Hung William W, Rossi Michelle, Thielke Stephen, Caprio Thomas, Barczi Steven, Kramer B Josea, Kochersberger Gary, Boockvar Kenneth S, Brody Abraham, Howe Judith L
a Department of Geriatrics and Palliative Medicine , Mount Sinai School of Medicine , New York , New York , USA.
Gerontol Geriatr Educ. 2014;35(1):23-40. doi: 10.1080/02701960.2013.870902.
Older patients who live in rural areas often have limited access to specialty geriatric care, which can help in identifying and managing geriatric conditions associated with functional decline. Implementation of geriatric-focused practices among rural primary care providers has been limited, because rural providers often lack access to training in geriatrics and to geriatricians for consultation. To bridge this gap, four Geriatric Research, Education, and Clinical Centers, which are centers of excellence across the nation for geriatric care within the Veteran health system, have developed a program utilizing telemedicine to connect with rural providers to improve access to specialized geriatric interdisciplinary care. In addition, case-based education via teleconferencing using cases brought by rural providers was developed to complement the clinical implementation efforts. In this article, the authors review these educational approaches in the implementation of the clinical interventions and discuss the potential advantages in improving implementation efforts.
居住在农村地区的老年患者往往难以获得专业的老年护理服务，而这种服务有助于识别和管理与功能衰退相关的老年疾病。农村初级保健提供者实施以老年医学为重点的医疗服务受到限制，因为农村医疗人员通常缺乏接受老年医学培训的机会，也难以咨询老年医学专家。为了弥补这一差距，四个老年医学研究、教育和临床中心（这些中心是退伍军人医疗系统中全国老年护理领域的卓越中心）制定了一个项目，利用远程医疗与农村医疗人员建立联系，以改善获得专业老年跨学科护理服务的机会。此外，还开发了通过电话会议利用农村医疗人员提供的病例进行案例教学的方式，以补充临床实施工作。在本文中，作者回顾了这些教育方法在临床干预实施中的应用，并讨论了在改进实施工作方面的潜在优势。
