Telemedicine has become of vital importance to nursing homes. Telehealth greatly expands access to physicians and advanced practice nurses that residents wouldn’t see otherwise, saving money and lives. More than 10% of patients that are admitted to a skilled nursing facility for post-acute care never see a doctor or advanced practice nurse during their stay. Post-acute nursing home patients who don’t see a physician or advanced practice nurse are two times more likely to be readmitted to the hospital or die within 30 days.
Post-acute care patients live in a facility for a temporary stay while getting the care they need. 20% of hospitalized patients are discharged to nursing homes for post-acute care. These patients need more medical intervention than long-term residents. Whether it is physical therapy, intravenous antibiotics, or skilled wound care, they require more attention than long-term residents in need of custodial care. On average patients wait 3.2 days to see a physician, and in rural nursing homes, the wait stretches to 8.1 days.
The median nursing home stay for post-acute patients who never see a physician is 11 days. Under current Medicare policy, there isn’t an issue with this, but it is causing serious consequences. Currently, Medicare requires residents to see a physician within 30 days of admission, but this policy is a holdover from the days when nursing home patients were primarily long-term residents in need of custodial care.
Missing or delayed medical care for nursing home residents leads to poor outcomes. A solution is needed to better serve this vulnerable population. One way to reduce poor outcomes is to staff nursing homes with advanced practice nurses. In one study, adding an advanced practice nurse to the staff led to 48% fewer avoidable hospitalizations and 40% lower costs. If they worked in every nursing home in the United States, Medicare costs could be reduced by nearly $2.8 billion annually.
In many cases, early detection is key. Acute conditions such as pneumonia, severe dehydration, and urinary tract infections as well as flare-ups of chronic conditions like congestive heart failure and uncontrolled diabetes can be treated in the nursing home if they are detected early. This alone stresses the importance of advanced practice nursing. They help to recognize signs of infection and improve the recognition skills of others.
Another important practice in nursing homes is vital sign monitoring. Manual vital sign monitoring takes an average of 16 minutes to read and document. Telemedicine allows for automated monitoring, which cuts the whole process down to less than a minute while eliminating the risk of human error. Readings are more consistent over time, and staff is notified when readings are outside of the prescribed parameters. All of this allows nursing staff to have more time to focus on patients, rather than paperwork, allowing patients to receive more immediate interventions and reducing readmissions.
Telemedicine enables all nursing homes to provide in-house medical care. In large facilities, telehealth augments onsite clinical staff for round-the-clock care, and it is scalable for homes that can’t employ onsite clinical staff in small or rural settings. 83% of health issues can be treated by a telemedicine physician working with the on-site nursing staff. Some of the most common diagnoses are chest pain, pneumonia, UTIs, and hypoglycemia.
Telehealth works along nursing home facilities to provide bedside access to a team of physicians and behavioral health services. It offers digital vital sign monitoring that automatically notifies nurses if readings are outside of the prescribed range, identifying problems early. A clinician is available virtually to respond to resident needs 24/7, which allows conditions to be treated early, preventing rehospitalization and improving outcomes. In addition, a dedicated clinician is assigned to every facility, building relationships with patients and staff for better care.
Learn more about telemedicine in nursing homes in the infographic below: