# 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

> **NIH NIH R01** · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · 2022 · $461,838

## Abstract

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.

## Key facts

- **NIH application ID:** 10345587
- **Project number:** 1R01AG075507-01
- **Recipient organization:** HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH
- **Principal Investigator:** Michael Lawrence Barnett
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $461,838
- **Award type:** 1
- **Project period:** 2022-04-01 → 2026-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10345587

## Citation

> US National Institutes of Health, RePORTER application 10345587, 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 (1R01AG075507-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10345587. Licensed CC0.

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