This age group is being left behind in the new healthcare era

Change is often predicated on necessity, and COVID-19 has certainly mandated a whole lot of upheaval. It feels like every aspect of life is different than it was just six short months ago.

While that last statement may be a slight exaggeration, there’s no denying that meeting with people in a closed setting is incredibly more complicated nowadays.

As such, we’ve all witnessed the rapid rise of video chatting services in 2020. This shift is particularly apparent in the healthcare industry. Considered a fringe and unusual option not so long ago, millions are now opting to “meet” with their doctors via video calls. 

For the most part, this recent boom in telemedicine, or receiving medical care remotely, has been a great way for Americans to stay on top of their health while simultaneously staying safe at home. Unfortunately, a new study finds that not all Americans in need are benefiting from this shift toward remote medical care.

Researchers from the University of California, San Francisco have discovered that many older adults are feeling even more cut off from their doctors and physicians since everything has shifted over to telemedicine. 

After analyzing data on thousands of Americans, the team at UCSF estimated that over a third of U.S. adults over the age of 65 face hurdles when it comes to meeting with their doctors remotely online. Among that age group, lower-income men living in rural areas (particularly those with disabilities and or overall poor health) are facing the most challenges, researchers say.

“Telemedicine is not inherently accessible, and mandating its use leaves many older adults without access to their medical care,” explains lead study author Kenneth Lam, MD, a clinical fellow in geriatrics at UCSF, in a release. “We need further innovation in devices, services and policy to make sure older adults are not left behind during this migration.”

These findings may confuse younger readers. But, it’s easy for the younger among us to forget that not everyone is comfortable using modern technology. 

For an older adult to really get what he or she needs out of a digital meeting with their doctor, that individual must be able to:

  • Go online and use the internet in the first place.
  • Properly operate whichever video chatting service or app the meeting is being held on.
  • Troubleshoot or address any video connection issues that inevitably come up during video conferences.

Aside from just technological considerations, many older adults suffer from hearing, vision, or verbalization issues that can make video calls especially difficult. During an in-person visit, these problems probably would present nothing more than a minor complication, but placed within the context of a video call, they become much bigger obstacles.

To study this issue, the research team analyzed a collection of data on 4,525 older Americans (65+ years old) that had been collected in 2018. That information, which was originally gathered as part of a larger scale Medicaid research initiative, featured insights into participants’ overall health and access to/understanding of the internet and modern technology.

Researchers looked to see what percentage of studied Americans dealt with the following potential video call complications: poor eyesight or hearing, problems speaking or expressing oneself, dementia, no access to the internet, inability to use a computer, and no use of email, text, or a computer in general over the previous month.

While these statistics are only truly accurate for 2018, they still provide a glimpse into just how many Americans may be struggling with video calls right now. After finishing their assessment, researchers concluded that roughly 38% of all Americans (13 million people) were unprepared to use video calling technology in 2018. 

Regarding studied Americans over the age of 85, 72% were found to be incapable of video chatting. For most of this group, a lack of technological understanding was to blame, followed by health conditions.

A logical way to help older Americans confer with their doctors over video calls would be for a relative or friend to sit in on the call and help take care of any problems that arise. When researchers factored this in, however, they concluded that 32% of older Americans would still have a very hard time meeting their health needs via telemedicine. It was also estimated that about 20% of all older U.S. adults are incapable of speaking with their doctor over a landline telephone due to either dementia or hearing/speaking problems.

“To build an accessible telemedicine system, we need actionable plans and contingencies to overcome the high prevalence of inexperience with technology and disability in the older population,” Dr. Lam concludes. “This includes devices with better designed user interfaces to get connected, digital accommodations for hearing and visual impairments, services to train older adults in the use of devices and, for some clinicians, keeping their offices open during the pandemic.”

The full study can be found here, published in JAMA Internal Medicine.