Telehealth Competencies to Ensure Health Care Access, Quality, and Equity for Older Adults: A Scoping Review.

Melanie T Gentry, Allison H Beito, Donald M Hilty
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Abstract

Background: During the COVID-19 pandemic, increased use of telehealth expanded access to health care for older adults. Many clinicians and health systems adjusted workflows and realized that certain competencies are needed to fully engage older adults in telehealth services. This scoping review evaluates the approaches needed to educate clinicians about providing telehealth services to older adults. Methods: We conducted a review of studies published from January 2000 through February 2024 by using the 6-stage scoping review process. Searches of PubMed/MEDLINE and five other databases included the concept areas of competencies, telehealth delivery of mental health services, and older adults. Results: We initially identified 813 articles, of which 89 were eligible for full-text review and 15 met our inclusion criteria. Most studies included training participants about the use of telehealth but without formal curricular interventions or evaluations and lacked details about topics, materials, methods, or outcomes. Telehealth training was general and focused primarily on the use of technology and telepresence, although not specifically for older adults. Three themes were identified from the studies: the role of teams and interprofessional education, the importance of training for clinicians and older patients, and adaptations to improve telehealth delivery for older adults. Conclusions: Individual and institutional competencies are needed to guide educational goals and outcome measures related to telehealth services for older adults. The use of telehealth specifically for older adults may require adaptation to clinical practice and delivery, adjustments to workflow, development of clinician skills, and promotion of interprofessional teamwork.

远程医疗能力以确保老年人的医疗保健获取、质量和公平性:范围审查。
背景:在2019冠状病毒病大流行期间,远程医疗使用的增加扩大了老年人获得卫生保健的机会。许多临床医生和卫生系统调整了工作流程,并意识到需要一定的能力才能使老年人充分参与远程医疗服务。本范围审查评估了教育临床医生为老年人提供远程医疗服务所需的方法。方法:我们对2000年1月至2024年2月期间发表的研究进行了综述,采用6阶段范围综述流程。对PubMed/MEDLINE和其他五个数据库的搜索包括能力概念领域、心理健康服务的远程医疗提供和老年人。结果:我们最初确定了813篇文章,其中89篇符合全文综述的条件,15篇符合我们的纳入标准。大多数研究包括对参与者进行关于使用远程保健的培训,但没有正式的课程干预或评估,也缺乏关于主题、材料、方法或结果的详细信息。远程保健培训是一般性的,主要侧重于技术和远程呈现的使用,尽管不是专门针对老年人。从这些研究中确定了三个主题:团队的作用和跨专业教育、对临床医生和老年患者进行培训的重要性以及改进老年人远程保健服务的调整。结论:需要个人和机构的能力来指导与老年人远程医疗服务相关的教育目标和结果测量。专门为老年人使用远程保健可能需要适应临床实践和交付、调整工作流程、发展临床医生技能和促进跨专业团队合作。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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