Telehealth encompasses the delivery and facilitation of health and health-related services, including medical care, education, health information services, and self-care, via telecommunication and digital communication technology.
Telemedicine emerged as a feasible and acceptable means for the Community Geriatric Assessment Team (CGAT) to deliver multidisciplinary care to residents in Residential Care Homes for the Elderly (RCHEs) in the early 2000s. However, its use was limited by costly hardware, unreliable connections, camera resolution, and data security concern etc. The COVID-19 pandemic revolutionized the development and application of telehealth in the care of older adults. More than 67,000 teleconsultations by CGAT were delivered to nursing home residents during the pandemic for medical care. Post-pandemic, teleconsultation by CGAT continues to support nursing home residents in scheduled follow ups and during outbreaks and long public holidays, aiming to reduce avoidable emergency department visits and hospital admissions. The development of institutional account for nursing homes can further enhance workflow and efficiency of teleconsultation. Tele-rehabilitation services have also been used in selected Geriatric Day Hospitals with promising outcomes. Moreover, residents and their families can access health data, health information, and manage appointment bookings with various mobile applications in HA Go.
Telemedicine can potentially improve accessibility, efficiency and quality of healthcare services. Nevertheless, teleconsultation is limited by the inability to conduct physical examinations and procedures as well as cognitive and sensory deficits in older adults. Other challenges in the use of telehealth include availability of user-friendly devices, digital literacy and additional resources in nursing homes. Continued development and careful evaluation of patients and clinical outcome are essential before a wider adoption of telemedicine in care homes.
