Dervan K, Mulkerrin G, McDonnell T, Mulkerrin E C
Department of Geriatric Medicine, University Hospital Galway, Republic of Ireland.
Department of Neurology, National Hospital for Neurology and Neurosurgery, Queen's Square, London, United Kingdom.
JAR Life. 2020 Oct 22;9:35-39. doi: 10.14283/jarlife.2020.8. eCollection 2020.
The COVID-19 pandemic poses a major challenge to delivering multi-disciplinary complex care for older patients. Modern technology can assist in providing such care. This article highlights efforts to bridge the "digital divide" between generations and addresses the beneficial impact telemedicine has on older people's lifestyles. Novel triage models for accessing emergency care which were successful for patients of all age groups including those over 65 years are described. Moreover, innovative successful approaches to the outpatient assessment of older patients with complex chronic health conditions using telemedicine are highlighted. Furthermore, innovative solutions piloted in remote areas of Australia offer promise for telemedicine-lead remote assessment of older patients, and the results are encouraging compared to in-person consultations. The experience with a General Practitioner (GP)/specialist online real-time interaction model for remote management of HF in mainly older people has also been encouraging. The use of telemedicine in falls prevention has produced impressive results in high-risk older patients albeit with some ambivalence from older participants. Virtual reality rehabilitation programmes have produced better physical outcomes than traditional rehabilitation programmes. Furthermore, telerehabilitation for chronic obstructive pulmonary disease (COPD) and HF have shown to be both feasible and effective. To maximise their benefits in the difficult post-COVID-19 period, technologies must be embraced by both physicians and older patients. Online community care platforms discussed have demonstrated a positive, tangible impact on the lifestyle of the older generation. Furthermore, educational guidelines can assist in implementing the fundamentals of telemedicine, but for the widespread successful and safe integration of these services, adoption of regulatory frameworks with a focus on ethical issues of telehealth is imperative.
新冠疫情给为老年患者提供多学科综合护理带来了重大挑战。现代技术有助于提供此类护理。本文强调了弥合代际“数字鸿沟”的努力,并探讨了远程医疗对老年人生活方式的有益影响。文中描述了新型分诊模式,该模式在包括65岁以上患者在内的所有年龄组患者中成功用于获取急诊护理。此外,还强调了使用远程医疗对患有复杂慢性健康状况的老年患者进行门诊评估的创新成功方法。此外,在澳大利亚偏远地区试点的创新解决方案为远程医疗主导的老年患者远程评估带来了希望,与面对面咨询相比,结果令人鼓舞。全科医生(GP)/专科医生在线实时互动模式用于主要针对老年人的心力衰竭远程管理的经验也令人鼓舞。远程医疗在预防跌倒方面的应用在高危老年患者中取得了令人瞩目的成果,尽管老年参与者对此存在一些矛盾情绪。虚拟现实康复计划比传统康复计划产生了更好的身体效果。此外,慢性阻塞性肺疾病(COPD)和心力衰竭的远程康复已证明既可行又有效。为了在新冠疫情后的艰难时期最大限度地发挥其益处,医生和老年患者都必须接受这些技术。所讨论的在线社区护理平台已证明对老年一代的生活方式产生了积极、切实的影响。此外,教育指南有助于实施远程医疗的基本原理,但为了这些服务广泛成功且安全地整合,采用侧重于远程医疗伦理问题的监管框架势在必行。