'Online' geriatric assessment procedure for older adults referred for geriatric assessment during an acute care episode for consideration of reliability of triage decisions

The study population will consist of 270 acutely hospitalized patients referred for geriatric consultation at three sites. Paired assessments (live and online) will be conducted by independent, blinded geriatricians and the level of agreement examined. This will be compared with the level of agreement between two independent, blinded geriatricians each consulting with the patient in person (i.e. "live"). Agreement between the triage decision from live-live assessments and between the triage decision from live-online assessments will be calculated using kappa statistics. Agreement between the online and live detection of common geriatric syndromes will also be assessed using kappa statistics. Resource use data will be collected for online and live-live assessments to allow comparison between the two procedures.If the online approach is found to be less precise than live assessment, further analysis will seek to identify patient subgroups where disagreement is more likely. This may enable a protocol to be developed that avoids unsafe clinical decisions at a distance.Trial registration number: ACTRN12611000936921Comprehensive geriatric assessment (CGA) is a core procedure in specialist geriatric care. There is evidence that this process improves functional recovery, reduces morbidity and attenuates demand for long term institutional care [1]. It is central to hospital triaging processes which direct patients to formal inpatient geriatric assessment, rehabilitation, long term institutional care and complex community support programs. Geriatric consultation services are the vehicle for delivering CGA to older hospitalised patients who are not located in specialist geriatric units.Geriatric consultation is delivered by geriatricians, gerontic nurses - alone or in partnership - sometimes with support from other allied health specialists. The availability of these aged care specialists, and the specialist services within which they work, is currently inadequate. Furthermore