Technology and Specialist Care for Older Patients in the Post Covid-19 Era.

JAR life Pub Date : 2020-01-01 DOI:10.14283/jarlife.2020.8
K Dervan, G Mulkerrin, T McDonnell, E C Mulkerrin
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Abstract

The COVID-19 pandemic poses a major challenge to delivering multi-disciplinary complex care for older patients. Modern technology can assist in providing such care. This article highlights efforts to bridge the "digital divide" between generations and addresses the beneficial impact telemedicine has on older people's lifestyles. Novel triage models for accessing emergency care which were successful for patients of all age groups including those over 65 years are described. Moreover, innovative successful approaches to the outpatient assessment of older patients with complex chronic health conditions using telemedicine are highlighted. Furthermore, innovative solutions piloted in remote areas of Australia offer promise for telemedicine-lead remote assessment of older patients, and the results are encouraging compared to in-person consultations. The experience with a General Practitioner (GP)/specialist online real-time interaction model for remote management of HF in mainly older people has also been encouraging. The use of telemedicine in falls prevention has produced impressive results in high-risk older patients albeit with some ambivalence from older participants. Virtual reality rehabilitation programmes have produced better physical outcomes than traditional rehabilitation programmes. Furthermore, telerehabilitation for chronic obstructive pulmonary disease (COPD) and HF have shown to be both feasible and effective. To maximise their benefits in the difficult post-COVID-19 period, technologies must be embraced by both physicians and older patients. Online community care platforms discussed have demonstrated a positive, tangible impact on the lifestyle of the older generation. Furthermore, educational guidelines can assist in implementing the fundamentals of telemedicine, but for the widespread successful and safe integration of these services, adoption of regulatory frameworks with a focus on ethical issues of telehealth is imperative.

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后Covid-19时代老年患者的技术和专科护理。
2019冠状病毒病大流行对为老年患者提供多学科复杂护理构成重大挑战。现代技术可以帮助提供这种照顾。本文重点介绍了为弥合代际之间的“数字鸿沟”所做的努力,并阐述了远程医疗对老年人生活方式的有益影响。描述了用于获得紧急护理的新型分诊模式,该模式对所有年龄组的患者,包括65岁以上的患者都是成功的。此外,还强调了利用远程医疗对患有复杂慢性疾病的老年患者进行门诊评估的创新成功方法。此外,在澳大利亚偏远地区试点的创新解决方案为远程医疗主导的老年患者远程评估提供了希望,与面对面的咨询相比,结果令人鼓舞。全科医生(GP)/专家在线实时互动模型远程管理HF(主要是老年人)的经验也令人鼓舞。远程医疗在预防跌倒方面的应用在高危老年患者中产生了令人印象深刻的效果,尽管老年参与者存在一些矛盾心理。虚拟现实康复方案比传统康复方案产生了更好的身体效果。此外,慢性阻塞性肺疾病(COPD)和心力衰竭的远程康复已被证明是可行和有效的。为了在covid -19后的艰难时期最大限度地发挥其效益,必须让医生和老年患者都接受这些技术。所讨论的在线社区护理平台对老年人的生活方式产生了积极而切实的影响。此外,教育准则有助于落实远程医疗的基本原则,但为了广泛成功和安全地整合这些服务,必须采用以远程保健的伦理问题为重点的监管框架。
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