The coronavirus pandemic has had a tremendous impact on large swathes of what was previously thought of as normal life, but one of the most significant changes has been the widespread adoption of telemedicine across the healthcare world.  What had previously been a somewhat marginal activity became mainstream as providers attempted to maintain a degree of normality while observing social distancing rules.

While the adoption of the technology was widespread, new research from the University of California, San Francisco, suggests that parts of society remained underserved.  The paper highlights how around a third of adults over 65 years of age have found themselves cut off from care due to technological difficulties accessing telemedicine platforms.

“Telemedicine is not inherently accessible, and mandating its use leaves many older adults without access to their medical care,” the researchers say. “We need further innovation in devices, services and policy to make sure older adults are not left behind during this migration.”

Health inequalities

This is obviously a vital segment of the market, as older adults account for roughly 25% of all medical visits in the United States, and often suffer from a range of morbidities.  The US Department of Health and Human Services has been strongly promoting video consultations during the pandemic to maintain outreach with this vulnerable group, but the data appears to suggest these efforts have not been as successful as they would have liked.

The researchers analyzed data from 4,525 patients identified as 65 and above from the National Health and Aging Trends Study of Medicare.  They then identified a number of scenarios that might make a video consultation difficult, including poor eyesight, difficulties making oneself understood, and various technical challenges, such as a lack of Internet or suitable devices.

In total, the analysis suggests that around 38% of older Americans are not ready for video consultations, which amounts to around 13 million people.  What’s more, this figure rises to 72% of those aged over 85.  The biggest barrier was the technology itself, with this barrier not surmounted by third-party support.  Indeed, around 20% of older people would struggle to conduct a consultation over the telephone due to difficulties with hearing or communicating.

“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,” the researchers conclude. “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.”