By Tasaduq Hussain Mir, MD, FAAFP
The COVID-19 pandemic has led to a paradigm shift in how we see patients. Many physicians have now switched to telemedicine. Prior to the pandemic, only about 11% of physician visits were done via telehealth and now almost 46% of visits are completed via telehealth, according to the American Medical Association.
Although telehealth visits have many benefits and are a preferred mode for a lot of patients to see their physician, they have their limitations, too. Many patients prefer telehealth because they do not have to spend hours in a doctor’s office, contend with heavy traffic, or struggle to find a parking spot to park their car. Having said that, many of the patients we schedule for telehealth visits are elderly, and problems like hearing loss, poor vision, and dementia are common in this age group.
Also, many elderly patients are not well acquainted with technology and although most have cell phones, many of them don’t know much about using them other than making phone calls or sending text messages. They often are unfamiliar with the apps that physician offices use to connect with patients. Many of my own patients’ schedule telehealth visits with me intending to use video but often we have to convert the visit to a phone call because they can’t operate the technology. This is a significant problem when it comes to providing complete and comprehensive care.
A recent study published in Journal of American Medical Association (1) explores the preparedness for telehealth visits among older adults. According to this study, a whopping 38% of elders might not be ready or have tools or skills to handle a telehealth video visit. This study suggests that telemedicine might be impossible for about 40% of elders, especially those with advanced age, lower income, and education. Unreadiness was most prevalent among unmarried, older Black and Hispanic male participants.
It is very important therefore that we assess each patient’s ability and readiness to handle a telehealth visit, especially with video, before we schedule it for them. Also, equally important is to speak at a volume that our patients can hear. One of the things that might be helpful is to use the teach-back method to make sure that our patients understand what we are discussing. This can easily be done by asking our patients to repeat what we have said.
- Lam K et al. Assessing telemedicine unreadiness among older adults in the United States during the COVID-19 pandemic. JAMA Intern Med 2020 Aug 3; [e-pub]. (https://doi.org/10.1001/jamainternmed.2020.2671)