Table 1.

Enhancements Needed to Make Nursing Home Telemedicine Encounters Easier and More Effective

Equipment and Infrastructure

1. NHs should invest in the infrastructure necessary to support telemedicine encounters through improved connectivity and bandwidth

2. NHs should invest in dedicated and adequate as well as appropriate equipment to conduct telemedicine encounters (eg, laptop or tablet)

3. NHs should have ready access to secondary sound amplification devices to use during telemedicine encounters with hearing-impaired residents

4. NHs should have ready access to a telehealth-enabled stethoscope that allows providers to remotely perform a heart and/or lung examination when necessary

5. NHs should have access to high-resolution video or camera equipment that enhances remote assessment of skin and wound findings

Scheduling

1. NHs should develop or invest in a common platform that allows key individuals to schedule telemedicine encounters

2. NHs should centralize scheduling of telemedicine encounters to a core individual(s)

3. NHs should adopt telemedicine block schedules that factor in sufficient time before and after encounters for interprofessional information exchange and care-planning

Information Exchange

1. NHs should provide clinicians and their staff with remote access to NH electronic health records

2. NHs and providers that engage in telemedicine encounters should develop and implement procedures and staff training that standardize (1) the types of information shared between NH staff and providers, (2) how these types of information should be shared, and (3) who is responsible for these information sharing tasks

Telemedicine Encounter Facilitator

1. NHs should identify and dedicate staff to facilitate telemedicine encounters

2. The telemedicine encounter facilitator should be a clinician (I.e., RN or LPN)