Understanding the Experience of Geriatric Care Professionals in Using Telemedicine to Care for Older Patients in Response to the COVID-19 Pandemic: Qualitative Study (Preprint)

Abstract

Geriatric care professionals were forced to rapidly adopt the use of telemedicine technologies to ensure the continuity of care for their older patients in response to the COVID-19 pandemic. However, there is little current literature that describes how telemedicine technologies can best be employed to meet the needs of geriatric care professionals in providing care to frail older patients and their caregivers, and families.

This study aimed to identify the benefits and challenges geriatric care professionals face when using telemedicine technologies with frail older patients, their caregivers, and families, and how to maximize the benefits of this method of providing care.

We conducted a mixed methods study that recruited geriatric care professionals to complete an online survey regarding their personal demographics and experiences with using telemedicine and participate in a semi-structured interview. Interview responses were analyzed using the Consolidated Framework for Implementation Research (CFIR).

We obtained quantitative and qualitative data from 30 practicing geriatric care professionals (22 geriatricians, 5 geriatric psychiatrists, and 3 geriatric specialist nurses) recruited from across the Greater Toronto Area. Analysis of interview data identified 5 CFIR contextual barriers (Complexity, Design quality and packaging, Patient needs and resources, Readiness for implementation, and Culture) and 13 CFIR contextual facilitators (Relative Advantage, Adaptability, Tension for Change, Available Resources, Access to Knowledge, Network and Communications, Compatibility, Knowledge and Beliefs, Self-Efficacy, Champions, External Agents, Executing, and Reflecting and Evaluating). The CFIR concept of External Policy and Incentives was found to be a neutral construct.

This is the first known study to use the CFIR to develop a comprehensive narrative to characterize the experiences of geriatric care professionals using telemedicine technologies in providing care. Overall, telemedicine can significantly enable most of the geriatric care that is traditionally provided in person, but is less useful in providing specific aspects of geriatric care to frail older patients and their caregivers, and families.