The Adoption of Telehealth among Older Adults During the COVID-19 Outbreak

December 19, 2022

Telehealth appointment


The number of Medicare beneficiaries who utilized telehealth increased from approximately 13,000 before the pandemic to 1.7 million during the last week of April 2020. During the outbreak, telehealth has served as an alternative way to deliver healthcare services and minimize the risk of COVID-19 transmission from in-person healthcare appointments. Telehealth can be particularly important to older adults during the pandemic as COVID-19-positive patients aged 60 or older have the highest mortality compared to younger individuals. Additionally, healthcare delays are prevalent among older adults during the COVID-19 outbreak, as a national poll shows that about one-third of US older adults have delayed health care due to COVID-19-related concerns. Therefore, improving older adults’ access to remote healthcare delivery (i.e. telehealth) is important to prevent health complications due to delayed care during the outbreak.

Unfortunately, approximately thirteen million older adults (38%) were not ready to use video visits with healthcare providers during the COVID-19 outbreak, largely due to a lack of confidence and inexperience with technology that is needed to communicate with healthcare providers. Furthermore, older adults can face distinct challenges in learning and navigating a new technology, such as frustration in their interactions with a new technology. 

The adoption of telehealth, such as emails and video calls, requires learning new technology or programs. Findings from a pilot program on rapid integration of home telehealth suggest that short-term technology learning may facilitate immediate adoption of telehealth. Additionally, qualitative evidence shows that the ability to quickly learn a new technology is crucial to older adults’ adaptation to telehealth during an outbreak. 

Findings based on 1,769 older adults from the National Health and Aging Trend Study (NHATS) show that the adoption of telehealth was substantially increased during the COVID-19 pandemic. Specifically, the prevalence of telehealth utilization among older adults increased by 5.59% for email and portal message and 19.99% for video calls to communicate with healthcare providers. In addition, the opportunity to learn a new technology was significantly associated with the adoption of telehealth. Specifically, compared to older adults who did not learn a new technology, those who learned a new technology during the outbreak were 2.42 times more likely to adopt emails and 2.72 times more likely to adopt video calls to communicate with their healthcare providers. 

This study found that older adults have substantially increased the utilization of telehealth during the COVID-19 outbreak, and that learning a new technology is associated with the adoption of telehealth. Although emerging evidence suggests that learning a new technology is related to older adults’ adoption of telehealth during the COVID-19 outbreak, these findings have been based on community samples and qualitative designs.

Interestingly, the increase in the prevalence of video calls utilization (19.99%) is higher than that of email utilization (5.59%). The difference between the changes in the prevalence of emails and video calls may reflect older adults’ preference for synchronous face-to-face connections over asynchronous email communication when it comes to virtual medical care, which may be due to the need to have more in-depth interactions with healthcare providers to receive prompt responses. Also, this difference may reveal the healthcare system’s capacity to provide telehealth. Specifically, there may be a lack of infrastructure for email communication, leading to difficulties in asynchronous care compared to synchronous care. Nevertheless, the overall prevalence of email utilization is higher than video calls, suggesting that some barriers, such as the opportunity to learn a new program, may be related to the adoption of video calls. Future efforts are needed to understand what types of treatments are more appropriate for using telehealth than in-person care, in conjunction with patients’ needs and preferences.

Additionally, learning a new technology during the outbreak predicts higher likelihood of the adoption of telehealth. This finding echoes recent qualitative evidence that older adults who received rapid training on technology were able to complete at least one telehealth visit during the outbreak. Altogether, older adults may be capable of quickly learning technology to access telehealth. Due to a massive transition from face-to-face to online healthcare services during the COVID-19 outbreak, older adults may find it necessary to learn technology to adopt telehealth and access essential health services. More specifically, reduced in-person healthcare appointments during the outbreak may have triggered older adults’ motivation to use telehealth. Older adults’ concerns over their privacy may be a barrier to adopting telehealth. In particular, evidence shows that privacy and security risks must be addressed to implement successful telehealth programs. 

In conclusion, older adults have substantially increased the utilization of emails and video calls to access healthcare services during the COVID-19 outbreak. Providing opportunities to learn new technology may help older adults facilitate the adoption of telehealth. Future technology training should be tailored to older adults in consideration of their distinct needs and preferences. Additional efforts are needed to identify effective approaches for older adults to learn a new technology and to develop training programs involving their caregivers.

This post was written by Weidi Qin based on a previously published study. Get the full study from Sage Publications:

Dr. Weidi Qin is a National Institute on Aging Postdoctoral Fellow at the University of Michigan Population Studies Center. She completed her PhD in Social Welfare at Case Western Reserve University and her MSW and MPH at Washington University in St. Louis. She is an interdisciplinary scholar trained in gerontological social work. Broadly, her research is focused on aging, cardiometabolic health, and social determinants of health.