Background: Geriatric and palliative care patients who have been discharged from hospital and are home-limited face challenges in effectively accessing ongoing healthcare and clinical follow-up after being discharged, leaving them at risk for unnecessary re-hospitalization. Health care video visits present a novel opportunity to expand patient access to clinical care remotely in their home, potentially decreasing unnecessary re-hospitalizations in this patient population. However, the feasibility and acceptability of video visits for home-limited patients is not known.
Purpose: To pilot a clinical video visit program for home-limited patients to assess the feasibility and acceptability.
Description: We developed and piloted a video-visit program for home-limited patients. There were three phases to our pilot:
1. Pre-implementation: 20 home-limited patients (14 female and 6 male) completed a telephone-based accessibility survey that assessed their interest and ability to participate in video visits with their physician. 13 (65%) were interested in participating in primary care video visits. Of these, the majority had the technological capability and caregiver support to utilize internet-enabled video visits. (Figure 1).
2. Implementation: Video visits were then completed with a separate set of 14 recently-discharged patients (6 female and 8 male). Patients were provided with printed resources on how to download the necessary software and start a video visit (Figure 2). A ‘test visit’ was then conducted with a research coordinator. The clinical care provided in the video visits was up to the discretion of the provider based on patient/family need.
3. Post-implementation: Post-visit feasibility patient surveys found high levels of satisfaction with clinical content of the visit and communication with their clinician, as well as with the audio and video quality. Patients reported that they would opt to utilize the video visit services again and that they were very likely to recommend video visits to others (Figure 1).
Conclusions: Our pilot program has demonstrated that recently-discharged home-limited adults can participate in video visits with a clinician for ongoing care and monitoring, and furthermore that many have the technological and logistical capabilities to do so. More studies are needed to determine if these visits could prevent future hospitalizations or re-admissions.
