Telemedicine and geriatric teleconsultations between the University Hospital of Nancy and retirement homes: Current situation after eight months of experimentation

Introduction: To improve the medical care of institutionalized elderly patients through advances in information and communication technologies, geriatric physicians of the University Hospital of Nancy carried out, since July 2014, remote and live consultations for retirement homes residents. Objectives: To analyze the progress and reasons for using teleconsultations during the experimental phase of the project: from July 1st 2014 to February 15th, 2015. Method: Data collection was performed retrospectively, from the informations contained in the report of each consultation. Results: During the trial period, including two nursing homes for a total of 167 residents, 47 teleconsultations were performed. There were 37 different patients (28 women), 8 residents received several “follow up” teleconsultations with reference to the initial medical problem. The average age of the 37 patients was 86.7 years. Each teleconsultation took place with the obligatory presence of the geriatrician and the patient. The patient may be accompanied by the nursing home physician and/or a nurse. We recorded 52 reasons for using teleconsultations: neuropsychiatric problems (34%), skin disorders (31%), advice on optimizing treatments taken by the patient (23.2%), help support patient in palliative care (5.9%), “other reasons” (5.9%). Conclusion: This experiment shows that the need for geriatric expertise is important in nursing homes. By enriching exchanges among health professionals, telemedicine improves the links between hospital and medico-social structures.