Halphen John M, Solis Christina F, Burnett Jason
Joan and Alexander Stanford Division of Geriatric and Palliative Medicine, McGovern Medical School, University of Texas Health Science Center, Houston, Houston, Texas, USA.
Texas Elder Abuse and Mistreatment Institute, a partnership between the Joan and Alexander Stanford Division of Geriatric and Palliative Medicine, and the Division of Adult Protective Services, Texas Department of Family and Protective Services, Houston, Texas, USA.
J Am Geriatr Soc. 2021 Oct;69(10):2759-2765. doi: 10.1111/jgs.17424. Epub 2021 Aug 30.
Telecommunication assisted forensic assessments of capacity and mistreatment by geriatricians with expertise in elder abuse and self-neglect are helping to meet the demand for such forensic services for Adult Protective Services (APS) clients in remote and underserved areas of Texas. The use of synchronous audiovisual assisted interviews instead of in-person interviews with clients to provide capacity assessments has become more important with the arrival of the COVID-19 pandemic. There is growing interest in establishing similar programs in other states using geriatrician faculty from medical schools to serve the clients of their state Adult Protective Services agencies. The arrangement between APS and the geriatricians at McGovern Medical School in Houston, Texas is novel. The structure of the arrangement is important for the success of the program. Legal, ethical, and practical considerations are discussed in this article, including approaches to the Health Insurance Portability and Accountability Act, physician liability, state law, and resource limitations. It is hoped that sharing how one such collaboration has addressed these important issues will suggest approaches for the structuring of similar programs.
由在老年人虐待和自我忽视方面具有专业知识的老年病医生进行的电信辅助法医能力评估和虐待评估，正在帮助满足德克萨斯州偏远和服务不足地区成人保护服务（APS）客户对这类法医服务的需求。随着新冠疫情的到来，使用同步视听辅助访谈而非亲自与客户面谈来提供能力评估变得更加重要。越来越多的人有兴趣在其他州建立类似项目，利用医学院的老年病医生为该州成人保护服务机构的客户提供服务。德克萨斯州休斯顿麦戈文医学院的APS与老年病医生之间的安排很新颖。这种安排的结构对项目的成功很重要。本文讨论了法律、伦理和实际考虑因素，包括《健康保险流通与责任法案》的处理方法、医生责任、州法律和资源限制。希望分享这样一种合作如何解决这些重要问题，能为构建类似项目提供方法建议。
