Challenges in the development of e-health strategies for geriatric medicine

Comprehensive geriatric assessment (CGA), supported by e-health, was provided to 89 frail veterans aged 70 years or older who were admitted to medical, surgical or orthopaedic units at two private hospitals in rural Queensland. Patients were screened and assessed by trained nurses using the interRAl-Acute Care tools. Data entry, validation, reporting and geriatrician comment were facilitated by an online, secure database and reporting system. The process was evaluated based on its utilization and staff satisfaction. The response to the project was generally very positive, but there were also some problems: (1) lack of staff, staff time and resources to successfully complete the assessments; (2) limited referrals from general practitioners (GPs) and difficulty with developing a sustainable communication and referral system between GPs and the hospital; (3) significant variations in caseloads between the study sites; and (4) the unfamiliarity of sufficient staff at the trial sites with the CGA process. Despite these challenges, the use of e-health-supported strategies in geriatric medicine certainly appears achievable and deserve further study.