The Use of Telemedicine in Nursing Homes: A Mixed-Method Study to Identify Critical Factors When Connecting with a General Hospital

Clément Cormi, Jan Chrusciel, Antoine Fayol, Michel Van Rechem, Khuloud Abou-Amsha, Matthieu Tixier, Myriam Lewkowicz, David Laplanche and Stéphane Sanchez
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Clément Cormi: Pôle Territorial Santé Publique et Performance des Hôpitaux Champagne Sud, Centre Hospitalier de Troyes, 10000 Troyes, France
Jan Chrusciel: Pôle Territorial Santé Publique et Performance des Hôpitaux Champagne Sud, Centre Hospitalier de Troyes, 10000 Troyes, France
Antoine Fayol: Hôpital Européen Georges Pompidou, AP-HP, Université de Paris, 75015 Paris, France
Michel Van Rechem: Service des Urgences, Centre Hospitalier de Troyes, 10000 Troyes, France
Khuloud Abou-Amsha: LIST3N/Tech-CICO, Troyes University of Technology, CEDEX, 10300 Troyes, France
Matthieu Tixier: LIST3N/Tech-CICO, Troyes University of Technology, CEDEX, 10300 Troyes, France
Myriam Lewkowicz: LIST3N/Tech-CICO, Troyes University of Technology, CEDEX, 10300 Troyes, France
David Laplanche: Pôle Territorial Santé Publique et Performance des Hôpitaux Champagne Sud, Centre Hospitalier de Troyes, 10000 Troyes, France
Stéphane Sanchez: Pôle Territorial Santé Publique et Performance des Hôpitaux Champagne Sud, Centre Hospitalier de Troyes, 10000 Troyes, France

IJERPH, 2021, vol. 18, issue 21, 1-11

Abstract: Evaluating the use and impact of telemedicine in nursing homes is necessary to promote improvements in the quality of this practice. Even though challenges and opportunities of telemedicine are increasingly becoming well documented for geriatrics (such as improving access to healthcare, patient management, and education while reducing costs), there is still limited knowledge on how to better implement it in an inter-organizational context, especially when considering nursing homes. In this regard, this study aimed first to describe the telemedicine activity of nursing homes when cooperating with a general hospital; and then understand the behavioral differences amongst nursing homes while identifying critical factors when implementing a telemedicine project. We conducted a sequential, explanatory mixed-method study using quantitative then qualitative methods to better understand the results. Three years of teleconsultation data of twenty-six nursing homes (15 rural and 11 urban) conducting teleconsultations with a general hospital (Troyes Hospital, France) were included for the quantitative analysis, and eleven telemedicine project managers for the qualitative analysis. Between April 2018 and April 2021, 590 teleconsultations were conducted: 45% ( n = 265) were conducted for general practice, 29% ( n = 172) for wound care, 11% ( n = 62) for diabetes management, 8% ( n = 47) with gerontologist and 6% ( n = 38) for dermatology. Rural nursing homes conducted more teleconsultations overall than urban ones (RR: 2.484; 95% CI: 1.083 to 5.518; p = 0.03) and included more teleconsultations for general practice (RR: 16.305; 95% CI: 3.505 to 73.523; p = 0.001). Our qualitative study showed that three critical factors are required for the implementation of a telemedicine project in nursing homes: (1) the motivation to perform teleconsultations (in other words, improving access to care and cooperation between professionals); (2) building a relevant telemedicine medical offer based on patients’ and treating physicians’ needs; and (3) it’s specific organization in terms of time and space. Our study showed different uses of teleconsultations according to the rural or urban localization of nursing homes and that telemedicine projects should be designed to consider this aspect. Triggered by the COVID-19 pandemic, telemedicine projects in nursing homes are increasing, and observing the three critical factors presented above could be necessary to limit the failure of such projects.

Keywords: telemedicine; nursing homes; rural health; urban health; health services (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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