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Older Adults Hesitant to Try Virtual Health Visits

You may have heard that “50 is the new 30” when it comes to healthy aging, activity levels and longevity. And it’s true in some ways. Yet a new poll finds that the 50 and older crowd may be lagging behind their younger counterparts in terms of their willingness to try virtual health visits. 

What’s behind their hesitancy? 

Some older adults simply like the personal touch better. Others are concerned about everything from reliability of the equipment to privacy to quality of this new-fangled method of health care delivery. And a good portion of them seem to be out of the loop about the technology that is available and how to use it.

The National Poll on Healthy Aging found that few patients over the age of 50 have tried telehealth and most see in-person care as better—but half of them would consider it for encounters with their primary providers.  

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Older patients and virtual health visits: Their top concerns 

Some key findings from the 2019 National Poll on Healthy Aging, with respondents aged 50+:

  • Only 4 percent of these older adults had had a video-based telehealth visit with a provider via smartphone or computer in the past year;
  • 55 percent didn't know if their health providers even offer telehealth visits;
  • More than 80 percent expressed at least one concern about seeing a doctor or other provider virtually rather than in person. For instance:
    • 68 percent worried the quality of care would be less than in-person visits;
    • 47 percent worried about getting the technology to work;
    • 49 percent had concerns about privacy related to virtual visits;
  • Yet, more than half said they'd be willing to try telehealth in some situations, for instance if they got sick while traveling or needed follow-up on previous care.

The poll, carried out by the  University of Michigan Institute for Healthcare Policy and Innovation with support from AARP and Michigan Medicine, U-M's academic medical center, involved a national sample of more than 2,250 adults aged 50 to 80. They answered questions about many aspects of video-based telehealth.

Among the one-third of poll respondents whose health providers don't yet offer telehealth, 48 percent said they'd be interested in trying it with their primary care provider. But fewer would try it for specialty or mental health care.

Addressing older adults’ concerns about telehealth

"As telehealth finally appears poised to live up to its potential, with insurance reimbursement in place or set to begin soon under many plans, and providers increasingly investing in systems, these poll data show a need to focus on the patient side," says Jacob Kurlander, MD, MS, a U-M and VA Ann Arbor Healthcare System gastroenterology specialist and telehealth researcher who helped lead the poll. "As the industry moves forward, we should heed the concerns and preferences of our patients, especially those over age 50, who use the most health care.”

Preeti Malani, MD, the poll's director and a professor of internal medicine at U-M, notes that focusing on certain types of telehealth visits might be a way to help older adults get comfortable with the concept and see its value.

"Telehealth won't replace in-person medical examinations completely, but for situations where in-person visits aren't essential, they can save time and resources for patients and providers alike," she says. "Providers shouldn't assume older adults aren't receptive to virtual visits, but they should understand and work to overcome some of the reasons for hesitation."

For instance, she points to the 64 percent of respondents who said they'd be interested in telehealth options if they became unexpectedly ill while traveling, and the 58 percent who said they'd be interested in using it for a return visit after seeing a provider in person for an issue.

Low use, high potential

Telehealth as a concept has been around for decades, but has lagged in development until state and federal laws, and insurance plan coverage, aligned with the technical capability of health providers and consumer electronics. The poll was taken in spring of 2019, as many new policies and coverage provisions began to kick in.

Some of those changes will specifically affect older adults. Starting in 2020, Medicare Advantage HMO insurance plans will be able to reimburse health care providers for seeing patients via computer or smartphone. Veterans have increasing access to telehealth, as do people who receive their health coverage through their employer or Medicaid.

But providers that have begun to offer telehealth options may need to do a better job of letting their older patients know it's an option, and helping them understand how it works, the poll suggests.

"Many older Americans can benefit from being able to get care through telehealth without long trips to their doctor's office," says Alison Bryant, PhD, senior vice president of research for AARP. "Telehealth allows people to schedule health-related appointments, request prescription refills, and link to health care providers when time or distance is a barrier. It can also support family caregivers who are taking care of their loved ones."

What this means for providers and payors

Sameer Saini, MD, MS, who leads a Michigan Program on Value Enhancement (MPrOVE) Innovation Challenge project that partly supported the work, notes that further research is needed to understand the best uses of telehealth among older adult populations.

"Especially for patients with mobility and transportation issues, who live in rural areas, or who live far from specialty care providers, telehealth could be an important improvement in access," says Saini, a U-M gastroenterologist and VA Center for Clinical Management Research acting director who is studying the use of telehealth in specialty care. "But we will need evidence-based approaches to sustain and increase participation."  

Source: MICHIGAN MEDICINE - UNIVERSITY OF MICHIGAN

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