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Telehealth visits have skyrocketed for older adults, but concerns remain

It's becoming much more popular among the age group, but many still don't see it as a substitute for in-person care.

Jeff Lagasse, Associate Editor

One in four older Americans had a telehealth visit in the first three months of the COVID-19 pandemic, most of them by video, a new telehealth poll finds. That's much higher than the 4% of people over 50 who said they had ever had a virtual visit with a doctor in a similar poll taken in 2019.

Comfort levels with telehealth have also increased. Back in 2019, most older adults expressed at least one serious concern about trying a telehealth visit. But by mid-2020, the percentage with such concerns had eased, especially among those who had experienced a virtual visit between March and June of this year.

Yet not all older adults see virtual care as an adequate substitute for in-person care, even in a pandemic, the National Poll on Healthy Aging findings show.

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And 17% of people over 50 still say they have never used any sort of video conferencing tool for any reason, including medical care. While that's 11 percentage points lower than in the 2019 poll, that lack of experience or access could be a barrier to receiving care without having to leave home as the pandemic continues to surge in dozens of states.

Both the 2019 and 2020 polls were done for the University of Michigan's Institute for Healthcare Policy and Innovation with support from AARP and Michigan Medicine, U-M's academic medical center. Both involved a national sample of more than 2,000 adults aged 50 to 80.

WHAT'S THE IMPACT

The poll finds that 30% of older adults had participated in a telehealth visit by June 2020, perhaps reflecting changes in insurance coverage that began to take effect before the pandemic. But the figure for March through June suggests that much of the movement to telehealth visits resulted from states mandating reductions in elective and non-emergency healthcare during the first months of the pandemic, as part of stay-at-home public health requirements aimed at reducing the spread of the virus.

Nearly half of those who'd had a telehealth visit said they had an in-person visit canceled or rescheduled by their healthcare provider between March and June, and 30% said that a virtual visit was the only option when they called to schedule an appointment.

Awareness about the special risks of COVID-19 among older adults may have also played a role, as 45% of respondents said the pandemic made them more interested in telehealth. The percentage was higher among those who'd had a telehealth visit in the past. But only 15% of the respondents who had a telehealth visit said that fear of the virus led them to request such a visit, whether for a new concern or in place of a previously scheduled visit.

Among those who had a telehealth visit this past spring, 91% said it was easy to connect with their doctor. One-third had their visits via a video connection from their phone, and another third carried out the video visit on a tablet or computer. In addition, 36% had an audio-only visit by phone, which the 2019 poll did not ask about.

YEAR-OVER-YEAR CHANGES

The new poll asked older adults many of the same questions as the poll conducted in 2019. This allows for comparisons between the two years, such as the 64% who said they feel very or somewhat comfortable with video conferencing technologies. That's up from 53% in 2019.

Sixty-two percent said at least one of their health providers offer telehealth visits, up from 14% the year prior, while 72% said they're interested in using telehealth to connect with a provider they had seen before, up from 58% in 2019.

The percentage of those interested in using telehealth for a one-time follow-up appointment after a procedure or operation climbed from 55% to 63% over the past year, while those with privacy concerns are down: 24% vs. 49% the previous year.

The percentage of those concerned they would have difficulty seeing or hearing the provider during a video visit also dipped, from 39% to 25%.

But there was almost no change in the percentage who said they would feel comfortable seeing a provider for the first time via a virtual visit (about one in three would), and the percentage who felt that the quality of care in a telehealth visit was not as good (about two-thirds).

THE LARGER TREND

Physician groups, insurers, professional societies and organizations including AARP are monitoring the situation with telehealth, and in some cases advocating for the temporary changes in Medicare and Medicaid payment policy, and other relevant regulations, to become permanent.

In June, AARP Research released a report about older adults' awareness of and attitudes toward telehealth. AARP has also published resources to help older adults and their caregivers use telehealth services.

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com