Can Your Grandma Reach Her Doctor?

With the rapid appearance of telehealth as the safest modality of healthcare during the Covid pandemic, a new landscape of healthcare inequities arose. Now persons without access to a smartphone, a computer, or high-speed internet service were at a disadvantage (Goldberg et al. 2021; Iyer et al. 2021; Neumannn et al. 2023). How does this affect older people’s access to care in the United States – seniors who are not tech-savvy, are likely retired, on a limited budget, maybe widowed, and often dealing with chronic conditions?

Telehealth? Tell Me More.

Telehealth is the delivery of healthcare from a remote location using technological means, such as phone or video calls, secure messaging or email, accessing online healthcare portals, or using wearable diagnostic devices, to name a few. Telehealth also includes non-clinical applications, like booking appointments or reviewing one’s medical record on a healthcare app or online portal. It can be used time-deferred, as in sending a message with a photo of an infected wound to a provider and waiting for the reply; or in real time, synchronous, like a direct phone or video visit with a clinician. (Hung et al 2023; Lopez et al. 2021; Steinman et al. 2024.)

A Narrative Literature review

The author’s intent was to provide insights and action points – whether you are a consumer, a healthcare provider, an industry leader, or a policy maker. To answer the question posed above, a thorough narrative literature review was conducted. Here is a link to the full text: https://urn.fi/URN:NBN:fi:amk-2025112730484. The review analyzed 23 relevant and current studies on the subject. The studies were obtained through a systematic and focused database search of thousands of reputable academic articles. The chosen studies were examined for recurring themes, and the review was structured along the lines of these themes. While the use of Artificial Intelligence (AI) for eloquent writing is common nowadays, this thesis was written entirely by a real human author.

Findings

The literature review found that older adults, who live in the United States, are 65 years of age and older, and who are typically on the government-run Medicare health insurance program, benefited from telehealth. How did they do it? They had access to devices and internet service. And they had support: social support and technological support. These were the two key factors for seniors to successfully engage in and benefit from telehealth. (Iyer et al. 2021; Goldberg et al. 2021; Lopez et al. 2021; Neumann et al. 2023; Pimentel et al. 2024.)

Were there any drawbacks? Yes. Some healthcare providers were unhappy with telehealth, especially in the thick of the Covid-19 pandemic, when they started out with no training or guidance and had to assess and diagnose patients over the phone. or at best during a video call, without a physical exam or getting a lab draw. The situation posed a real risk of malpractice, and most importantly, it put the patient at risk. (Ladin et al. 2021; Lynch 2021, 34.)

Some patients did not believe that a virtual visit could ever replace an in-person encounter (Nguyen-Truong et al. 2024). Some were worried about cybersecurity and privacy (Steinman et al. 2024). Some did not even know that remote visits were an option (Pimentel et al. 2024). But most patients who tried telehealth, with adequate support by caregivers and/or medical office staff, realized that it saved them time, effort, and cost, while meeting their healthcare needs (Iyer et al. 2021; Ladin et al. 2021; Schorn et al. 2023).

Conclusion

Telehealth in the United States has proven to serve older adults well when they have the devices and technical skills or support to access it. (Action item: please assist your grandmother.) Virtual visits work best for preventive care, chronic illness management, medication refills, mental health, specialty consultations, and care team conferences (Goldberg et al. 2021; Schorn et al. 2023). More research and funding are needed to help expand internet service infrastructure, provide low-income seniors with free devices, and find creative and equitable ways to close disparity gaps.

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Author:

Saskia Verbeck, RN, BSN, PHN, Digitalization Expert in Social and Health Care, Master’s degree Student, Savonia University of Applied Sciences.

Editor:

Teija Niskanen, Senior lecturer, MSc (Health Sci) Savonia University of Applied Sciences, Business and Continuous Learning; Bryn Lane, CFA.

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References:

Goldberg, Elizabeth M., Jiménez, Frances N., Chen, Kevin, Davoodi, Natalie M., Li, Melinda, Strauss, Daniel H., Zou, Maria, Guthrie, Kate, & Merchant, Roland C. 2021. Telehealth was beneficial during COVID‐19 for older Americans: A qualitative study with physicians. Journal of the American Geriatrics Society, 69(11), 3034–3043. https://doi.org/10.1111/jgs.17370. Accessed 25.8.2024.

Hung, Man, Ocampo, Monica, Raymond, Benjamin, Mohajeri, Amir, & Lipsky, Martin S. 2023. Tel-emedicine among Adults Living in America during the COVID-19 Pandemic. International journal of environmental research and public health, 20(9), 5680. https://doi.org/10.3390/ijerph20095680. Accessed 23.10.2024.

Iyer, Sowmya, Mehta, Priyanka, Weith, Joanne, Hoang-Gia, Dat, Moore, Janet, Carlson, Chalise, Choe, Philip, Sakai, Erin, & Gould, Christine 2021. Converting a Geriatrics Clinic to Virtual Visits during COVID-19: A Case Study. Journal of Primary Care & Community Health, 1–8. https://doi.org/10.1177/21501327211000235. Accessed 25.8.2024.

Ladin, Keren, Porteny, Thalia, Perugini, Julia M., Gonzales, Kristina M., Aufort, Kate E., Levine, Sa-rah K., Wong, John B., Isakova, Tamara, Rifkin, Dena, Gordon, Elisa J., Rossi, Ana, Koch-Weser, Susan, & Weiner, Daniel E. (2021). Perceptions of Telehealth vs In-Person Visits Among Older Adults With Advanced Kidney Disease, Care Partners, and Clinicians. JAMA Network Open, 4(12), e2137193. https://doi.org/10.1001/jamanetworkopen.2021.37193. Accessed 10.8.2024.

Lopez, Ana M., Lam, Kenneth, & Thota, Ramya 2021. Barriers and Facilitators to Telemedicine: Can You Hear Me Now? Am Soc Clin Oncol Educ Book. 2021 Mar; 41:25-36. doi: 10.1200/EDBK_320827. PMID: 34010056. https://ascopubs.org/doi/10.1200/EDBK_320827?url_ver=Z39.88-2003. Accessed 1.9.2024.

Lynch, Kimberly L. 2021. Telehealth for older women: Practice considerations for the WHNP. Women’s Healthcare: A Clinical Journal for NPs, 9(6), 32–37. https://www.npwomenshealthcare.com/wp-content/uploads/2021/11/Dec-WH-TELE-1.pdf. Accessed 24.8.2024.

Neumann, Alicia V., Gonzalez, Andrea, Walter, Louise C., & Rivera, Josette 2023. Improving older adults’ telehealth through a novel community–academic partnership: Preliminary data. Journal of the American Geriatrics Society, 71(12), 3886–3895. https://doi.org/10.1111/jgs.18556. Accessed 31.8.2024.

Nguyen-Truong, Connie K. Y., Wuestney, Katherine, Leung, Holden, Chiu, Chenya, Park, Maria, Chac, Christina, & Fritz, Roschelle L. 2024. Toward Sustaining Web-Based Senior Center Programming Accessibility With and for Older Adult Immigrants: Community-Based Participatory Re-search Cross-Sectional Study. Asian Pacific Island Nursing Journal, 8, 1–20. https://doi.org/10.2196/49493. Accessed 4.7.2025.

Pimentel, Camilla B., Dryden, Eileen M., Nearing, Kathryn A., Kernan, Laura M., Kennedy, Meaghan A., Hung, William W., Riley, Jessica, & Moo, Lauren R. 2024. The role of Department of Veterans Affairs community‐based outpatient clinics in enhancing rural access to geriatrics tele-medicine specialty care. Journal of the American Geriatrics Society, 72(2), 520–528. https://doi.org/10.1111/jgs.18703. Accessed 10.8.2024.

Schorn, Mavis N., Myers, Carole R., Barroso, Julie, Hande, Karen, Hudson, Tamika, Kim, Jennifer, & Kleinpell, Ruth 2023. Changes in Telehealth Experienced by Advanced Practice RNs During COVID-19: US Survey Results. CIN: Computers, Informatics, Nursing, 41(7), 507–513. https://doi.org/10.1097/CIN.0000000000000979. Accessed 25.8.2024.

Steinman, Lesley, Chavez Santos, Erica, Chadwick, Kelly, Mayotte, Caitlin, Johnson, Selisha, Kohn, Marlana, Kelley, James, Denison, Paige, Montes, Clarissa, Spencer-Brown, Lesha, & Lorig, Kate 2024. Remote Evidence-Based Health Promotion Programs During COVID: A National Evaluation of Reach and Implementation for Older Adult Health Equity. Health Promotion Practice, 25(3), 475–491. https://doi.org/10.1177/15248399231175843. Accessed 25.8.2024.

Written by: Saskia Verbeck, RN, BSN, PHN, Digitalization Expert in Social and Health Care, Master’s degree Student, Savonia University of Applied Sciences.

Editors: Teija Niskanen, Senior lecturer, MSc (Health Sci) Savonia University of Applied Sciences, Business and Continuous Learning; Bryn Lane, CFA.