Highlights
- •What is the primary question addressed by this study? This program evaluation aimed to characterize patients served and referring provider perceptions of a cross-facility tele-geriatric psychiatry consultation program.
- •What is the main finding of this study?— This approach is feasible, acceptable, and highly valued by referring providers. The program served older Veterans with complex psychiatric and cognitive needs across multiple care settings including outpatient and rehabilitation/long-term care.
- •What is the meaning of the finding?—Geriatric psychiatry consultation delivered to multiple VA medical systems via telehealth may increase access to this specialty in rural areas.
Abstract
Objectives
Cross-facility tele-geriatric psychiatry consultation is a promising model for providing
specialty services to regions lacking sufficient geriatric psychiatry expertise. This
evaluation focused on assessing the feasibility and acceptability of a consultation
program developed by a geriatric psychiatrist in a Veterans Health Administration
regional telehealth hub.
Design
Concurrent, mixed methods program evaluation
Setting
A region served by a VA health care system telehealth hub
Participants
Patients with at least 1 geriatric mental health encounter with a geriatric psychiatrist
consultant during a 1 year-period; referring providers.
Intervention
Virtual psychiatric evaluation of Veterans with time-limited follow-up and e-consultation
with providers.
Measurements
Interviews with consultant, medical record data, and referring provider surveys
Results
315 Veterans (M = 76.0 ± 9.64 years; 40% rural-dwelling) had 666 encounters (M = 2.11 ± 1.78) with most occurring via clinical video telehealth (n = 443; 67.6%), e-consultation (n = 99; 15.1%), or video to home (n = 95; 14.5%). Most encounters were related to neurocognitive disorders, depressive
disorders, trauma-related disorders, or serious mental illness. Referring providers
(N = 58) highly recommended the program, reported high satisfaction, followed through
with recommendations, and believed that this program increased access to geriatric
psychiatry.
Conclusions
This single program was shown to be feasible, acceptable, and valued by the referring
providers. The findings highlighted the complex presentations of Veterans referred,
and the current unmet need of providers of such Veterans, providing impetus for wider
implementation.
Keywords
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Article info
Publication history
Accepted:
January 5,
2023
Received in revised form:
January 4,
2023
Received:
October 27,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Published by Elsevier Inc. on behalf of American Association for Geriatric Psychiatry.
