Video consultations to ease stress on frail patients

Monash University's Department of Geriatric Medicine is pioneering a high-tech way of consulting with elderly patients so they do not have to leave their nursing home beds.

Professor Barbara Workman, head of geriatric medicine and director of the Monash Ageing Research Centre, based at the Kingston Centre in Cheltenham, says pain management is one of the biggest challenges facing geriatricians.

In an Australian first, Professor Workman, who is also director of the centre's Pain Clinic, has developed a way for specialists to consult with frail patients via video-conferencing.

"At the pain clinic, we are often asked to see nursing home patients -- the frailest, most vulnerable and most complex patients in our communities," Professor Workman said. "But we found we couldn't get to the many people who needed specialist care, and the trauma, time and cost involved in transporting frail elderly patients to pain management clinics was just too great."

So Professor Workman came up with the idea of using video-conferencing as a solution. With $50,000 funding from a Department of Health and Ageing innovation grant, she began testing the method last month, using technology to provide 'bedside' consultations to patients at Kingston.

"I have been able to provide full consultations, talking with the patients about their conditions and where they're experiencing pain -- and I can also see if a patient is wincing but claiming she does not have pain in a particular area," Professor Workman said. "And the patient can see me, which is equally important for credibility and feeling comfortable."

The clinic is also exploring the possibility of using video phones for the consultations, which can provide top-quality images. Professor Workman and her colleagues, including Dr Chris King who is also working on the project, are evaluating the success of the video-conferencing by surveying the patients and nursing home staff.

The next step will be applying for funding to expand the program -- not just for pain management but also for a range of conditions affecting elderly patients.

"The physical, emotional and financial savings for patients, their families and the health care system could be enormous," Professor Workman said.

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