Student-Facilitated, Enhanced Telehealth Home Care for Older Adults and People with Disabilities.

BACKGROUND

Primary care home visits benefit older adults and adults with disabilities but are often challenging to sustain. While telehealth is less costly and time-intensive, potential limitations include access, assessment adequacy, and patient satisfaction.

AIM: To improve patient access to effective telehealth encounters as a component of home-based care while educating medical students via home visits.

SETTING

Home-based primary care program partnership between a federally qualified health center and a tertiary academic center in the Southeast US from November 2022 to June 2023.

PARTICIPANTS

Eight medical students and eight patients.

PROGRAM DESCRIPTION: Student pairs facilitated video telehealth encounters with patients in their homes supervised by an off-site clinician. Outcome measures included clinical activities conducted, patient satisfaction, and medical student reflections.

PROGRAM EVALUATION: Students facilitated 28 enhanced telehealth visits. In total, 287 clinical activities were performed. Of the 238 activities evaluated for clinical utility, 13.2% warranted an intervention. All patient participants were satisfied and interested in continuing. Student reflection themes included valuing longitudinal relationships, home-based care, and social determinants of health.

DISCUSSION: This novel program may improve patient access to home-based care via telehealth encounters facilitated by medical students and, concurrently, provide a model for student participation in home visits.