Skilled Nursing Facilities Had Mixed Reviews of Telehealth Use

Telehealth helped increase access to care and reduce stress for some skilled nursing facility residents and staff, but others faced unexpected challenges and consequences of telehealth use, a study from the University of Missouri found.

Like other healthcare organizations, skilled nursing facilities were hit hard by the COVID-19 pandemic, prompting many to implement telehealth programs in an attempt to relieve some of the burden.

Kimberly Powell, an assistant professor at the MU Sinclair School of Nursing, led the study and interviewed 21 administrators and clinicians from 16 skilled nursing facilities across the country about their experiences with telehealth.

Telehealth proved to be convenient for some nursing home residents, as they could access timely care without having to travel, the study indicated.

“Transporting a resident to the hospital can be a very traumatic and stressful experience,” Powell stated in a press release. “Whether it’s a fall in the middle of the night or a sudden change in vitals, if a nurse can quickly hop on a Zoom call with a resident and make an assessment, perhaps an intervention plan can be developed that allows the resident to be treated in the nursing home, which saves time, money, and an unnecessary transfer to the hospital.”

Additionally, the clinicians and administrators said that using telehealth with the residents improved access to care, saved organizational resources, and enhanced communication.

However, like most healthcare innovations, telehealth did not work perfectly for everyone.

Since the pandemic hit, seniors have faced increased rates of mental health concerns and social isolation, and nursing home residents are not immune to those challenges.

Many patients look forward to attending in-person appointments as it can be one of their only chances to socialize with older adults, Powell said. A trip to the doctor’s office provides residents with an opportunity for a change of scenery, if only for a little while. Implementing telehealth for monthly wellness appointments eliminated the socialization aspect of in-person visits for some residents.

The study also revealed that telehealth use in skilled nursing facilities may confuse residents who have cognitive impairments and may not understand why or how their doctor is communicating with them virtually.

“While telehealth can be very convenient and beneficial, it should not be viewed as a one-size-fits-all solution, and this study helped us see various nuances involved,” Powell continued.

Skilled nursing facilities experienced a common trend of pandemic telehealth use. Facilities that had already used telehealth at some point before the pandemic were more comfortable using it when the coronavirus hit, compared to those that had no experience with virtual care. The former also had smoother and timelier transitions to telehealth use than the latter, the study noted.

Telehealth requires healthcare staff to have a basic knowledge of technology, and those who are new to it will understandably take longer to adjust. According to Powell, this indicates the need for more technical training in skilled nursing facilities.

Clinicians and residents could also benefit from better EHR integration that would allow staff to easily access patient medical records during a video visit, Powell pointed out.

Ensuring that nursing home staff are properly trained to take on the addition of telehealth may help tackle the workflow and technology challenges that the study participants reported. Adequate preparation may also help relieve some of the administrative burden that telehealth brought to nursing homes.

Despite the challenges, more skilled nursing facilities are recognizing the benefits of telehealth and are planning for post-pandemic use. With the right strategies in place, clinicians and administrators can help prevent the struggles that may accompany telehealth adoption.