Reliability of an Online Geriatric Assessment Procedure Using the interRAI Acute Care Assessment System
- 21 August 2017
- journal article
- research article
- Published by Wiley in Journal of the American Geriatrics Society
- Vol. 65 (9), 2029-2036
- https://doi.org/10.1111/jgs.14895
Abstract
To determine whether geriatric triage decisions made using a comprehensive geriatric assessment (CGA) performed online are less reliable than face-to-face (FTF) decisions. Multisite noninferiority prospective cohort study. Two specialist geriatricians assessed individuals sequentially referred for an acute care geriatric consultation. Participants were allocated to one FTF assessment and an additional assessment (FTF or online (OL)), creating two groups—two FTF (FTF-FTF, n = 81) or online and FTF (OL-FTF, n = 85). Three acute care public hospitals in two Australian states. Admitted individuals referred for CGA. Nurse-administered CGA, based on the interRAI Acute Care assessment system accessed online and other online clinical data such as pathology results and imaging enabling geriatricians to review participants’ information and provide input into their care from a distance. The primary decision subjected to this analysis was referral for permanent residential care. Geriatricians also recorded recommendations for referrals and variations for medication management and judgment regarding prognosis at discharge and after 3 months. Overall percentage agreement was 88% (n = 71) for the FTF-FTF group and 91% (n = 77) for the OL-FTF group. The difference in agreement between the FTF-FTF and OL-FTF groups was −3%, indicating that there was no difference between the methods of assessment. Judgements made regarding diagnoses of geriatric syndromes, medication management, and prognosis (with regard to hospital outcome and location at 3 months) were found to be equally reliable in each mode of consultation. Geriatric assessment performed online using a nurse-administered structured CGA system was no less reliable than conventional assessment in making clinical triage decisions.Keywords
Funding Information
- National Health and Medical Research Council (569688)
This publication has 21 references indexed in Scilit:
- The Hidden Economics of TelemedicineAnnals of Internal Medicine, 2015
- The emerging field of mobile healthScience Translational Medicine, 2015
- Telemedicine, Telehealth, and Mobile Health Applications That Work: Opportunities and BarriersAmerican Journal Of Medicine, 2013
- The Diagnostic Accuracy of Telegeriatrics for the Diagnosis of Dementia via Video ConferencingJournal of the American Medical Directors Association, 2012
- Reliability of online geriatric consultation triage decisions: A pilot studyAustralasian Journal on Ageing, 2011
- Comprehensive geriatric assessment for older adults admitted to hospital: meta-analysis of randomised controlled trialsBMJ, 2011
- A systematic review of studies concerning observer agreement during medical specialist diagnosis using videoconferencingJournal of Telemedicine and Telecare, 2011
- A systematic review of comprehensive geriatric assessment to improve outcomes for frail older people being rapidly discharged from acute hospital: 'interface geriatrics'Age and Ageing, 2011
- Acute Care for Elders (ACE) Tracker and e‐Geriatrician: Methods to Disseminate ACE Concepts to Hospitals with No Geriatricians on StaffJournal of the American Geriatrics Society, 2010
- The Efficacy of Diagnostic ImagingMedical Decision Making, 1991