# Telehealth for Elderly Patients: Benefits and Barriers - Savonia AMK

> 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.

## Overview
With the rapid appearance of telehealth as the safest modality of healthcare during the Covid pandemic, a new landscape of healthcare inequities arose. Persons without access to a smartphone, a computer, or high-speed internet service were at a disadvantage. This literature review explores how this affects 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.

## Defining Telehealth
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. It 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 (e.g., sending a message with a photo of an infected wound) or in real-time, synchronous (e.g., a direct phone or video visit with a clinician).

## Research Methodology
The author conducted a thorough narrative literature review to provide insights and action points for consumers, healthcare providers, industry leaders, and policy makers. The review analyzed 23 relevant and current studies obtained through a systematic database search. The full text is available here: [https://urn.fi/URN:NBN:fi:amk-2025120331944](https://urn.fi/URN:NBN:fi:amk-2025120331944).

## Key Findings: Benefits and Support
The literature review found that older adults (65+) in the United States, typically on Medicare, benefited from telehealth when they had access to devices and internet service. Two key factors for success were identified:
*   Social support
*   Technological support

## Drawbacks and Challenges
The review identified several challenges:
*   **Provider Concerns:** Some healthcare providers were unhappy with telehealth, particularly during the pandemic, due to a lack of training and the inability to perform physical exams or lab draws, which posed risks of malpractice and patient safety issues.
*   **Patient Perceptions:** Some patients doubted that virtual visits could replace in-person encounters, while others expressed concerns regarding cybersecurity and privacy.
*   **Awareness:** Some patients were unaware that remote visits were an option.

However, most patients who utilized telehealth with adequate support from caregivers or medical staff found that it saved time, effort, and cost while meeting their healthcare needs.

## Conclusion and Recommendations
Telehealth serves older adults well when they have the necessary devices and technical skills or support. Virtual visits are most effective for:
*   Preventive care
*   Chronic illness management
*   Medication refills
*   Mental health
*   Specialty consultations
*   Care team conferences

Future efforts should focus on expanding internet infrastructure, providing low-income seniors with free devices, and finding creative, equitable ways to close disparity gaps.

## Credits
*   **Author:** 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.

## 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.