. INTERVENTION: Interactive video conferencing to provide physician specialty visits to residents at the LTC center. MEASUREMENTS: Satisfaction ratings and record review to determine changes in treatment plan and follow-up care. RESULTS: Data were collected on 76 individual consultations in six clinics. The most frequent outcome was a change in treatment plan with the resident remaining at the LTC setting (n=29, 38%) or no change in treatment (n=26, 34%). Physicians' ratings were 78% good to excellent for usefulness in developing a diagnosis, 87% good to excellent for usefulness in developing a treatment plan, 79% good to excellent for quality of transmission, and 86% good to excellent satisfaction with the consult format. Overall, 72% of residents were satisfied with the consult format, and 92% felt that it was easier to obtain medical care via telemedicine. Nurses felt that the telemedicine clinics were a good use of their time and skills (100%). CONCLUSION: There was a high rate of physician, patient, and nurse satisfaction with interactive video conferencing. Care delivered to residents of LTC settings via video conferencing offers a number of potential advantages, including avoidance of travel for patient and provider and potentially greater continuity of care.