Ufholz Kelsey, Sheon Amy, Bhargava Daksh, Rao Goutham
Department of Family Medicine and Community Health, School of Medicine, Case Western Reserve University, Cleveland, OH, United States.
Public Health Innovators LLC, Cleveland, OH, United States.
JMIR Form Res. 2022 Jul 27;6(7):e35028. doi: 10.2196/35028.
Older adults are a high priority for telemedicine given their elevated COVID-19 risk and need for frequent provider contact to manage chronic illnesses. It seems that many older adults now use smartphones but few studies have examined their overall readiness for telemedicine.
The aim of this study is to survey older primary care patients about their telemedicine preparedness, including internet usage, internet-capable devices, telemedicine experiences and concerns, and perceived barriers. Results were used to inform a telemedicine preparedness training program.
Community-dwelling older adult patients (aged 65-81 years; N=30) with a chronic health condition that could be managed remotely who were present at a family medicine clinic that primarily serves an urban African American population for a prescheduled in-person appointment were asked to complete a brief survey written for this study. Data were collected February-June 2021 at a large, urban, Midwestern hospital. To minimize patient burden, the survey was limited to 10 questions, focused on the most critical topics.
Most participants (21/30, 70%) reported having a device that could be used for telemedicine and using the internet. However, about half had only a single connected device, and messaging and video calling were the most commonly used applications. Few used email and none used online shopping or banking. Only 7 patients had had telemedicine appointments. Telemedicine users were younger than nonusers and used more internet functions than nonusers. Only 2 people reported problems with their telemedicine visits (technology and privacy). Nearly all respondents recognized avoiding travel and COVID-19 exposure as telemedicine benefits. The most common concerns were loss of the doctor-patient connection and inability to be examined.
Most older adults reported having devices that could be used for telemedicine, but their internet use patterns did not confirm the adequacy of their devices or skills for telemedicine. Doctor-patient conversations could be helpful in addressing telemedicine concerns but device and skill gaps must be addressed as well.
鉴于老年人感染新冠病毒的风险较高，且需要经常与医疗服务提供者联系以管理慢性病，因此远程医疗对他们来说是一个高度优先事项。许多老年人现在似乎都在使用智能手机，但很少有研究考察过他们对远程医疗的整体准备情况。
本研究旨在调查老年初级保健患者的远程医疗准备情况，包括互联网使用情况、具备上网功能的设备、远程医疗体验与担忧以及感知到的障碍。研究结果用于为远程医疗准备培训项目提供信息。
社区居住的老年患者（年龄65 - 81岁；N = 30），患有可远程管理的慢性健康状况，他们在一家主要服务城市非裔美国人的家庭医学诊所参加预定的面对面预约时，被要求完成一项为本研究编写的简短调查。2021年2月至6月在中西部一家大型城市医院收集数据。为尽量减轻患者负担，调查限于10个问题，聚焦于最关键的主题。
大多数参与者（21/30，70%）报告拥有可用于远程医疗的设备并使用互联网。然而，约一半人只有一台联网设备，消息传递和视频通话是最常用的应用程序。很少有人使用电子邮件，没有人使用网上购物或网上银行。只有7名患者有过远程医疗预约。使用远程医疗的患者比未使用者更年轻，使用的互联网功能也比未使用者更多。只有2人报告了远程医疗就诊存在问题（技术和隐私方面）。几乎所有受访者都认识到避免出行和接触新冠病毒是远程医疗的好处。最常见的担忧是医患联系的缺失以及无法进行检查。
大多数老年人报告拥有可用于远程医疗的设备，但他们的互联网使用模式并未证实其设备或远程医疗技能的充分性。医患对话可能有助于解决对远程医疗的担忧，但设备和技能差距也必须得到解决。
