Special Issue: Telehealth
Telehealth & Mental Healthcare of Older Adults
Dr. Tzung-Jeng Hwang (Taiwan)
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|The COVID-19 pandemic has been unexpected and created many problems and challenges in healthcare. Mental healthcare especially old age mental healthcare, is no exception. For example, many long-term care facilities were closed due to the COVID-19 pandemic, and relatives were not allowed to visit their loved ones residing in these facilities. In response to the regulations of physical distancing to prevent COVID-19 transmission, telehealth has been increasingly adopted. Typical applications include telehealth in outpatient service, inpatient care, virtual visits for nursing home residents, and teleconference, etc. Besides, technology-enabled social and recreational programming has been adopted, specifically in the field of old age psychiatry. Because of the persistence and impact of this pandemic, telehealth will undoubtedly be used more widely in old age mental health in the future. In this special issue of the IPA Bulletin, we have a total of eight articles from around the globe sharing different experiences and visions on telehealth in old age mental healthcare. These articles provide unique viewpoints and perspectives from a variety of regions of the world and deserve our IPA members’ attention during the current difficult time in facing the pandemic.|
Although telehealth may emerge as a new kind of care method, there are several problems and challenges in most regions of the world, including but not limited to the following issues:
- Laws and regulations on telehealth may be inadequate, including the scope of telehealth, practice standards, personnel certification, data security, and reimbursement, etc. 
- Special applications such as capacity assessment should be addressed clearly if possible (see the article of Sorinmade et al. in this issue).
- Telehealth hardware may be hard to use for older adults. The devices should be tailored to serve the needs of older adults, especially patients with dementia. Ideally, the devices have to be not only user friendly but also with adequate aids for sensory impairments common in this target population. Good connection quality is also crucial since it is challenging to integrate unsynchronized information resulting from a connection lag.
- Though telehealth has become a necessary component in healthcare nowadays, we should systemically examine its efficacy, practicality, and cost-effectiveness. The pros and cons of different telehealth models, either in a naturalistic way or through a well-designed experiment, should be investigated. 
In sum, we must learn from the current massive deployment of telehealth to inform better practice in the future. It is beneficial to establish the infrastructure of telehealth, develop and assess different models of telehealth, and catch opportunities from new technologies. The scientific and technological advances can enhance and revolve telehealth rapidly. Future development of artificial intelligence may assist in laboratory/ imaging result interpretation and medical decision making. It can also help to overcome language barriers when patients use a different kind of native language, even in the context of compromised language capacity due to neurodegeneration. As an old age professional, our IPA members should pay attention to these telehealth issues and follow its progression and application closely in the future.
- Marcoux, R.M. and F.R. Vogenberg, Telehealth: Applications From a Legal and Regulatory Perspective. P T, 2016. 41(9): p. 567-70.
- Bashshur, R., et al., Telemedicine and the COVID-19 Pandemic, Lessons for the Future. Telemed J E Health, 2020. 26(5): p. 571-573.