Towards data-driven tele-medicine intelligence: community-based mental healthcare paradigm shift for smart aging amid COVID-19 pandemic.

Purpose: Telemedicine are experiencing an unprecedented boom globally since the beginning of the COVID-19 pandemic. As the most vulnerable groups amid COVID-19, the digital delivery of healthcare poses great challenges to the elderly population, caregiver, health service providers, and health policy makers. To bridge the service delivery gaps between the telemedicine demand side and supply side, explore evidence-based approach for integrated care, address challenges for aging policy, and build foundation for the development of data-driven and community-based telemedicine, our R&D team applied translational research to design and develop telemedicine "SMART" for enhancing elderly mental health wellbeing amid COVID-19. Our aim is to investigate the preparedness mechanisms of mental health disease including response, intervention, and connection these three healthcare delivery pipelines with the collection, consolidation, and synergy of heath parameters and social determinants, using data analytics approach to achieve Evidence-Based Medicine (EBM).

Methods: A mix of quantitative and qualitative research design for scientifically rigorous consultation and analysis was conducted from Jan 2020 to June 2021 in Hong Kong. An exploratory and descriptive qualitative design was used in this study. The data were collected through focus group discussions conducted from elderly and their caregivers living in 10 main districts of Hong Kong. Our research pilot tested "SMART" targeting for elderly with mental health improvement needs. Baseline questionnaire with 110 tele-medicine product users includes questions on demographic information, self-rated mental health digital adoption. The follow-up five focus group discussions with 57 users (elderly and their caregivers) further explore the social determinants of telemedicine transformation and help propose the integrated telemedicine paradigm shift framework establishment, development, and enhancement.

Results: Grounded on the baseline needs assessment and feedbacks collected, it is evident that multi-dimensional health information from the four various streams (community, clinic, home, remote) and customized digital health solutions are playing a key role in addressing elderly mental health digital service needs and bridging digital divide. The designed tele-medicine product lines up health service provider (supplier side) and elderly specific needs (demand side) with our three-level design, enables elderly and their families to follow and control their own health management and connect with the service provider, community of practice (CoP), and health policy makers.

Conclusion: It's beneficial to involve elderly and gerontechnology stakeholders as part of Community-Based Participatory Research (CBPR) before and throughout the developing and delivery phases an integrated and age-friendly digital intervention. The challenges in applying and disseminating telemedicine reflected by the elderly and caregivers can be used as important input for further development and indicators for the sustainable and integrated elderly primary care framework.

Supplementary information: The online version contains supplementary material available at 10.1007/s13755-022-00198-4.