title: Interactive video specialty consultations in long-term care.
abstract: OBJECTIVE
  To assess provider and resident satisfaction with and outcomes of specialist physician consultations provided via interactive video to residents of a long-term care (LTC) center.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Two Veterans Affairs Medical Centers (VAMC) and a state LTC center.
  
  
  METHODS
  Physicians (n=12) at the VAMC and nurses (n=30) and residents (n=62) at the LTC center.
  
  
  METHODS
  Interactive video conferencing to provide physician specialty visits to residents at the LTC center.
  
  
  METHODS
  Satisfaction ratings and record review to determine changes in treatment plan and follow-up care.
  
  
  RESULTS
  Data were collected on 76 individual consultations in six clinics. The most frequent outcome was a change in treatment plan with the resident remaining at the LTC setting (n=29, 38%) or no change in treatment (n=26, 34%). Physicians' ratings were 78% good to excellent for usefulness in developing a diagnosis, 87% good to excellent for usefulness in developing a treatment plan, 79% good to excellent for quality of transmission, and 86% good to excellent satisfaction with the consult format. Overall, 72% of residents were satisfied with the consult format, and 92% felt that it was easier to obtain medical care via telemedicine. Nurses felt that the telemedicine clinics were a good use of their time and skills (100%).
  
  
  CONCLUSIONS
  There was a high rate of physician, patient, and nurse satisfaction with interactive video conferencing. Care delivered to residents of LTC settings via video conferencing offers a number of potential advantages, including avoidance of travel for patient and provider and potentially greater continuity of care.
authors.affiliation: Iowa City VA Medical Center, Iowa City, Iowa, USA. Bonnie.wakefield@med.va.gov
authors.forename: Bonnie J
authors.initials: BJ
authors.lastname: Wakefield
authors.forename: Kelli A
authors.initials: KA
authors.lastname: Buresh
authors.forename: James R
authors.initials: JR
authors.lastname: Flanagan
authors.forename: Michael G
authors.initials: MG
authors.lastname: Kienzle
mesh_terms: D003430:Cross-Sectional Studies; D006801:Humans; D008134:Long-Term Care; D008511:Medicine; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D010549:Personal Satisfaction; D012017:Referral and Consultation; D019114:Remote Consultation; D013038:Specialization; D017216:Telemedicine