Malaysian clinicians draft shared telemedicine recommendations for older adults

Seventeen family medicine specialists and geriatricians with experience in telemedicine developed seven preliminary recommendations for coordinating community geriatric care in Malaysia through virtual consultations. Created through a modified Delphi process, the recommendations address service eligibility, consultation roles, conditions suitable for remote assessment, quality assurance and shared-care arrangements between the two specialties. The study reports expert consensus, not proof that the proposed model improves patient outcomes.

The initiative, called Community geriatric telemedicine in Malaysia, or CORTICAL©, was designed to support the integration of telemedicine into a collaborative care framework involving community-based family medicine specialists and hospital-based geriatricians. This focus reflects a practical gap in Malaysia, where few guidelines currently govern geriatric telemedicine and where implementation is constrained by contextual, infrastructural, clinical and operational barriers. Access to care can be difficult for older adults who face mobility restrictions, depend on carers or have difficulty reaching healthcare facilities.

Telemedicine offers an alternative route to assessment for some patients, but the study emphasizes that its use requires locally informed decisions about patient eligibility, technology, workflows and clinical responsibilities. The recommendations are intended to establish a preliminary structure for those decisions rather than prescribe a universal model for every older adult or clinical situation. Researchers used a qualitative modified Delphi method with purposive sampling and snowball recruitment.

The 17 participants were geriatricians and family medicine specialists with experience in telemedicine. They completed an online questionnaire addressing evidence for implementing geriatric telemedicine and best-practice recommendations for managing older adults in public healthcare settings. Seven members of the larger participant group subsequently took part in a virtual focus group discussion.

The discussion supplemented and consolidated the questionnaire results. The resulting CORTICAL© recommendations establish criteria and prerequisites for providing a geriatric telemedicine service. They also specify the functions of initial and unscheduled consultations and identify geriatric conditions that may qualify for telemedicine clinical assessment.

Additional recommendations cover quality-assurance measures for telemedicine care and a shared-care pathway between family medicine specialists and geriatricians. The shared-care pathway is designed to organize collaboration between the specialties involved in a patient’s care. Together, the recommendations provide locally informed guidance for service prerequisites, clinical workflows and the division of work within shared care.

The study did not test the recommendations in routine clinical practice or evaluate them with patients. It also did not compare virtual consultations with in-person care or measure whether the proposed pathway improves access or produces better clinical outcomes. Because the findings come from a structured consensus exercise involving experienced clinicians, they should be interpreted as a preliminary expert-consensus baseline rather than a validated implementation model.

Prospective clinical evaluation and pilot implementation testing are needed to establish the safety, feasibility and effectiveness of the CORTICAL© recommendations in real-world practice. Until then, the work represents an expert-informed development stage for integrating community geriatric telemedicine into Malaysia’s shared-care framework. Its immediate contribution is a structured set of consensus recommendations from clinicians familiar with telemedicine, intended to guide subsequent pilot testing and formal assessment.

Subject of Research: Expert-consensus development of shared geriatric telemedicine recommendations for older adults in Malaysia

Article Title: Community geriatric telemedicine in Malaysia (CORTICAL©): A collaborative modified Delphi method for shared care strategies involving family medicine specialists and geriatricians

Article References: Tamring, S., Abdul Aziz, A. F., Ali, M. F., Khor, H. M., Ong, T., Ghazali, N. F., Ishak, N. H., Yunus, N. I., Ahip, S. S., & Mohd Yusoff, Y. A. (2026). Community geriatric telemedicine in Malaysia (CORTICAL©): A collaborative modified Delphi method for shared care strategies involving family medicine specialists and geriatricians. BMC Geriatrics. https://doi.org/10.1186/s12877-026-08362-1

Image Credits: AI Generated

DOI: 10.1186/s12877-026-08362-1

Keywords: geriatric telemedicine, older adults, Malaysia, shared care, family medicine, geriatrics, modified Delphi method, clinical guidelines, healthcare access, Community, geriatric, telemedicine