Online geriatric assessments are as reliable as face-to-face decisions when geriatricians consider the suitability of residential care for older hospital patients, a study has found.
Researchers at The University of Queensland tested whether decisions made by geriatricians based on a structured online assessment - using data collected in person by a trained nurse - were any less reliable than face-to-face decisions.
Dr Melinda Martin-Khan from the Centre for Health Services Research (CHSR) said the online method had a 91 per cent rate of agreement, compared to 88 per cent for the conventional assessment.
“This outcome shows that if there is good preparation of the clinical case a geriatrician can make decisions online, without seeing the person, as accurately as conventional in-person consultations,” Dr Martin-Khan said.
“Nurses are trained to collect case information from patients and to work in collaboration with families and other medical staff - they play a key role in this process.
“Nurses, along with the sophisticated assessment system, may have helped to close the gap between agreement with the online assessment and face-to-face decisions.”
Study participants were individuals admitted to three participating hospitals who required comprehensive geriatric assessment.
CHSR Director, Professor Leonard Gray, said the study outcome was particularly important for those communities where there is no geriatrician available.
“When an older person is referred to residential care it is often the last life move they will make,” Dr Martin-Khan said.
“It can be a very complex decision taking into account a whole gamut of issues ranging from medication management to physical health and depression, dementia, delirium and social circumstances.
“Families want to be confident that their loved ones are not being prematurely placed in residential care, if referral can be delayed by adjusting their medication or providing other support.
“Equally, we need to be sure that if an older person is not referred to residential care that they will be safe and supported.”
UQ’s Centre for Research in Geriatric Medicine and Centre for Online Health are using a combination of online and video conference consultations to support small rural hospitals where specialist advice for the care of older adults is often not available.
“Even in city practice where geriatricians are in short supply this consultation method could make reliable assessments available for more patients, without increasing healthcare costs,” Dr Martin-Khan said.
The study is published in the Journal of The American Geriatrics Society.
Media: Dr Melinda Martin-Khan, m.martinkhan@uq.edu.au, +61 7 3176 5677; Kim Lyell, k.lyell@uq.edu.au, 0427 530647.
