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Friday Feature | Golden Oldies Want to Take Health IT for a Spin

Friday Feature | Golden Oldies Want to Take Health IT for a Spin

BookZurman is proud to share a recent post featuring the insights from guest author, Lorilei Richardson

Picture5Golden Oldies Want to Take Health IT for a Spin
originally published 05/21/2021 by Lorilei Richardson, PhD

Older adults are some of the largest consumers of healthcare as they tend to have more chronic conditions, but they are typically lower users of health information technology (IT)—and not necessarily because they cannot or do not want to use it.

Because of misconceptions and assumptions, health IT is not always offered to older adults. This large subset of people could be users if providers and provider organizations combat societal preconceived notions about technology and work with older patients, instead of contributing to the digital divide. Well over half of U.S. older adults already use the internet1 and are just as well-poised to adopt health IT as younger patients are.

The following graphic illustrates the upward trend of internet use for all adults and for older adults age 65+. While the numbers are slightly lower for older adults, this age group sees a steadfast steep incline in internet use over time.

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Older Adults are Large Consumers of Healthcare
More than half of older adults have two or more chronic conditions,2 these accumulating comorbidities and chronic disease conditions increase their medical care needs. One tribulation that comorbidities often bring is poor coordination of care,3 a problem that could be abetted by health IT.

Yet, few older adults are users of health IT and fewer are using the internet as a means to reach their healthcare teams. Imagine the time and cost savings, as well as increased care coordination, health IT could bring to older adults with comorbidities.

Interoperable health IT systems are a catalyst to care coordination. This is yet another reason why adopting 21st Century interoperability and compliance with the new 21st Century Cures Act program rules on interoperability and information blocking is so important. Patients and their caregivers can not only access their health information, but can take that information with them from primary care physician to specialist in order to streamline processes and provide comprehensive care.

Older Adults Can and Do Use Technology
While barriers to health IT use exist, health IT adoption is widely increasing among older adults.5 More than half of older adults have a smartphone (a common hardware regularly necessary to engage in health IT) and that number rises each year.6 More still, many older adults report being interested in engaging with health IT in various ways.

The following chart demonstrates two ways that older adults are willing to engage in health IT. Forty percent of older adults would be interested in using medication reminder technology that would remind them to take their medications and would also provide medication adherence feedback to their healthcare provider. Twenty-one percent of older adults said they would be willing to have a video visit with their healthcare provider.

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One avoidable health IT use barrier is misconception; many healthcare professionals may not offer health IT to older patients if they assume the patient would not be interested or have the capability to use it.7 Many older adults have the technology, the know-how, and the interest in using health IT.

Of course, the health IT digital divide affecting older adults can also be somewhat self-imposed (e.g., lack of interest or perceived need), or an issue of socioeconomic disparities (e.g., lack of access to technology hardware), and those are poignant discussions for another day.

In such cases, one possible solution is surrogate or proxy access where an informal caregiver or family member can access health IT on behalf of the patient.8 This access benefits both patient and informal caregiver assisting with healthcare management. Are you engaging informal caregivers in health IT (under the consent of the patient)? 

Many older adults are well-versed on the benefits, and are willing and able to use health IT – they just need to be asked. The communication and engagement that health IT provides fosters goal setting, improves access to care, saves time and energy, and emboldens health equity in the face of social determinants of health (SDOH).9

The benefits of health IT are perhaps amplified in the older adult population. As we’ve mentioned, living with multiple chronic conditions means handling multiple self-management tasks such as self-administering several kinds of medications at different times throughout the day—something that technology could facilitate and support (e.g., via medication reminders). Health IT is a tool that should be available to all patients given its potential for positive effects on quality, safety, and efficiency outcomes.

Driving home the access to care point, transportation can also be a challenge for older adults. Some older adults are not comfortable with driving, or are unable to drive given the physical changes associated with aging (e.g., reduced visual acuity), which can lead to driving cessation.

According to the National Association of Area Agencies on Aging (n4a), about 600,000 older adults stop driving each year. Many larger healthcare systems make a note in a patient’s chart that the patient requires transportation assistance. Without access to readily available public transportation or surrogate transportation (i.e., rides from family or friends) to reach target destinations such as medical appointments, health IT can save the day for most minor medical questions or check-ins (e.g., medication refill). Health IT can offer convenient solutions to complicated problems and deserves the community’s attention.

There are Potential Solutions to the Digital Divide
The community is making great strides to work toward health equity. The non-profit organization, The National Health IT Collaborative for the Underserved, launched a platform enabling actionable insights using SDOH data.10

Using nontraditional clinical data (e.g., access to transportation) as well as telehealth utilization data, can help to paint an accurate picture of the digital divide. Armed with this knowledge, the community can make recommendations and find solutions to narrow the digital divide.

Possible solutions include increasing affordability, empowering users, improving the relevance of online content and increasing security, bolstering internet infrastructure development (e.g., broadband vs. dial up), and addressing gender gaps in internet use (i.e., in rural and developing nations, women have a digital disadvantage).11 Government subsidies, education, equal opportunity, and community engagement are conduits to narrowing the digital divide, not just for older adults, but for all groups impacted by the digital divide.

Offer Health IT to Older Baby Boomers and Up Too
A quick note about the focal population in this piece, older adults: Within the gerontological literature base, the definition of “older adults” varies but often starts around ages 60-65, which also relates to the age at which retirement eligibility most commonly has occurred in the U.S., and is regularly deemed “old age.”

Older adults can be further subdivided into categories such as young-old 65-74, old-old 75-84, and oldest-old 85+. While there may be substantial nonlinear differences within these subdivided groups (e.g., between age 65 and age 85), research shows that nearly 40% of older adults over age 80 are using the internet. While using the internet is not the same thing as using health IT, it is certainly a stepping stone in the right direction.

The following graph explains that while internet use declines across older age groups, a significant number of older adults are indeed internet users.

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COVID-19, the Ultimate Use Case Scenario
With the COVID-19 pandemic forcing everyone’s hand, there was a large uptake of telehealth across the board as in-person visits decreased,12 with one in four older adults having a telehealth visit earlier in the pandemic. This is promising and demonstrates that older adults are not only willing to engage with health IT, but that they are in fact engaging with health IT.

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Challenges of Health IT for Older Adults
There are reasons some older adults still will continue to be disinterested in engaging with health IT. Older adults may not feel comfortable with using technology—think of the complexity of health portals today (e.g., logging in, passwords, clicking through different windows, etc.).

Face-to-face contact for medical visits may still be preferred. There may be a mistrust in health IT and worry about data privacy. Moreover, an older adult may not have anyone to help them get set up with or to use health IT.

Engage Older Adults in health IT
While barriers and personal situations may lead to a patient rejecting health IT adoption, other patients may very well be interested.

Some older adults may say no, but some may say yes. Be a part of the solution. Do not dismiss the golden oldies.

And, bonus, the Centers for Medicare & Medicaid Services (CMS) requirements to increase access to telehealth for seniors in Medicare Advantage plans enables incentives for providers to invest in telehealth with their patients if they aren’t already.14 Do not miss the opportunity to engage this group.


1Smith A. [2016-07-07]. Older adults and technology use. Pew Research Center. 2014 Apr 03. http://www.pewinternet.org/2014/04/03/older-adults-and-technology-use/ webcite.
2Wolff JL, Starfield B, Anderson G. Prevalence, expenditures, and complications of multiple chronic conditions in the elderly. Arch Intern Med. 2002; 162(20): 2269–2276.
3Noel PH, Frueh BC, Larme AC, et al. Collaborative care needs and preferences of primary care patients with multimorbidity. Health Expect. 2005; 8(1): 54–63.
4Bujnowska-Fedak MM, Mastalerz-Migas A. Usage of medical internet and e-health services by the elderly. Adv Exp Med Biol. 2015;834:75-80. doi: 10.1007/5584_2014_74. PMID: 25315621.
5Fischer SH, David D, Crotty BH, Dierks M, Safran C. Acceptance and use of health information technology by community-dwelling elders. Int J Med Inform. 2014 Sep;83(9):624-35. doi: 10.1016/j.ijmedinf.2014.06.005. Epub 2014 Jun 16. PMID: 24996581.
6Nelson KB. 2020 Tech Trends of the 50+. Washington, DC: AARP Research, January 2020. https://doi.org/10.26419/res.00329.001

7Greenwald P, Stern ME, Clark S, & Sharma R. (2018). Older adults and technology: in telehealth, they may not be who you think they are. International Journal of Emergency Medicine, 11(1), 2. https://doi.org/10.1186/s12245-017-0162-7
8Huh J, Koola J, Contreras A, et al. Consumer health informatics adoption among underserved populations: thinking beyond the digital divide. Yearb Med Inform. 2018;27:146–155.
9Ricciardi L, Mostashari F, Murphy J, Daniel JG, Siminerio EP. A national action plan to support consumer engagement via e-health. Health Aff (Millwood) 2013 Feb;32(2):376–384. doi: 10.1377/hlthaff.2012.1216. http://content.healthaffairs.org/cgi/pmidlookup?view=long&pmid=23381531
10Jercich, K. (2021, April 20). Amazon-powered Data Fusion Center could shed light on who isn't using telehealth – and why [web log]. https://www.healthcareitnews.com/news/amazon-powered-data-fusion-center-could-shed-light-who-isnt-using-telehealth-and-why.
11Steele, C. (2018, November 16). Top Five Digital Divide Solutions. http://www.digitaldividecouncil.com/top-five-digital-divide-solutions/
12Ateev Mehrotra et al., The Impact of COVID-19 on Outpatient Visits in 2020: Visits Remained Stable, Despite a Late Surge in Cases (Commonwealth Fund, Feb. 2021). https://doi.org/10.26099/bvhf-e411
13Buis L, Singer D, Solway E, Kirch M, Kullgren J, Malani P. Telehealth Use Among Older Adults Before and During COVID-19. University of Michigan National Poll on Healthy Aging. August 2020. http://hdl.handle.net/2027.42/156253
14https://www.federalregister.gov/public-inspection/current


Get to know the guest author!

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Lorilei Richardson, PhD
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Dr. Richardson wears many professional hats: Researcher, Writer, Editor, and Public Health Professor. With nearly fifteen years of health informatics research experience, six years in the federal sector, Dr. Richardson is a contributor to numerous publications and presentations. She has a PhD in Gerontology and is passionate about older adults and technology. As a Technical Writer for BookZurman, Inc., Dr. Richardson employs this enthusiasm to contribute to BZ’s healthcare interoperability efforts.