Perceived limitations to video visits, new technology learning curves and a preference for in-person care create substantial barriers to independent living residents connecting to care providers through telemedicine, according to a recent Stanford University study.
Researchers surveyed and interviewed residents at two Northern California independent living communities between September 2020 and March 2021 to better understand barriers to telemedicine and how to improve access and the experience.
One community, identified by the authors as Site A, was home to mostly middle and upper middle class native English speakers, whereas the second site, identified as Site B, provided subsidized senior housing and served a large population of non-English-speaking residents. The sites were chosen to try to better understand the needs of older adults with differing socioeconomic and language backgrounds.
Hearing difficulty largest hurdle
The largest reported barriers to telemedicine visits for the 249 participants were hearing difficulties (35.7%), unfamiliarity with how to use technology or the internet (30.1%), not knowing hot to connect to the telemedicine platform (29.7%) and language issues (26.5%).
Other barriers from both sites included a lack of resident interest in seeing providers outside of a clinic (24.5%), poor internet connectivity (15.7%) or lack of smart devices (12.9%), or difficulties with attention and memory (13.3%), expressing oneself (12.4%) or seeing (8.4%).
The top barriers for Site A included not knowing how to connect to the platform (24%), lack of familiarity with the technology (22.4%) and difficulty hearing (15.2%). At this community, 30% of participants did not perceive any barriers to accessing telemedicine via video visits.
The top barriers reported at Site B included the inability to speak English well (54.6%), not being familiar with the technology or internet (37%) and a lack of interest in seeing a provider outside of the clinic (35.3%).
Support, training helpful
The researchers found that independent living residents are more familiar with telephone than online video platforms, although the majority of study participants were interested in learning to use both to connect with their providers. Most (53%) participants said they were interested in using telemedicine to connect with care providers through video visits.
“Given a multitude of institution-specific platforms used for telemedicine, it is important to make sure platforms are streamlined and easy to use, or consider adopting platforms that already have widespread social adoption,” the authors wrote.
On-demand telephone or in-person support for troubleshooting, as well as caregiver training, also would be beneficial, they said.
The study, published in JMIR Aging, was conducted by Stanford University in partnership with Veterans Affairs Palo Alto Health Care System and the On Lok Program of All-Inclusive Care for the Elderly in San Jose, CA.