Table 2.

Intervention Details

Study	Focus	Intervention Details	Diagnoses	Roles Involved	Resident Mean Age in Study, y	NH Beds	Setting	Country
Telemedicine Consults
Cheng et al, 202024	•Access to orthopedic specialist •Patient and Provider perceptions of quality and utility of telemedicine	•32 musculoskeletal consults delivered over videoconferencing telemedicine solution •Included 26 long-term care facilities •8-mo study period (September 2018 through April 2019)	•Musculoskeletal	•Orthopedic surgeon (n = 1) •NH RN •Patient and patient family (n = 14) •Unknown (“representatives from Ontario Telehealth Network”)	—	26 NHs	Rural	Canada
Driessen et al, 201825	•Provider perceptions of quality and utility of telemedicine	•N/A (study is reviewing results from a survey distributed at a conference)	•Interest in teleconsults	•NH providers (N = 524)	—	—	—	United States
Georgeton et al, 201526	•Telemedicine access to geriatrician specialists •Adherence to specialist advice and recommendations	•Dedicated rooms with high-def cameras in 3 NHs •Teleconsultations between patients and remote geriatricians and advice for GPs. •8-mo study period (July 2013 to March 2014)	•Dementia •High burden of comorbidities	•Residents (N = 69) •General practitioners •Geriatricians •Telemedicine assistant (undefined)	86	220 beds (across 3 NHs)	—	France
Gordon et al, 201627	•Access to geriatricians and geropsychiatric specialists •Focus on quality measure results between telemedicine and control groups •Physical and chemical restraint usage	•120-min biweekly case-based video consultation •Connecting frontline NH staff with Beth Israel Medical Center in Boston •3-4 NH residents presented each session •18-mo study period	•Dementia •Restraint use	•Geriatricians •Geropsychiatrists •Nurses •Nursing assistants •Activities directors •Social workers	—	16 NHs (min 46, max 335 beds)	—	United States
Helmer-Smith et al, 202028	•Asynchronous eConsults	•Online application allows NH providers to submit nonurgent questions to specialists from 100 specialty groups.	•Not limited	•Residents (n = 64) •NH providers (n = 52) •Administrators •Nurse champion	80	3400 beds (across 18 NHs)	—	Canada
Hofmeyer et al, 201629	•Access to infectious disease, wound care, cardiology, nephrology, and other specialists •Decreasing preventable hospitalizations	•24/7 pilot model of telephone- and video-based consultations in rural areas •2-way video, stethoscope, high-definition camera •Specialties included infectious disease, wound care, cardiology, nephrology, and others •Used interventions to reduce acute care transfers tool •3-y study period (2012-2015)	•Transfers for syncope, neurologic issues, respiratory distress	•Residents (N = 736) •Director of eLTC •Service line manager •Advanced practice providers •Specialist physicians •Registered nurses	-	5000 beds (across 34 NHs)	Rural	United States
Low et al, 202030	•Clinical workings of teleconsult program	•1673 consults •8 NHs •6.5-y study period (December 2010 through March 2017)	•Not limited	•Hospital doctors (N = 6) •NH senior nurses	77	1600 beds (across 8 NHs)	Urban	Singapore
Perri et al, 202014	•Access to palliative care specialists •Patient and provider perceptions of quality and utility of telemedicine	•Clinical staff at 2 pilot sites monitored residents weekly for predefined events that trigger a palliative care consult •Gold Standard Framework Proactive Identification Guidance tool used to evaluate palliative care needs •Dedicated conference room at NH with videoconferencing included computer, widescreen monitor, external microphone, high-definition camera •Family given choice to join via videoconference or in person •6-mo study period (November 2017–April 2018)	•Dementia	•Residents (n = 61) •Clinical staff (n = 22) •Medical doctors •Registered nurses •Social workers •Palliative care specialists •Patient families	87	472	Urban	Canada
Piau et al, 202031	•Management of neuropsychiatric symptoms via telemedicine	•Telemedicine consult visits within 72 h of disruptive neuropsychiatric symptom between NH and geriatricians at expert memory centers •Interview NH staff before and after telemedicine experience •2-y study period (2015-2017)	•Neuropsychiatric symptoms	•Residents (N = 90) •NH providers •NH nurses •NH psychologists •Consulting geriatricians	—	10 NHs (min 60, max 133 beds)	—	France
Stern et al, 201432	•Access to wound care specialists •Outcomes were reduction in pressure ulcer (PU) surface area, time to complete healing, PU incidence, PU prevalence, and wound pain	•Each facility appointed wound care lead to be primary contact for study team •Wound care nurse practitioner in person for phase 1 (3 mo) •NP was primarily remote and provided wound care via digital photos, video visits, e-mail, and phone conversations (1-11 mo) •Compared usual care to intervention	•Pressure injury	•Residents (N = 137) •Advanced practice nurses specialized in wound care •NH registered nurses	82	1992 beds (across 12 NHs)	-	Canada
After-Hours Support and Remote Assessments
Grabowski and O’Malley, 201433	•Coverage of nights and weekend hours for NHs •Impact of telemedicine on number of residents hospitalized. •Comparing NH data	•Provider coverage for NHs through telemedicine group to cover urgent and emergent weeknight calls from 5p-11pm, and weekend day coverage (10am-7pm). •Cart with videoconferencing and high-res camera •NH providers not informed that would be studying hospitalizations •13 month study period (October 2009 through November 2010)	•Reducing hospitalizations •Financial savings	•NH physicians (primary group practices typically covered off-hours care) •Telemedicine group registered nurse, nurse practitioner, physician •NH-level patient data	-	11 NHs (min 140, max 175 beds)	-	United States
Stephens et al, 202034	•Explore experiences of NH resident transfers to ED through qualitative methods	•Initial focus groups were of like individuals (eg, NH nurses) •After recurrent themes emerged, focus groups of mixed stakeholders were held. •Semi-structured interview •Focus groups viewed video demo of telehealth consult flow •Participants asked how technology may change ED transfer experience	•Transfers from NH to ED	•NH resident family members (n = 6) •NH providers and nursing staff (n = 30) •ED and hospital providers (n = 5) •NH administrators	—	—	Urban, suburban, and semirural	United States
Remote monitoring
Dadosky et al, 201835	•Access to HF specialists •Decreasing hospital readmissions •Improving time to intervention in SNF •Collaboration between HF clinic, SNF, and HHC •Evaluate patient provider acceptance of telehealth	•HF clinicians in office setting assessed patient in SNFs with telemedicine sessions. •A sensor worn on the chest provided HR, RR, body position, and single-lead ECG. •BP, pulse-oximeter, and weight were monitored via Bluetooth devices. •The HF and SNF providers used a Bluetooth stethoscope to remotely auscultate heart and lung sounds. •POC lab testing used to measure BNP, BMP •Data viewable on dashboard for SNF and HF clinic clinicians •21-mo study period (March 2014–December 2015)	•Heart failure	•Patients (N = 141) •HF office clinicians (unknown roles) •NH providers •NH nursing staff •HHC staff	81	—	Suburban	United States
De Luca et al, 201637	•Access to neurology and psychology specialists •Telehealth impact on psychological measures, quality of life, and neurobehavioral symptoms •Improving vital signs and clinical management	•BP, pulse-oximeter, ECG via Bluetooth devices •Recorded sounds from Bluetooth stethoscope •Dashboard for providers •Videoconferencing solution for telemedicine visits •Study period undefined, T0 = before telecare protocol T1 = after telecare protocol	•Dementia •Depression	•Residents (N = 59) •Neurologist •Psychologist •NH nursing staff	80	—	—	Italy
De Vito et al, 202036	•Activity monitors and monthly wellness telemedicine visits with PLWD	•Activity monitor to track steps, HR, and sleep data •Monthly telemedicine visits with neuropsychologists and PLWD and their caregiver: setting wellness goals, care recommendations •Monthly questionnaires •6-mo study period	•Dementia	•Residents (n = 18) •NH caregiver (n = 6) •Neuropsychologists (n = 1)	84	—	—	United States
Yu et al, 201438	•Using telehealth and sensors to record incontinence episodes •Using technology insights to develop clinical care plans	•Use sensor to collect baseline data of incontinence episodes and time •Dashboard allowed SNF staff to see when sensor activated •Manually collect other voiding events •Consultant used data to develop individualized urinary continence care plans •Outcomes of the intervention were recorded by using sensor to collect incontinence data and SNF staff manually recording voiding events. •12-week study period (in 2011)	•Urinary incontinence	•Personal care workers •Residents (N = 31) •Continence consultants from vendor	81	120	Urban	Australia

BMP, basic metabolic panel; BNP, B-type natriuretic peptide; BP, blood pressure; ECG, electrocardiogram; GP, general practitioner; HF, heart failure; HHC, home health care; HR, heart rate; N/A, not available; NP, nurse practitioner; PLWD, person living with dementia; POC, point of care; PU, pressure ulcer/injury; RN, registered nurse; RR, respiratory rate; SNF, skilled nursing facility.