A sample of clinicians and administrators at 700 nursing homes nationwide revealed that while telehealth appears to be one COVID-19 trend that’s here to stay, integration of the technology can come at a cost.

For some facilities, telehealth was found to cause less socialization opportunities for older adults, and for a patient population that includes many patients with dementia, those opportunities can be vitally important to their overall health, a recent study from the University of Missouri showed.

“The reason for the expanded telehealth was to keep residents safe,” Kimberly Powell, assistant professor in the MU Sinclair School of Nursing and the study’s lead author, told Skilled Nursing News. “But unfortunately, the flip side of that was that for these nursing home residents, who were perhaps isolated to begin with, the use of telehealth only exacerbated that problem.”

Powell and other researchers interviewed nursing home administrators and clinicians across the country to better understand the benefits and challenges of telehealth adoption.

A simple trip to the doctor’s office became an opportunity to have a change of scenery and get outside the nursing home and when it all switched to telehealth that opportunity was lost.

“Then there was the increased burden on the nursing home staff,” Powell added. “[Telehealth] increased what staff had to do, which I think is very problematic given the staffing crisis in nursing homes that we are at now.”

The study was recently published in the Journal of Applied Clinical Informatics, and found benefits of telehealth include avoiding unnecessary travel for nursing home residents, saving organizational resources, improved access to care and enhanced communication.

However, undesirable consequences included patients having a preference for in-person encounters, worsening social isolation, difficulty for residents with cognitive impairment, workflow and technology usability challenges and an increased burden on nursing home staff and infrastructure.

Rural nursing homes found a perceived lack of training, poor video and sound quality and internet connectivity issues to be potential pitfalls in telehealth.

Powell suggested that telehealth should not be a “one-size-fits-all solution” for nursing home operators as its integration into many facilities continues.

“We have to think about whether getting a nursing home resident outside the facility is with the risk because of the benefit of having some sort of social engagement,” she said. “Clinicians and nursing home staff need to think about whether this is the most appropriate and safest way to have a visit for each individual resident. It needs to be based on individual circumstances.”

The study found that the use of telehealth reduced stress for nursing home residents and increased access to convenient care.

Hospital transportation is one area telehealth was suggested to be a proven cost-saving approach that had a positive impact on patient care.

“One of the unexpected benefits was having an opportunity for more timely intervention,” Powell explained. “Transporting a resident to the hospital can be a very stressful experience and oftentimes in the night, a provider or nurse practitioner is not in the nursing home. [With telehealth] they can jump on a quick call and avoid sending a nursing home resident out to the hospital, which saves time, money and an unnecessary transfer to the hospital.”