The truth about seniors and telehealth

Updated: Feb 27

When it comes to seniors’ telehealth use, there seem to be two stories. But which one is true?

People over 65 are regularly listed among the groups who have the most trouble accessing telehealth. Articles like this one list numerous barriers, including not understanding technology, and cognitive, hearing, or visual impairments.

Reading this and the many similar reports, it seems like getting seniors to use telehealth platforms will be a formidable challenge. But if you look into senior telehealth use more deeply you’ll find that this group is already are using telehealth -- and generally greatly appreciate it.

A November 2022 article from the American Medical Association (AMA), for instance, declared “Senior patients happy with telehealth and want it as care option.”

According to U.S. News & World Report, a recent National Center for Health Statistics survey found that 1 in 3 US adults had used telemedicine in 2021. And adults 65 and over were 14% more likely to use telehealth than younger patients.

You might think that this high rate of telemedicine use was due to the Covid pandemic, but the site mHealthIntelligence shared the results of a 2022 study, which found that 1/3 of adults aged 50 and over still want to use telehealth for themselves or someone close to them.

The same article also cites an AARP survey in which 60% of respondents reported facing no barriers to using telehealth.

So what’s really going on with seniors and telehealth use?

The article gives us an important clue, in these lines:

Meanwhile, a federal report…which includes survey responses from over 600,000 adults, showed that Black patients, those older than 65, and those with government-sponsored insurance were those most likely to use telehealth. These patient groups were also more likely to use audio-only services.

The AMA article mentions the high percentage of audio telehealth consultations among senior patients as well, explaining that according to their survey, senior patients prefer video consultations but that 47% of these patients were unable to access video functions.

And another study found that even among those survey participants with a strong broadband connection and no pronounced disabilities, over 1/4 had to have an audio-only telehealth visit instead of one by video, due to technical problems.

Clearly, while all of the barriers to telehealth use that are commonly listed for seniors play a part, it may be that the biggest barrier is internet connection issues.

In many cases, it may not be whether or not senior patients can connect to telehealth platforms, but to what extent. A video consultation is in most cases far better than an audio visit, but it may not always be possible. This is the case for millions of seniors who don’t have a broadband internet connection.

Knowing all of this is important because while many studies and organizations offer advice for helping senior patients use telehealth, not many address connectivity as a possible or predominant problem.

It’s a complicated subject, because connection issues can be difficult for even the most tech-savvy among us to resolve. One thing that may help at least a little is for care providers to ask senior patients questions that can help determine how likely connection problems and the inability to resolve them might be.

Dr. John Torous, a psychiatrist who focuses on digital platforms, has developed a “digital literacy checkup”.

Although it deals specifically with patients who are interested using mental health platforms, many of the items on the questionnaire can easily apply to potential users of telehealth platforms in general.

These include:

1. Do you have internet access at home?

Torous specifies that this isn’t just a “yes” or “no” question. It’s important to determine if a patient has access to a broadband connection; otherwise, they’re unlikely to be able to connect to a telehealth platform for a video consultation.

Additionally, it’s important to know which device(s) a patient would use for a telehealth consultation, to determine compatibility with a specific platform.

2. Are you currently using any other health apps?

Torous points out that this is an excellent indirect way to find out, among other things, how familiar a patient is with using telehealth platforms and, in general, how easily he or she can connect to the internet.

At the end of the questionnaire, Torous suggests that in cases where a patient may not be able to use telehealth on their own, they could call upon a digital navigator, a person who’s certified in helping patients use the internet and troubleshoot issues. Healthcare providers themselves can also become certified digital navigators.

The truth behind what’s blocking telehealth access for seniors often comes down to a single, yet complicated issue: internet connection problems.

It’s one that plagues all age groups, notably because access to a broadband internet connection is far from universal.

Unfortunately, this knowledge doesn’t necessarily lead to a solution. But it may shift assumptions about senior patients, both among healthcare providers and advocates alike. This could lead to a stronger push for broadband coverage across the US, and making digital navigator training more common or even required for certain healthcare workers.

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