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Dear Editor, The coronavirus disease 2019 (COVID-19) outbreak first began in early December in Wuhan, China and was reported by World Health Organisation on 31st December 2019.1 The outbreak escalated and was characterised as a pandemic on 11 March 2020.1 Amidst the avalanche of COVID-19 cases, Singapore’s Ministry of Health implemented a series of Circuit Breaker (CB) measures on 7 April 2020, whereby non-essential specialist appointments were advised to be deferred and where possible, for services to continue via teleconsultation.2 The CB measures were in place until 1 June 2020, and as of 30 June 2020, Singapore had a total of 43,635 cases and 26 deaths.3 While specialist geriatric care does not constitute urgent care, many geriatric issues can lead to complications if not addressed on a timely basis. Uncontrolled geriatric problems, particularly behavioural and psychological symptoms in dementia (BPSD) is known to lead to further medical complications, which inevitably worsen caregivers’ well-being.4 Furthermore, geriatric patients often present with more co-morbidities and non-specific presenting symptoms, which lead to transfers to emergency department, if not promptly recognised and managed.5 Prevention of hospitalisations for this vulnerable group during the pandemic is critical. Therefore, it is imperative to ensure that geriatric patients are able to access specialist geriatric care in the midst of a pandemic. Telemedicine is routinely used for geri-psychiatric consultations and has been acknowledged as a useful tool in combating epidemics.6,7 In the current global outbreak, where social distancing is key in slowing the transmission of COVID-19 virus, telemedicine via videoconference is ideal in providing remote assessment, routine care and improved provider diagnostic accuracy compared to phone consults, without the risk of exposure in a congested hospital or in clinic waiting areas.1,3,8,9 In view of the above circumstances, a pilot Telemedicine Specialist Outpatient Clinic (Tele-SOC) unit was set up within the Geriatric Medicine clinic in an acute hospital in Singapore. In this paper, we shared a proof of concept study, which comprised of the demographics of the first 15 patients, protocol and feedback from patients, caregivers and the healthcare professionals (HCPs) involved.

Using Telemedicine for Outpatient Geriatric Care During the Novel Coronavirus Outbreak: Experience from the First 15 Patients