Does the elderly population have available and accessible telehealth solutions during the Covid-19 pandemic?

By Dr. Motti Haimi

Telehealth is the delivery of healthcare services by healthcare professionals through information and communication technologies, where distance separates between the participants. During the last years, with the impressive development of the Internet and communication infrastructure, telehealth has become a convenient and safe method for patients to obtain reliable information and medical consultation.

There are many benefits in using telehealth, especially in routine care and in cases where a direct patient-healthcare provider interaction is not mandatory.

Since December 2019, the world has been facing an epidemic threat to global health, caused by a novel coronavirus, “SARS-CoV-2".

Elderly people and those who have underlying medical conditions are at greater risk of developing an intensive and severe form of the disease. On the other hand, people who are not currently infected with COVID-19 but are being at greater risk of “catching” the infection (e.g., elderly people and people with underlying diseases), should be able to get their continuous routine healthcare without being at a risk due to exposure to others.

COVID-19 has catalyzed rapid use of information communication technologies such as telehealth and virtual software platforms to deliver healthcare at a distance.

Telehealth had become an important tool for the general population, healthcare providers, and patients with COVID-19, enabling patients to maintain in real-time contact with healthcare providers for advice on their health problems, especially when people are in quarantine. Remote medical treatment, using telemedicine services, can promote the patients’ access to professional medical advice without having to wait for a long period. It reduces unnecessary visits to clinics and hospitals, in ordinary times and especially during the Covid-19 outbreak.

Among the most significant benefits of telehealth technologies will be how they will enable healthcare providers to effectively address and treat chronic diseases, which are one of the major health problems nowadays, and the largest cause of death.

Even before the COVID-19 pandemic, older adults with complex medical diseases had limited access to healthcare. Concerning the elderly population, telehealth has the potential to increase equality in care, especially in times such as the Covid-19 era, but unfortunately, it can also further exacerbate disparities.

The covid-19 pandemic further exacerbated the access-to-care problem, especially among the elderly population, due to reduced clinic visits, transportation restrictions, and other societal measures to mitigate the pandemic. Age-related barriers exist due to lack of exposure to the new technology and patients’ lack of training.

Nevertheless, there is a misconception that older people do not have internet or network connection, which serves as a platform for telehealth solutions. Most of them do have such accessibility, however, they find it difficult to use. Several studies also described a successful experience for older adults in cases in which special equipment was provided and installed, enabling them to experience home telehealth services.

In this systematic review, we explored the availability, application, and implementation of telehealth services during the Covid-19 pandemic designed for the aged population (age 65 and more), who needed them the most during this challenging period.

In our analysis- a total of 5319 articles were identified in the database, of which 3225 articles were left after deleting the duplicates. Following the removal of duplicate studies and screening titles and abstracts of the different study reports, we finally appraised 40 relevant studies in full text. 11 studies were finally included after reviewing the full texts.

Our study shows that although older patients may benefit the most from using home telehealth visits, which improve their access to care, especially in the Covid-19 era, in which the necessity of such solutions was undoubtedly proved, still, paradoxically, there are not enough telehealth solutions addressed and aimed at this special population. It seems that not enough efforts were made to satisfy this purpose.

Many older adults may have trouble accessing telemedical services. Policymakers should recognize and bridge this digital divide.

We suggest using simple, uncomplicated devices (such as tablets), which will be supplied to the elderly people enabling them to easily communicate with their physicians or other healthcare providers. Lectures and demonstrations on telehealth opportunities given to the general population can help address this digital divide. Another option is to train and prepare special health-related or technology-related personnel who can visit the elderly patients several times a month, and help them operate the telehealth devices, thus connecting them to their remote healthcare professionals.

We believe that appropriate and successful digital solutions should be tailored and developed specifically for the elderly sub-groups, and aim to address their needs, desires, and everyday activities, not only in pandemic crises. Solutions, as demonstrated in this systematic review, show that despite the hesitations of operating telehealth solutions for older patients, it can be done and be effective.

This article is in memory of my mother- Rachel Haimi, who passed away one year ago, not from Covid-19 infection, but due to the lack of appropriate medical attention caused by the Covid-19 restrictions.

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Article details:

Application and implementation of telehealth services designed for the elderly population during the COVID-19 pandemic: A systematic review
Motti Haimi, Anat Gesser-Edelsburg
First Published February 17, 2022 Research Article
DOI: 10.1177/14604582221075561
Health Informatics Journal

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Professor Anat Gesser-Edelsburg, PhD, is associate professor (tenured), the head of Health Promotion Program, School of Public Health, Faculty of Social Welfare and Health Sciences, and the Founding Director of the Health and Risk Communication Research Center at University of Haifa. During 2020 Anat was a visiting scholar at the School of Public Health, University of Illinois at Chicago.

Anat is also a researcher at The Center for Evaluation of Health Promotion Interventions and at The Emili Sagol Creative Arts Therapies Research Center, University of Haifa.

Anat has won or collaborated in many research grants, and she has published extensively in peer-reviewed journals.

Anat has a BA (Summa Cum Laude) and PhD (With Distinction) both from the Faculty of the Arts, Tel-Aviv University. She has completed her post-Doc research being awarded the Vidal Angel Postdoctoral Fellowship for Research Against Hate and Bigotry at the Minerva Center for Human Rights, The Faculty of Law, The Hebrew University of Jerusalem.

Her areas of research include health and risk communication, positive deviance, social marketing, persuasive communication, health-promotion programs, entertainment-education and qualitative research. Anat investigate a variety of health-related issues, including emerging infectious disease communication, vaccination compliance, drugs and alcohol abuse, drinking-and-driving, sex education, nutrition, and hospital-acquired infections prevention.

Dr. Motti Haimi MD. PhD, MHA, is an experienced Pediatrician and pediatric- Onco-Hematologist, and Medical Director, working at Clalit Health Services since 2007.

He has a demonstrated history of working in the hospital & health care industry. Skilled in Clinical Research, Medical Education, Epidemiology, Pediatrics, Hematology, telehealth, and anti-healthcare disparities activist.

He is a clinical Lecturer at the Rappaport Faculty of Medicine, Technion; He is also a Research Associate and Lecturer at the School of Public Health, University of Haifa, and at HIT (Holon Technological Institute).

He got a MD degree from the medical school of Hebrew University in Jerusalem. He also got a Ph.D. degree, and master's degree (Cum Laude) in Health Administration and Health Care Management from the School of Public Health -Haifa University.

His areas of research and interest include Pediatric Hematology, Dysmorphology and familial genetic syndromes, hereditary predisposition for cancer, Gastroenterology and nutrition in children, and decision making of the primary care doctor.

During the last years, he is especially interested in the field of Telemedicine and health-informatics, pediatric telemedicine services, and especially finding telehealth solutions for the elderly population and for other populations who may have difficulties in accessing the digital solutions.

He is part of the Healthcare Disparities and Digital Health working group of the international society for telemedicine & e-health.