Community geriatric telemedicine in Malaysia (CORTICAL©): A collaborative modified Delphi method for shared care strategies involving family medicine specialists and geriatricians

Geriatric telemedicine serves as a vital resource for the older adult population who face obstacles to access care, mobility restrictions, and carer dependence. In Malaysia, there are currently few guidelines governing the practice of geriatric telemedicine. Its implementation is constrained by contextual, infrastructural, clinical, and operational barriers. Family Medicine Specialists (FMS) in the community and hospital-based Geriatricians have the opportunity to optimise shared care approaches via telemedicine to enhance access to geriatric healthcare. This study aims to develop guidelines for geriatric telemedicine within a collaborative care framework involving both specialties. This qualitative study utilised a modified Delphi method to engage geriatricians and FMS’ who have experience with telemedicine. Seventeen geriatricians and FMS were selected using a purposive sampling and snowball approach to respond to an online questionnaire concerning the evidence for implementation of geriatric telemedicine, in accordance with best practice recommendations for older adult care management in public healthcare settings. Seven FMS and geriatricians then participated in a virtual focus group discussion (FGD) to supplement and consolidate the results of the online questionnaire. The FGD was analysed qualitatively through deductive framework analysis after being transcribed verbatim. Seven recommendations for geriatric telemedicine for FMS and geriatricians were identified by CORTICAL © . These included the following: criteria or prerequisites for geriatric telemedicine service provision, the function of initial and unscheduled telemedicine consultations, a list of geriatric conditions that qualify for telemedicine clinical assessments, quality assurance measures for geriatric telemedicine care, and a shared care pathway between FMS and geriatricians. The locally informed CORTICAL © recommendations provide a preliminary, expert-consensus baseline for integrating community geriatric telemedicine into Malaysia’s shared-care framework. While offering a foundational structure for patient eligibility, technological requirements, and clinical workflows, these consensus recommendations require prospective clinical evaluation and pilot implementation testing to demonstrate safety, feasibility, and effectiveness in real-world practice.