Dr. Hye-Young Jung, associate professor of population health sciences, and Dr. Jiani Yu, assistant professor of population health sciences, have received an R01 award for their research on telehealth use in nursing homes (NHs).
Of the 1.4 million residents receiving care in NHs in the US, more than half have Alzheimer’s disease and related dementias (ADRD). These progressive, debilitating conditions can impair memory, thought processes, and functioning. Telehealth in NHs allows for audio and audiovisual encounters between clinicians, residents, and caregivers, and may facilitate cognitive screening, review of medications, and more.
During the COVID-19 public health emergency, telehealth coverage was expanded for Medicare fee-for-service (FFS) and Medicare Advantage beneficiaries. As certain Medicare FFS telehealth flexibilities waivers supporting telehealth use in NHs are set to end in December 2024, research on the impact of telehealth on care for NH residents with ADRD is critical.
“This work is very timely,” said Dr. Yu, “as there are a lot of opportunities for telehealth to be used in NHs. However, there is a gap in understanding why it isn’t being adopted more, particularly for patients with significant mobility issues, who could benefit from virtually seeing specialists who are otherwise difficult to access.”
Their study will examine how telehealth has been used for long-stay NH residents with ADRD and measure the relationship between their access to telehealth and the quality and cost of care from 2018 through 2024. The study will further characterize the uptake and patterns of telehealth and in-person care for these residents.
“In the nursing home setting, more than 30 percent of residents are MA beneficiaries,” explained Dr. Jung. “However, we don’t have much data on the use or quality of telehealth among this group. Our proposal will evaluate the needs of both the FFS and MA populations, given that most prior studies have focused heavily on the FFS population.”
Using both quantitative and qualitative methods, she and Dr. Yu aim to determine whether residents with higher access to telehealth have improved quality outcomes compared to residents who do not. Given the inherent challenges to using telehealth in NHs, including staffing shortages and limited health information technology infrastructure, the study could provide new evidence on the potential impact of broader NH adoption of telehealth.
Dr. Jung and Dr. Yu will work alongside Dr. Jessica S. Ancker, professor of biomedical informatics and vice chair for educational affairs at Vanderbilt University, Dr. Paul R. Katz, professor and chair of the department of geriatrics at Florida State University, and Dr. Mark A. Unruh, associate professor of population health sciences.
“The nursing home population is such a big one,” said Dr. Yu, “and long-term care is such an important facet of the healthcare system. With impending policy changes, we really hope our study can be informative for this population.”
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