Clinicians Should Ease Transition to Telehealth for Patients, Particularly Older Adults

When shifting to telehealth, older adults and patients without access to technology feel the highest burden. Although the weight of this transition falls more heavily on patients, clinicians should still work to decrease these barriers, says Ipsit Vahia, MD, associate chief, division of geriatric psychiatry at McLean Hospital. Whether this is ensuring a patient has the correct technology and know-how or showing them how to use a virtual care platform, Vahia says clinicians "owe it" to their patients to make sure they can take advantage of the benefits telehealth can provide. 

Dr Vahia recently spoke at the virtual Psych Congress Regionals on this topic and other frequently asked questions about the ever-evolving field of technology and telehealth. To stay up to date on more conference news, insights, and updates, visit our newsroom.

Missed part 2: Older Adults and Their Clinicians Benefitted From Shift to Telehealth? Watch it here. 
 

Ipsit Vahia, MD, is a geriatric psychiatrist, clinician, and researcher. He is medical director of geriatric psychiatry outpatient services at McLean Hospital and the McLean Institute for Technology in Psychiatry. He is also director of the Technology and Aging Laboratory. His research focuses on the use of technology and informatics in the assessment and management of older adults and currently, he oversees a clinical and research program on aging, behavior, and technology. He has published extensively in major international journals and textbooks.

Dr Vahia serves on the American Psychiatric Association (APA) Council on Geriatric Psychiatry and the Geriatric Psychiatry Committee of the American Board of Psychiatry and Neurology. He has served on the board of directors of the American Association for Geriatric Psychiatry (AAGP) and on the editorial boards of 5 journals including his current role as social media editor of the American Journal of Geriatric Psychiatry. He is a recipient of several prestigious awards including the 2016 AAGP Barry Lebowitz Award and the 2014 APA Hartford Jeste Award.

Read the Transcript: 

I think there's several factors into making a successful transition to hybrid care for most clinical providers at this point, again, two and a half years into the pandemic, we've had to learn how to do telemedicine ourselves. This was formally the biggest barrier that getting the clinicians to become comfortable with virtual care and virtual platforms used to be the biggest barrier into implementing hybrid care. That barrier is substantially reduced because many of us had no choice but to take this on. But I think for those that are looking to make this a more permanent feature, I would say the first step is to establish that their patients are able to make this transition. This might involve assessing what kind of technology someone has access to, what kind of wifi or data someone has access to, and then once you establish that the patient has the technological capability that they also have the know how needed to use these platforms.

That may mean making sure that they have an email address that they access. For example, sometimes it may mean taking the time or dedicating the resources to teaching a patient how to use a virtual care platform. We've had to do this in our clinical service, for example, where we made the decision to dedicate resources to having a staff member available to teach some of our patients how to use telecare, and once we did that, we would actually do a mock visit, and then once we did a mock visit, we found that it increases the likelihood that this person would be able to have a proper virtual care visit. This needs to be reinforced. It means sometimes looking into whether there's a friend or a family member that they can have. So I think the burden of making the switch to virtual care is higher for patients than it might be for clinicians, but I think for a clinician that's looking to move into this direction, we owe it to our patients to ensure that they have the capability.

Otherwise we risk making a disparity worse rather than improving it by switching to hybrid care. Once this is done, I think we also have to realize that one size does not fit all. One size fits one. Every individual patient likely has different preferences, different proficiencies and different likes and dislikes. I have had patients that are able to do virtual care, but they will insist on coming in person only because they find it subjectively more impactful to see me in person. That's okay. Other clinicians may not be able to accommodate such things. That's probably okay too, but it has to be transparently shared and worked out which each individual patient. The biggest benefit that hybrid care provides us is that it allows us to customize the format in which we see somebody for care, but this has to work on our terms. More importantly, it has to be on our patient's terms. This takes some figuring out, it adds an extra wrinkle to the process of delivering care, but I think the payoff is worth it.