Though intended to streamline the doctor-patient interaction, telehealth can prove particularly challenging to a vulnerable population it otherwise has potential to serve: older adults. To unpack the topic of telehealth, and to address the challenges that come with it, we sat down with Dr. Joseph K. West. Dr. West is an epidemiologist, population health and data analytics leader with over 15 years of experience in healthcare, research, and enterprise consulting, as well as a member of the Sage Collective leadership team.
What Is Telehealth?
Telehealth (also called telemedicine) is the provision of healthcare through electronic communications. Dr. West describes in greater detail: “Telehealth is the opportunity to use technology (such as a tablet, mobile device or desktop computer) to connect any recipient, older adult or otherwise, to their care provider — whether that’s a nurse, RN, physician or specialist.”
“This online connection allows healthcare providers and patients to do a couple things remotely: to conduct initial screenings, to ask and answer questions related to physical or mental health and to conduct medication adherence followup. And because telehealth appointments are conducted over video conferencing technology, it gives healthcare providers the ability to actually see the patient and assess how they’re doing more intimately,” explains Dr. West.
Overall, Dr. West says, “telehealth is really an opportunity to expedite the physician patient interaction, which is of particular benefit when access to transportation may be an issue, or when patients have other safety concerns about physically going to their healthcare provider.”
Particularly during the time of COVID-19, the ability to connect online rather than in-person has proved beneficial for many. But telehealth isn’t always an accessible option for all.
Challenges Related to Telehealth
Like any technology, telehealth is intended to streamline an oft complicated process, but the experience is only as seamless as one’s access to infrastructure and understanding of the technology. And access can be a barrier for some, says Dr. West: “For some areas, like high-concentration urban centers with strong Internet access, telehealth can be great. But we have to remember the extent of telehealth’s capability is built upon whether or not you have the right infrastructure, and in rural areas — oftentimes where telehealth can be most necessary — the infrastructure isn’t always there, and therefore, neither is access.”
Another hurdle to overcome, particularly for older adults, is building understanding and trust of the devices used in telehealth. “There’s a number of wearable devices, which can track anything from blood pressure to gait, that can further streamline telehealth communication between provider and patient. But for a generation that’s already weary of technology, many older adults see these devices as intrusive. And addressing those concerns can be tricky,” explains Dr. West.
And building trust is a challenge now more than ever. “Throughout the COVID-19 pandemic, we’re finding that people are more and more distrustful of their providers and of information. They’re trying to decipher what’s accurate and what’s in their best interest, and there are so many conflicting sources,” says Dr. West.
As telehealth’s popularity rises, many older adults have been receiving free tablets in the mail (or similar offers), from invested parties that see the device as an opportunity to hook business down the line, Dr. West tells us. For seniors, this becomes an increasing source of confusion, because they don’t know whether the third party truly has their best interest in mind. With so many players in the field, and so many different agendas, the subsequently bred mistrust flourishes amongst older adults, who feel they have no advocate to help them navigate a confusing new arena.
“When we think about finding solutions to these challenges, in telehealth and beyond,” reflects Dr. West, “the core issue is ensuring older adults have ample access to care and ample access to information. We have to build trust not just in providers, but in healthcare itself, and demonstrate that those in charge are invested in providing care that’s in older adults’ best interest. What older adults truly need are more people on their side, and more people advocating for them. Otherwise, we’re not providing the right kind of support for one of our most vulnerable populations.”
