New research appearing in a high-profile medical journal suggests that millions of U.S. seniors aren’t ready to participate fully – or in some cases, at all – in telehealth visits due to a lack of technical knowledge or health-related issues.
The study, which was published in JAMA Internal Medicine, looked the degree to which U.S. seniors were ready to participate in telemedicine sessions. To look at these issues, the researchers analyzed 2018 data from the National Health and Aging Trends Study, a nationally representative study of Medicare beneficiaries age 65 and older. The mean age of patients included in the study was 79.5 years.
When looking at whether these seniors were prepared to participate in telehealth sessions, they assumed that the elderly patients were unready if they had health issues such as difficulty hearing well, problems with speaking, possible or established dementia or limited vision.
Other signs that they weren’t telehealth ready included having never owned Internet-enabled devices or being unaware of how to use them, as well as not having used email, texting or Internet services during the previous month.
When they completed their analysis, researchers concluded that 13 million older adults (38%) would not be ready to fully participate in telehealth visits. Seventy-two percent of adults who were 85 years or older met the criteria for unreadiness.
Interestingly, this problem didn’t go away when helpful family members and friends and other social supports were factored into the equation. The number of elders unready to participate when social supports were in place or caregivers were available fell only modestly, to 10.8 million (32%).
In addition, despite their being familiar with phone conversations, researchers estimated that 20% of older patients weren’t ready to participate in telephone visits due to difficulty hearing and communicating or dementia.
They also concluded that unreadiness was more prevalent among patients who were older, male, unmarried, were Black or Hispanic and lived in a nonmetropolitan area. Other factors associated with unreadiness included less education, lower income and poorer self-reported health.
In their discussion, the authors suggested that public policies should recognize and bridge this digital divide. For example, they recommended extending accessibility accommodations such as closed captioning for those with impaired hearing to virtual visits.
Meanwhile, one key inference that I took from this data is that when health systems model the effect of telehealth on their population health management strategies, they should pay special attention to the older adults in the mix.
While providing telehealth options may be valuable for some elders, especially those who have mobility issues, the study suggests that health leaders may well want to get a better sense of how ready seniors were to actually use such technology. Without this information, they may make incorrect assumptions about the impact virtual care can have in managing a subgroup that may have more need for resource-intensive care.