Addressing Inequities in Older Adults’ Health: A Role for Emerging Technologies

Bicket, Mark C.; Iyengar, V.; States, Leith

doi:10.1001/jamahealthforum.2021.0680

Cited by 3 publications

(2 citation statements)

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“…Krishnaswami and colleagues 53 also identify smartphone features and solutions to digital health use barriers that should be considered when caring for older adults. To reduce the potential for telehealth solutions to inadvertently worsen health disparities among older adults, EDs can design telehealth systems with older adults in mind by incorporating older adults in the design and evaluation of telehealth systems, building in high‐quality interpreter services for deaf or hard of hearing patients, and addressing low health and technology literacy through patient education 54,55 . Although efforts to evaluate telehealth specific to older adults in the ED are limited, models exist for EDs seeking to implement or adapt telehealth systems to be suitable for older adults, including geriatrician consultations in the ED, 56 provider‐to‐provider nursing home visits, rural and critical access hospital settings, and forward triage in the ED 57…”

Section: Discussionmentioning

confidence: 99%

“…To reduce the potential for telehealth solutions to inadvertently worsen health disparities among older adults, EDs can design telehealth systems with older adults in mind by incorporating older adults in the design and evaluation of telehealth systems, building in high-quality interpreter services for deaf or hard of hearing patients, and addressing low health and technology literacy through patient education. 54,55 Although efforts to evaluate telehealth specific to older adults in the ED are limited, models exist for EDs seeking to implement or adapt telehealth systems to be suitable for older adults, including geriatrician consultations in the ED, 56 provider-to-provider nursing home visits, rural and critical access hospital settings, and forward triage in the ED. 57 Although many solutions have been developed to meet patient needs during the pandemic, telehealth integration into EDs is still a novel concept, and more research should evaluate patient-centered outcomes such as quality of care, cost, and convenience.…”

Section: Discussionmentioning

confidence: 99%

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Emergency physician perspectives on using telehealth with older adults during COVID‐19: A qualitative study

et al. 2021

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Objectives Emergency medicine physicians have played a pivotal role throughout the coronavirus disease 19 (COVID‐19) pandemic through in‐person and remote management and treatment. Our primary objectives were to understand emergency medicine physicians’ experiences using telehealth throughout the pandemic, any facilitators/barriers to successful usage, lessons learned during implementation, and successful/abandoned strategies used to engage with older adults. Methods Using a semi‐structured interview guide, we conducted 30‐min interviews. We used purposeful sampling to recruit emergency medicine physicians from all United States regions, rural–urban settings, and academic and community practices, who reported caring for patients 65 years or older in‐person or virtually during the pandemic. Interviews were audio‐recorded, transcribed, double‐coded, and analyzed for emergent themes using framework analysis. Results A total of 15 in‐depth interviews were completed from September to November 2020. Physicians had a median age of 37 years, 7 were women, and 9 had experience with telehealth before the pandemic. We identified several themes: (1) there were various motivations for telehealth use; (2) telehealth was used primarily to supplement, not replace in‐person care; (3) most platforms were easy to use; (4) patients and caregivers had high acceptability of telemedicine; and (5) older adults with sensory and cognitive impairments often relied on caregivers. Emergency medicine physicians played a critical role during primary care office closures during the first wave—dispelling misinformation about COVID‐19, triaging patients to testing and treatment, and providing care that would otherwise have been deferred. Conclusions Our data show that telemedicine gained acceptability among emergency medicine physicians and provided options to patients who may have otherwise deferred care. These findings can inform future healthcare delivery for acute care needs or pandemic responses.

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Section: Discussionmentioning

confidence: 99%