Residents in skilled care often carry a high burden of comorbidities, with their cardiovascular disease complicated by multiple chronic conditions, such as hypertension, diabetes, stroke and dementia.
Considering that helping these residents means bringing multiple stakeholders to the table, from cardiologists and geriatricians to primary nursing home clinicians, the in-person coordination of care is often too arduous for these residents.
Instead, skilled nursing facilities (SNFs) are bringing this care directly to their residents through telemedicine.
“The complexity of addressing the holistic heart health needs of this increasingly vulnerable population lends itself to a collaborative care model, including post-acute care telemedicine clinicians,” says Ifedolapo Sulyman Olanrewaju (MD, MHI, SFHM, CPE), Post-Acute Telemedicine Regional Medical Director of Sound Physicians.
Given that cardiovascular disease is the leading cause of mortality in older adults, Olanrewaju and his team spent time recently reflecting on the role of telemedicine in the national armamentarium for addressing care gaps for older adults in nursing homes. Here is a look at how SNFs are using telemedicine to address the unique challenges of heart health, bringing their residents the timely, expert help they need.
SNF resident heart health management: 3 ways telemedicine is bridging the care gap
The typical SNF resident has care needs that are complex, urgent and always in flux. And because heart health is only one of their problems, the solutions are never simple. A resident’s multimorbidity, coupled with polypharmacy, increases the risk for cardiovascular disease and overall morbidity from greater likelihood of falling, increased rate of muscle loss, decreased physical activity and frailty. This perpetuates a vicious cycle that translates to accelerated aging and increased cardiovascular mortality.
Maintaining optimal heart health for this vulnerable population therefore requires a proactive, comprehensive and agile approach.
“Annual wellness visits provide a high-value care opportunity to proactively identify risk factors and help set health goals, but they fall short in providing ongoing cardiovascular care,” Olanrewaju says. “The limited access to specialized care with inconsistent follow-ups as well as sparse clinician presence, especially after-hours, also negatively impacts cardiovascular outcomes among this population, highlighting the need for approaches such as telemedicine, which help fill unmet clinical needs.”
Telemedicine offers support for the traditional care model for nursing home residents and provides additional resources to intervene sooner rather than later. By leveraging technology, telemedicine clinicians can provide timely, consistent and personalized care that complements and enhances annual wellness visits as well as the traditional nursing home care model, thus offering an innovative solution to address the resident population’s unmet cardiovascular needs.
Here, Olanrewaju explains three distinct ways that Sound’s post-acute care telemedicine can support your traditional nursing home care model and deliver improved cardiovascular outcomes for your patients.
1. Enhanced medication management
“Our team of post-acute telemedicine clinicians can help appraise the accuracy of the medication reconciliation list when the patient is admitted as well as identify risks inherent in polypharmacy that can negatively impact cardiovascular health outcomes,” he says.
2. Proactive multimorbidity appraisal
“Our telemedicine clinicians support your on–site teams in early recognition of multimorbidity and intervene through therapeutic recommendations at tuck-in visits,” he says. “We also help reduce risk and set up your nursing home residents for success by addressing issues such as uncontrolled hypertension and hyperglycemia at the time of admission.”
3. Improved emergency response
Sound’s telemedicine clinical team provides ongoing support to each nursing home staff to manage acute cardiovascular events, virtually triaging them with a higher degree of precision than traditional cross coverage and intervening to resolve many issues on site and avoiding unnecessary emergency department transfers.
This facility-based care mirrors home-based care, which is associated with faster recovery and decreased risk for geriatric syndromes such as delirium.
“When an emergency department transfer is indicated, the decision is also swift, and nursing colleagues feel supported to initiate life-saving measures with telemedicine clinician guidance pending formal execution of the transfer,” Olanrewaju says.
A powerful tool to bridge the gap for patients
Managing the heart health of nursing home residents requires an ongoing proactive and multidisciplinary approach. Post-acute telemedicine offers a powerful tool to bridge existing gaps in care, providing continuous support and after-hours access to clinicians who can offer treatment tailored to the unique needs of this vulnerable population while reducing the burden on caregivers and health care systems.
This Views article is sponsored by Sound Physicians. To learn more, visit soundphysicians.com/specialties/telemedicine/snf-telemedicine.
