Primary care
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Telehealth is commonly used in the care of geriatric patients; however, it requires special considerations for effective implementation. Although available evidence suggests that this model of care is useful and feasible, interventions should be carefully designed with the unique needs of geriatric patients in mind. Further, more research is needed to determine the most effective telehealth interventions in this population, which will assist in determining cost-effectiveness and reimbursement policies.
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Asynchronous telehealth provides a viable option for improving access in a convenient and timely manner to patients seeking care as well as for physicians seeking subspecialty consultation. Access to technology, clear guidelines, standards, and expectations is required for this innovation to function well. ⋯ Positive impact on access and quality has been demonstrated. Rapid development continues and was enhanced with the Sars-CoV-2 pandemic.
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Recent rapid expansion of telemedicine services has included delivery of those services to adolescents and young adults. Telemedicine can be used to provide a wide array of health services to adolescent and young adult (AYA) including the treatment of mental health and substance use disorders, gender-affirming services, contraception, acute care, and health education. Special attention to minor consent laws which vary by state and country should help inform the health system and practice decisions for patient portal access, delivery of confidential care, and care for which the consent of a guardian or parent is required. For AYA with limited transportation options or who are geographically distant from specialty care, telemedicine helps expand access to those services.
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Telemedicine was underused and understudied until the COVID-19 pandemic, during which reduced regulations and increased payment parity facilitated a rapid increase in telemedicine consultation. Telemedicine literature to date suggests that it holds benefits for patients and health care providers, may result in outcomes not inferior to in-person care, and has cost-saving implications. Future research should investigate which conditions are best suited to assess and treat via telemedicine (including physical exam elements), what techniques improve telemedicine communication, how to help patients equitably access telemedicine, and how to best educate the future health care workforce.