Differences in Challenges to Using Telehealth Among Older Adult Video and Telephone Users With Frailty: Retrospective...

Area of Science:

• Gerontology
• Health Services Research
• Telemedicine

Background:

• The COVID-19 pandemic accelerated the adoption of video care, potentially widening health access disparities.
• High-need, high-risk older adults, particularly those with frailty, faced challenges in accessing healthcare via video visits.

Purpose of the Study:

• To assess the capability of high-need, high-risk older veterans in utilizing video visits for healthcare.
• To identify factors correlating with the successful completion of video visits among this demographic.

Main Methods:

• Veterans in a Frailty Intervention and Treatment (FIT) clinic received comprehensive baseline assessments.
• The study analyzed patient groups based on visit type: video, telephone, reached but no visit, or unable to contact.
• Statistical tests (t-test, chi-square) were employed to compare variables and identify predictors of video visit completion versus telephone visits.

Main Results:

• Of 110 patients, 65 agreed to a televisit, with 19 (29.2%) completing a video visit and 37 (57%) a telephone visit.
• Successful video visit completers were more likely to have computer/internet access, email proficiency, and confidence in internet use.
• Video visit users also demonstrated higher health literacy, better cognitive function (MoCA score ≥26), and fewer mobility issues compared to telephone visit users.

Conclusions:

• Video visit completion among frail older veterans is contingent upon technology access, usability, and user confidence.
• Only approximately 25% of frail older veterans successfully completed video visits, primarily those with existing technological resources and comfort.
• Future strategies should involve screening for video visit suitability and enhancing access to user-friendly home telehealth technologies for older adults.