Table 1.
Domains of the comprehensive geriatric assessment (CGA) as delivered during in-person vs. telehealth clinical encounters.
| Domain | In-person CGA | Telehealth CGA |
|---|---|---|
| Comorbidities | Chart review Clinical interview | Same, but improved interview with involvement of caregiver |
| Geriatric Medication Review | Semi-structured interview using chart list and patient input | Semi-structured interview and medication reconciliation in the home |
| Function | ADLs and IADLs | Same |
| Mobility | Falls screen | Falls screen |
| Chair stands | With video: Chair stands, observation of gait and movement in living space | |
| Timed up and go (TUG) Gait speed | ||
| Sensory | Finger rub/whisper test for hearing | For patients who are hard of hearing: ensure access to hearing aids, use amplification device, use closed captioning. |
| Visual screening | ||
| For patients with visual impairment: ensure access to glasses, involve caregiver with video technology. | ||
| Cognition | Clinical interview Cognitive screening tests* | Telephone-only: clinical interview, telephone-MoCA, CAM |
| With video: Mini-Cog or MoCA | ||
| Mood | Mood screening questionnaire# | Same |
| Nutrition | Food quality and access | Food quality and access |
| Mini Nutritional Assessment (MNA) | MNA | |
| Clinic weight | Ask for weight on home scale | |
| Physical exam | With video: Physical exam | |
| Social Domains | Clinical interview regarding social domains (e.g. home services, caregiver stress/support, social network, etc.) | Same |
| Advance Care Planning | Serious illness conversation | Serious illness conversation |
| Completion of HCP and/or MOLST form in person | Completion of remote HCP and/or MOLST form (via two-clinician verbal authorization, electronic communication, or mail) | |
| Frailty | Frailty screen^ | Same |
*Confusion Assessment Method (CAM), Mini-Cog, Montreal Cognitive Assessment (MoCA), or other indicated cognitive screening tool.
#May include Patient Health Questionnaire (PHQ) -2 or − 9, Geriatric Depression Scale (GDS), Generalized Anxiety Disorder (GAD) -2 or − 7, and/or other indicated tools.
^FRAIL scale (fatigue, resistance, ambulation, illnesses, and loss of weight), Clinical Frailty Scale (CFS), and/or frailty index (FI).