Telemedicine Uptake Among Older Adults During the COVID-19 Pandemic

Frydman, Julia L.; Li, Weixin; Gelfman, Laura P.; Liu, Bian

doi:10.7326/m21-2972

Cited by 22 publications

(27 citation statements)

References 3 publications

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“…While much has been published on the feasibility of telemedicine in older adults domestically and abroad [ 13 - 18 ], there is limited information regarding the challenges of telemedicine from the perspective of patients. Existing work in the United States tends to focus on homogeneous English-speaking older adults [ 19 - 22 ].…”

Section: Introductionmentioning

confidence: 99%

Barriers to Telemedicine Video Visits for Older Adults in Independent Living Facilities: Mixed Methods Cross-sectional Needs Assessment

Mao¹,

Tam²,

Xu³

et al. 2022

JMIR Aging

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Background Despite the increasing availability of telemedicine video visits during the COVID-19 pandemic, older adults have greater challenges in getting care through telemedicine. Objective We aim to better understand the barriers to telemedicine in community-dwelling older adults to improve the access to and experience of virtual visits. Methods We conducted a mixed methods needs assessment of older adults at two independent living facilities (sites A and B) in Northern California between September 2020 and March 2021. Voluntary surveys were distributed. Semistructured interviews were then conducted with participants who provided contact information. Surveys ascertained participants’ preferred devices as well as comfort level, support, and top barriers regarding telephonic and video visits. Qualitative analysis of transcribed interviews identified key themes. Results Survey respondents’ (N=249) average age was 84.6 (SD 6.6) years, and 76.7% (n=191) of the participants were female. At site A, 88.9% (111/125) had a bachelor’s degree or beyond, and 99.2% (124/125) listed English as their preferred language. At site B, 42.9% (51/119) had a bachelor’s degree or beyond, and 13.4% (16/119) preferred English, while 73.1% (87/119) preferred Mandarin. Regarding video visits, 36.5% (91/249) of all participants felt comfortable connecting with their health care team through video visits. Regarding top barriers, participants at site A reported not knowing how to connect to the platform (30/125, 24%), not being familiar with the technology (28/125, 22.4%), and having difficulty hearing (19/125, 15.2%), whereas for site B, the top barriers were not being able to speak English well (65/119, 54.6%), lack of familiarity with technology and the internet (44/119, 36.9%), and lack of interest in seeing providers outside of the clinic (42/119, 35.3%). Three key themes emerged from the follow-up interviews (n=15): (1) the perceived limitations of video visits, (2) the overwhelming process of learning the technology for telemedicine, and (3) the desire for in-person or on-demand help with telemedicine. Conclusions Substantial barriers exist for older adults in connecting with their health care team through telemedicine, particularly through video visits. The largest barriers include difficulty with technology or using the video visit platform, hearing difficulty, language barriers, and lack of desire to see providers virtually. Efforts to improve telemedicine access for older adults should take into account patient perspectives.

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Section: Introductionmentioning

confidence: 99%

Barriers to Telemedicine Video Visits for Older Adults in Independent Living Facilities: Mixed Methods Cross-sectional Needs Assessment

Mao¹,

Tam²,

Xu³

et al. 2022

JMIR Aging

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“…We bring specific data from patients with hematologic malignancies into the expanding literature on virtual assessment and care in older adults from other populations. [16][17][18][19][20] The high percentage of our patients who completed virtual assessments is encouraging, especially given that other studies have identified lower uptake of telehealth among older adults compared with younger populations. 18,19 Further education regarding the purpose and benefits of frailty assessment could increase our enrollment rate, which was lower than our in-person enrollment rate.…”

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confidence: 74%

Virtual frailty assessment for older adults with hematologic malignancies

et al. 2022

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“…Telehealth has been proposed as a strategy to increase access to specialized services for rural communities and may be a valuable tool for pharmacogenetic implementation ( Danylchuk et al, 2021 ; Westby et al, 2021 ). The COVID-19 pandemic has highlighted opportunities for telehealth to address healthcare disparities, however, the adoption is still lower in nonmetropolitan areas ( Chen et al, 2021 ; Frydman et al, 2022 ). Access to high-speed internet is also a challenge for rural communities to take full advantage of the benefits offered by telehealth, although Montana is forward-thinking in improving and expanding high-speed internet for its citizens.…”

Section: Discussionmentioning

confidence: 99%

Ensuring equity: Pharmacogenetic implementation in rural and tribal communities

et al. 2022

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Implementation strategies for pharmacogenetic testing have been largely limited to major academic medical centers and large health systems, threatening to exacerbate healthcare disparities for rural and tribal populations. There exists a need in Montana (United States)—a state where two-thirds of the population live in rural areas and with a large proportion of tribal residents—to develop novel strategies to make pharmacogenetic testing more broadly available. We established partnerships between University of Montana (UM) and three early adopter sites providing patient-centered care to historically neglected populations. We conducted 45 semi-structured interviews with key stakeholders at each site and solicited participant feedback on the utility of a centralized pharmacogenetic service at UM offering consultations to patients and providers statewide via telehealth. For settings serving rural patients—tribal and non-tribal—participants described healthcare facilities without adequate infrastructure, personnel, and funding to implement pharmacogenetic services. Participants serving tribal communities stressed the need for ethical practices for collecting biospecimens and returning genetic results to patients, largely due to historical and contemporary traumas experienced by tribal populations with regard to genetic research. Participants expressed that pharmacogenetic testing could benefit patients by achieving therapeutic benefit sooner, reducing the risk of side effects, and improving adherence outcomes for patients with limited access to follow-up services in remote areas. Others expressed concern that financial barriers to pharmacogenetic testing for patients of lower socioeconomic status would further exacerbate inequities in care. Participants valued the role of telehealth to deliver pharmacogenetic consults from a centralized service at UM, describing the ability to connect providers and patients to resources and expertise as imperative to driving successful pharmacogenetic implementation. Our results support strategies to improve access to pharmacogenetic testing for neglected patient populations and create opportunities to reduce existing healthcare inequities. By exploring critical challenges for pharmacogenetic implementation focused on serving underserved communities, this work can help guide equitable frameworks to serve as a model for other resource-limited settings looking to initiate pharmacogenetic testing.

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Telemedicine Uptake Among Older Adults During the COVID-19 Pandemic

Cited by 22 publications

References 3 publications

Barriers to Telemedicine Video Visits for Older Adults in Independent Living Facilities: Mixed Methods Cross-sectional Needs Assessment

Barriers to Telemedicine Video Visits for Older Adults in Independent Living Facilities: Mixed Methods Cross-sectional Needs Assessment

Virtual frailty assessment for older adults with hematologic malignancies

Ensuring equity: Pharmacogenetic implementation in rural and tribal communities

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