Technology-enabled home visits to understand the context of health for older adults with multiple chronic conditions

Background: Understanding the context of patients' lives is vital to delivering person-centered care for older adults with multiple chronic conditions (MCC) Home visits can be an effective tool to provide personalized care accounting for the medical and social complexities of patients As part of a broader study on the contextual factors (e g , fall risk, medication use) of older adults with MCC, we report on the feasibility of technology-enabled home visits to explore the contextual factors relevant to self-management of MCC among diverse older adults Methods: From an urban academic general medicine practice during the COVID-19 pandemic, we recruited patients age 65+ with uncontrolled diabetes and at least one coexisting chronic condition who spoke English, Spanish, or Chinese to participate in a video conference or phone interview We provided training to use video conferencing as requested We conducted audio-recorded semi-structured interviews exploring patient self-management practices of MCC After the interview, patients were provided a checklist to take photos in 5 domains: home environment and neighborhood, prior fall locations, medication use areas, diet/food experience, and sources of social support Patients sent photos to the study team by email Results: Over a 6 month period, six older adults have been recruited with 83% male with a mean age 75+/-8 years 83% identified as Asian or Latinx Five video conferences and one phone interview have been completed One participant requested video conferencing training All except one interview was completed without caregiver assistance Participants took on average 8+/-3 photos Most participants shared photos from 3 out of 5 domains with few photos illustrating fall location and social support Conclusions: Technology-enabled home visits including photo-taking by patients were feasible among diverse older adults with MCC Telehealth approaches with focused photo-taking by patients could support efforts for comprehensive geriatric assessment of vulnerable older adults