TeleDementia
Opportunity
Dementia, including Alzheimer's disease and related disorders (ADRD), represent a growing epidemic in the United States, particularly in rural communities. According to the Alzheimer's Association, ADRDs are the sixth leading cause of death, growing by 71 percent between 2000 and 2013. Rural health studies show non-metropolitan areas tend to be disproportionately affected by ADRDs due to higher populations of aging communities and limited access to care. Researchers argue that individuals suffering from ADRDs in rural areas are more likely to receive suboptimal care, experience unnecessary hospitalizations and are less likely to be diagnosed with an ADRD overall.
Solution
OSF Innovation is providing accessible, preventive care solutions for dementia patients living in rural communities across the Ministry through OSF TeleDementia. The OSF HealthCare Illinois Neurological Institute is serving communities around Galesburg and Ottawa, Illinois with unprecedented access to dementia care through telehealth since 2017. Employing sophisticated tele-carts equipped with video conferencing technology, a cognitive neurologist can administer full dementia care visits locally for patients in rural communities that previously had limited or no options for care.
Impact
OSF HealthCare is providing timelier, localized access to expert dementia care for patients located in two geographically separate communities. Through the use of OSF TeleHealth technology and support, the neurologist can expand access to service without requiring patients to travel long distances or sacrificing limited provider availability to visit distant locations.
In less than a year, OSF TeleDementia has provided more than 170 dementia care visits to rural patients who would normally be required to travel as much as 100 miles to see a provider. OSF TeleDementia allows OSF HealthCare the ability to better serve patients and expand its reach and impact of service.
"As the only Alzheimer's disease and dementia trained neurologist serving Central Illinois, I am excited to be able to provide the patients of rural communities and their families with a comprehensive assessment as well as therapeutic recommendations for management of dementia and cognitive disorder. Since August 2017, telemedicine has allowed me to expand my presence to patients in two rural OSF INI locations via video-conference sessions. This has allowed me to provide accessible care to many patients who, due to mobility problems and convenience, would prefer to be seen closer to home."
- Julia Biernot, MD, cognitive neurologist, OSF HealthCare Illinois Neurological Institute Memory & Dementia Care Clinic
Understanding the Needs of Rural Communities
In 2015, the Alzheimer's Association (AA) estimated 5.3 million cases of Alzheimer's and related disorders (ADRD) in the United States with a projected rise to 8.4 million by 2030. The challenges of dementia care are being exacerbated in rural communities by issues related to the aging baby boomer generation – immigration of retirees to rural areas, the growing desire to "age-in-place" and out-migration of youth to urban areas.
The AA reports 20 percent of the population in non-metropolitan areas is over the age of 65. The mortality rate, due to ADRDs, was 11 percent higher in rural areas between 2005 and 2009. On top of this, ADRDs may also contribute to other health challenges. For example, studies show rural health patients are less likely to receive an influenza diagnosis, have shorter hospital stays and are 50 percent more likely to die from influenza.
Care for dementia patients is limited to a subset of specialized neurologists, meaning that referred patients may not have convenient or timely access to care. Recognizing the challenges for individuals seeking dementia care, OSF Innovation joined with OSF INI to help solve this problem for rural communities by developing the OSF TeleDementia program which employs the use of OSF TeleHealth applications.
Unparalleled Access to Care through Innovation
Using video conferencing technology run through a clinical tele-cart system, OSF TeleHealth began offering tele-visits for dementia patients at the Galesburg OSF INI in September of 2017. OSF TeleDementia has been expanded to the OSF INI Ottawa location as well with plans to serve more rural communities.
OSF TeleDementia patients check-in to their respective OSF INI clinic locations as they would for an in-person appointment with their provider. Vitals and medication history are taken by nursing staff and proper documentation is recorded in the patient electronic medical record. Patients along with approved caregivers are then guided to a private room with a tele-cart equipped with high-quality video conferencing technology and clinical assessment tools that allow the patient and physician to interact with the help of a tele-presenter. Patients of OSF TeleDementia receive a full standard of care including a cognitive and neurological examination.
After the assessment, the physician discusses the findings and any additional testing needed to facilitate a diagnosis. A second encounter is typically scheduled after testing has been completed to discuss the diagnosis, management and treatment recommendations. At the conclusion of any visit, an after visit summary with detailed instructions is provided to the patient. The use of OSF TeleHealth technology allows neurologists to administer full 90-minute dementia care visits to patients remotely located throughout the Ministry.
Results
Through OSF TeleDementia, patients are able to meet locally with specialized physicians who can provide care without sacrificing their available hours to travel time. In less than a year, OSF HealthCare neurologists have provided more than 170 dementia care visits to rural patients who would normally be required to travel as much as 100miles or more to see a provider. OSF TeleDementia is enabling our specialized providers the ability to better serve patients and expand their impact of care.