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Treatment: Integration of Nursing homes and Telemedicine  

Why

Nursing home hosts over 5 % of elderly adults in the US and the percentage goes up in the mid west

It presents a set of problems that need to be solved as the aging population increases 

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Telemedicine is the trend for regular checkup and screening which is made into reality during the COVID pandemic. Yet, current legislation structure and providers are not ready for this rapid change. 

WHat

In light of the problems presented in nursing home and current telepsychiatry and telemedicine legislation, we see the need to advocate for an integration of both methods in order to increase mental health monitoring and treatment among geriatric population.

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We propose that an integration of the physical care and mental health care via telemedicine can effectively screen people with depressive symptoms for timely care provision

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Three main objectives for this integrative

treatment plan:  

Increase collaboration between nursing homes and primary care providers for telemedicine visits    

Increase staffing for technicians to support and facilitate telemedicine visits at nursing homes 

Promote monitory mental health applications for nursing home residents that allow timely alert for their nurses and primary physicians 

How

With the newly passed "Supporting Older Americans Act of 2020" on March 25th, 2020, we see the opportunity to promote this integrative plan as one of the implementation under Title III— Modernizing Activities for Health, Independence, and Longevity that includes Section 304, specifically addressing the need to increase projects related to social isolation. We hope to start this integration pilot project by increasing staffing telehealth personnels in the mid west. 

As high costs listed as one of the main reasons that prevent elderly populations from seeking mental health care, we propose to expand Medicare plan B's depression screening to broader mental health screening in order to monitor senior mental health and provide timely treatment 

Expanding the Chinese telehealth application system, we should expand the options for mental health consulting and monitoring to screen patients with loneliness symptoms that may easily build up to suicidal inclinations  

A conversation with a family physician who has newly switched to telemedicine during the pandemic seres as a testimony to support our proposal on the integration of nursing homes and telemedicine

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Interview with Dr. Lozano 

As a family physician practicing for 28 years, I think this policy advocacy is important because eldelry patinets need to stay connected and be screened for any symptoms of loneliness.  

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I see the convenience of telemedicine. I found it effective and time saving for patients too, becuase they do not need to waste time at the waiting room. Also, we can prevent uncessary patient contacts. 

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However, I found that younger generations adapt to telemedicine a lot faster than my elderly patients. You will be surprised by some of them, but most of them do not have the level of comforatbility as the younger folks. 

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I think telemedicine is here to stay, but the most important question is who would pay for it? We are now waiting to see whehter telehealth policies during COVID will continue even after COVID. If Medicare keeps its reimbursement rate, private insurance companies will followup.

  

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Excerpt from interview with Dr. Lozano, a UCLA primary care physicians 

Sources: 

1. Our Parents, Ourselves: Health Care for an Aging Population. Dartmouthatlas. Retrieved from https://www.dartmouthatlas.org/downloads/reports/Our_Parents_Ourselves_021716.pdf

2. H.R.4334 - Supporting Older Americans Act of 2020. Congress.gov. Retrieved from https://www.congress.gov/bill/116th-congress/house-bill/4334/text?q=%7B%22search%22%3A%5B%22social+isolation%22%5D%7D&r=3#toc-H93422C27DC904E2A810D563B561E4E88.

3. Depression screenings. Medicare.gov. Retrieved from https://www.medicare.gov/coverage/depression-screenings

4. Shang, J., Jin, J., Zhang, P., & Wei, S. Mental Health Apps in China: Analysis and Quality Assessment. JMIR mHealth and uHealth. https://mhealth.jmir.org/2019/11/e13236/.

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