key: cord-0871128-9gqjf40z
authors: Tan, Li Feng; Seetharaman, Santhosh Kumar; Yip, Wenjun Alexander
title: Telehealth utilisation amongst older adults during a pandemic year
date: 2021-03-30
journal: Geriatr Gerontol Int
DOI: 10.1111/ggi.14161
sha: bd8669a76ceb50e0a8f55809907cdb90c96f36de
doc_id: 871128
cord_uid: 9gqjf40z

nan

Telehealth utilisation amongst older adults during a pandemic year Dear Editor, We thank Nakamura et al. 1 for their interest in our letter. 2 Their insights and perspectives on the COVID-19 situation in Japan are notable and informative for the world. We agree with their viewpoint that telehealth has an important role in mitigating potential exposure to the SARS-CoV-2 virus, especially for older adults who are most vulnerable to the disease.

Telehealth services can indeed be used for the homemonitoring of stable patients with COVID-19, with likely benefits in terms of healthcare cost and resource utilization, as well as in increasing physical activity compared with usual hospital care. 3 We present the trends of telehealth usage in our general and geriatric medicine clinics since the start of the COVID-19 pandemic in Fig. 1 . Whilst telehealth services are not new internationally or locally, our institution's telehealth services really only kicked off when the COVID-19 pandemic arrived on our shores in late January 2020.

As the number of COVID-19 cases rapidly increased within a few months, the utilisation of teleconsultations increased in tandem, reaching a peak of 18% of all consults in geriatric medicine in April 2020. This coincided with the peak number of daily COVID-19 cases in Singapore. As soon as Singapore ended a partial lockdown in June 2020, the proportion of teleconsultations plunged for older adults to 1.3%. This is probably because those who had postponed clinic consultations and did not choose the option of telehealth were more likely to request in-person medical consultations. The rate of decline for general medicine patients was not as steep, reaching a stable plateau of 6-7% of all clinic consultations. The barriers and the reasons why older adults may not adopt the use of telehealth were discussed in our article. 2 The COVID-19 pandemic has remained under control in Singapore since July 2020, and the government continues to relax measures around social distancing and public gatherings to Letters to the Editor -Comments © 2021 Japan Geriatrics Society.

| 439 facilitate the recovery of the economy. Apart from a limited period of local spread that was contained by a partial lockdown, the majority of cases occurred in the population of foreign workers in dormitories. COVID-19 transmission was finally contained amongst the foreign worker population in October 2020. Since then, the majority of cases have been imported, with zero to single-digit daily community cases.

Interestingly, the utilisation of teleconsultations by older adults has only increased since the nadir in June 2020, despite good control of the COVID-19 pandemic locally. Percentage utilisation has surpassed that of general medicine patients and continues to be on an upward trend. This suggests that whilst the COVID-19 pandemic helped to catalyse a greater uptake of telehealth amongst patients, fear of virus transmission itself is not the only factor influencing the uptake of this service. In fact, the trends suggest that use of telehealth may be greater in older adults when the process is facilitated well and patients have had the chance to experience and use telehealth for themselves.

Since the introduction of telehealth services in our institution, we have continued to develop the range of services available through telehealth. These include teleconsultations with allied health practitioners, including dieticians, psychologists, pharmacists, social workers and nurses, to provide a plethora of services such as tele-medication reconciliation, tele-counselling, tele-nurse education and tele-advanced care planning. Patients and their families have realised the convenience of telehealth services, and uptake continues to increase even as the number of COVID-19 cases declines. Telehealth increased the productivity of our community nursing team by enabling more cases to be managed per nurse with the use of assistive devices such as home blood pressure monitoring and glucometer sets with Bluetooth-and Wi-Fi-enabled cloud computing. 4 There is great potential for telehealth services to bring benefits and convenience to the general population, even after the end of the pandemic. Further study into the health outcomes and costeffectiveness of telehealth services is warranted. Because the COVID-19 pandemic led to an unprecedented upheaval of daily routines and assumed patterns of healthcare delivery, there is considerable room for innovation and new models of care 5 to deliver services effectively to patients.

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Telehealth utilisation amongst older adults during a pandemic year

of clinic consultations seen as teleconsultations in general medicine vs. geriatric medicine clinics from

No funding was received for this letter.

The authors have no conflicts of interest to declare.Li Feng Tan, 1 Santhosh Kumar Seetharaman 1 and Wenjun Alexander Yip 2