New Study Finds Telemedicine Enhances Access to Primary Care for Dementia Patients
A recent study reveals that telemedicine enables individuals with dementia to access primary care approximately two days earlier than traditional in-person care. The findings, from the University of California, San Francisco (UCSF) and Kaiser Permanente Division of Research, were published in the Journal of General Internal Medicine (JGIM) on November 18, 2024. Further, use of telemedicine did not lead to meaningfully higher levels of post-visit utilization – such as emergency department visits.
The study addresses a critical gap in understanding the benefits and limitations of telemedicine for people with dementia, a population for whom timely care and reduced travel burden are essential. While telemedicine can offer quicker access to primary care, challenges such as the inability to perform physical exams and communication difficulties due to cognitive impairments may limit its effectiveness.
The research team examined if these limitations could lead to higher post-visit utilization, such as emergency department visits or subsequent in-person care, signaling unmet care needs.
By analyzing data from two large health systems – UCSF Health and Kaiser Permanent Northern California (KPNC) – with significant telemedicine adoption following the COVID-19 pandemic, the study provides valuable insights into balancing the strengths of virtual and in-person care to optimize outcomes for this complex patient population. They also highlight telemedicine's ability to deliver timely care without increasing subsequent utilization, supporting its role in managing the complex needs of people with dementia.
“These are the findings we had hoped for,” said Julia Adler-Milstein, PhD, who is the lead author of the study and chief for the UCSF Division of Clinical Informatics and Digital Transformation (DoC-IT). “Our study reveals that those with dementia are realizing a key benefit of telemedicine – more timely access to care without the need to travel – and are not suffering unintended consequences if telemedicine were not used appropriately, such as needing to go to the ED.”
The study, titled “Telemedicine Use in Primary Care Associated with More Timely Access Without Unintended Subsequent Utilization for People with Dementia,” was conducted by Julia Adler-Milstein, PhD, chief and professor for DoC-IT, Christopher Toretsky, MPH, data analyst for DoC-IT, Anjali Gopalan, MD, MS, research scientist for the Division of Research at KPNC, Jie Huang, PhD, data scientist for the Division of Research at KPNC, and Mary E. Reed, DrPH, research scientist for the Division of Research at KPNC. The project was supported by the NIH National Institute on Aging (NIA).
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This study is a continuation of the research partnership between UCSF and KPNC to evaluate the effectiveness of telemedicine on dementia patients. Their analysis, also published in JGIM in July 2024, focused on the patterns of telemedicine use in primary care after the pandemic among this patient population.
Upcoming Event – Thursday, December 12, 2024
Interested in hearing directly from the study’s lead author? Catch Julia Adler-Milstein, PhD, as she presents at the upcoming PennAITech Collaboratory for Healthy Aging Webinar Series.
“Assessing the Use and Impact of Telemedicine in the Primary Care Setting for People with Dementia”
Thursday, December 12, 2024
4-5 p.m. Pacific Time
Virtual event
About the UCSF Division of Clinical Informatics and Digital Transformation (DoC-IT)
DoC-IT serves as the academic home for applied clinical informatics researchers within the UCSF Department of Medicine. We also serve as a coordinating entity with key internal and external digital stakeholders across all UCSF mission areas, schools, departments, and divisions. Clinical informatics is approached as a multidisciplinary field that involves the use of technology by a broad spectrum of health professionals, patients, and other stakeholders.
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