Telemedicine Preparedness Among Older Adults With Chronic Illness: Survey of Primary Care Patients

Background: 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. Objective: 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. Methods: 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. Results: 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. Conclusions: 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.