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Abstract Background With the geriatric population in the United States growing rapidly, the prevalence of mental health or substance use disorders, including dementia-related behavioral and psychiatric symptoms, is expected to rise concomitantly. Despite this clear and growing demographic need, the number of physicians formally trained in geriatric psychiatry is shrinking, reducing the availability of specialty care to this vulnerable demographic. This disparity is magnified in rural settings and/or historically disadvantaged areas and populations where access to geriatric psychiatrists may be severely limited, if available at all. Methods Two asynchronous geriatric psychiatry consultation programs, one EMR based e-consultation program and one on-demand telephone consultation program, were developed and implemented by geriatric psychiatrics within the Dartmouth Health and New Hampshire Hospital systems. Data was gathered and analyzed retrospectively to examine the outcomes of the one programs. Results The majority of EMR based e-consultations and telephone consults are appropriate, relate to management questions and neurodegenerative disorders, are requested by primary care providers (PCPs) or medical specialists, result in a total uptake of recommendations in a high percentage of cases, reduce reliance on overburdened mental healthcare systems, and result in a high level of reported satisfaction among consultees. Conclusion In resource poor areas, or within health systems where access to geriatric psychiatry is limited, EMR based e-consultations and telephonic consultations are an effective means of alleviating the burden on patients and providers. Broader implementation should be considered and studied further.
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Volle et al. (2024) studied this question.