Background: Geriatrics specialists are scarce but needed to provide comprehensive, individualized care to older rural Veterans with complex needs. Tele-geriatrics and geriatric mental health (tele-GGMH) services, where clinicians provide specialized consultation and/or time-limited care to residents of a wide geographic area via telehealth, can help meet these needs. Clinicians referring Veterans patients to tele-GGMH services were surveyed to understand their reasons for requesting consultations and satisfaction with services provided. Methods: Veterans Health Administration clinicians from seven regions referring to tele-GGMH services between October 2021 and September 2023 completed the survey. Qualitative and quantitative analyses summarized referring clinicians’ experience and satisfaction with tele-GGMH services. Differences between rural- and nonrural-serving clinicians and prescribing and nonprescribing clinicians were examined. Results: Sixty-nine clinicians responded. Most learned about the tele-GGMH services via word-of-mouth and believed the service increased access to geriatric mental health care. Follow-through with specialists’ recommendations was associated with satisfaction, however nonprescribers and nonrural clinicians had decreased follow-through linked to lower satisfaction. Qualitative data indicated that the top reasons clinicians asked for consultation was to request specific services including subcategories of diagnostic clarification or evaluations, medication management or recommendations and nonpharmalogical interventions. The most frequent barrier reported was postservice barriers implementing the recommendations. Most additional feedback was of general satisfaction and appreciation. Conclusions: Tele-GGMH services are appreciated by referring clinicians and facilitate access to geriatrics expertise. Ability to follow through with the specialist’s advice predicted satisfaction with the service. Receiving assistance with specific services was the most frequent reason for requesting services.
Carlson et al. (Sun,) studied this question.