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The Use of Telemedicine in the Care of Nursing Home Residents with Alzheimer's Disease and Related Dementias During and After the COVID-19 Pandemic

Award Number: R01AG075507
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

Group Awards By Issue Date FY or Funding FY:

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The Use of Telemedicine in the Care of Nursing Home Residents with Alzheimer's Disease and Related Dementias During and After the COVID-19 Pandemic PROJECT SUMMARY The novel coronavirus disease 2019 (COVID-19) pandemic has devastated nursing home residents in the US, nearly half of whom are diagnosed with Alzheimer's and other related dementias (ADRD). To limit resident exposure and expand safe access to desperately-needed care from physicians and advanced practice providers, Medicare dropped previously tight restrictions and temporarily allowed SNFs to broadly use telemedicine to obtain care for residents. Dropping these restrictions helped facilitate a rapid adoption of telemedicine in SNFs, from <1% of SNFs billing for any telemedicine services in Oct-Dec 2019 to 55% in Apr- May 2020. Telemedicine has long been regarded as a promising, but underused, delivery innovation for SNFs addressing two major gaps in care. First, SNF clinicians are not always onsite, so medical issues that present during off-hours are often addressed by transferring patients, often unnecessarily, to the emergency department. Second, due to both financial and logistic reasons it is very difficult for SNF residents to obtain specialty care, including specialties critical those with ADRD like neurology or psychiatry. A limited literature suggests that telemedicine can bridge both of these care gaps, but more rigorous evidence is needed. In 2021, understanding the adoption and clinical impact of SNF telemedicine for the vulnerable population of older adults with ADRD has new urgency. We propose to use Medicare claims, the Minimum Data Set and a national survey on SNF telemedicine implementation to answer the following specific aims: 1) Evaluate the patient-level association of SNF adoption of telemedicine in 2020 with health care use and clinical outcomes (COVID-19 and non-COVID-19) for SNF residents with and without ADRD. 2) Use group-based trajectory models to characterize 2020-2021 SNF-level patterns of telemedicine use (e.g., sustaining vs. de-adopting) and SNF characteristics associated with different trajectories. 3) Survey a national sample of SNFs, stratified by their trajectories measured in Aim 2, to assess facility leadership perceptions of telemedicine use and telemedicine implementation strategies. Understanding how SNFs have used telemedicine and its association with clinical outcomes is essential to inform how Medicare and state Medicaid programs should regulate and promote telemedicine use in SNFs. Our findings will also help guide clinicians who care for SNF residents with ADRD on the clinical impact associated with telemedicine use and how it is being used nationally.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = $510,404 )
2024	2024	HARVARD COLLEGE PRESIDENT & FELLOWS OF	677 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Aging Research	002	3	2/9/2024	NON-COMPETING CONTINUATION	$0
2024	2024	HARVARD COLLEGE PRESIDENT & FELLOWS OF	677 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Aging Research	001	3	1/18/2024	NON-COMPETING CONTINUATION	$518,379
2024	2023	HARVARD COLLEGE PRESIDENT & FELLOWS OF	677 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Aging Research	000	2	11/2/2023	NON-COMPETING CONTINUATION	-$7,975
														Subtotal = $510,404

Issue Date FY: 2023 ( Subtotal = $536,943 )
2023	2023	HARVARD COLLEGE PRESIDENT & FELLOWS OF	677 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Aging Research	000	2	3/13/2023	NON-COMPETING CONTINUATION	$536,943
														Subtotal = $536,943

Issue Date FY: 2022 ( Subtotal = $461,838 )
2022	2022	PRESIDENT AND FELLOWS OF HARVARD COLLEGE	677 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Aging Research	000	1	3/18/2022	NEW	$461,838
														Subtotal = $461,838

Grand Total All Awards = $1,509,185

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The Use of Telemedicine in the Care of Nursing Home Residents with Alzheimer's Disease and Related Dementias During and After the COVID-19 Pandemic

Award Number: R01AG075507

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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