The patient population that is 65 years old and older represents the sickest, most expensive and fastest growing segment of the U.S. population. And, while digital health technology has been advocated as a tool to improve healthcare quality and cost, a study by Boston-based Partners Healthcare finds low use rates of digital health technology tools among seniors.
For the study, which was published in the Journal of the American Medical Association, researchers from Partners Healthcare used the National Health and Aging Trends Study (NHATS) to track digital health and technology use of 7,600 Medicare beneficiaries 65 years and older between 2011 and 2014. Each year, that study examined the same respondents use of everyday non-health technology and four digital health modalities—the use of the Internet to fill prescriptions, contact a clinician, address insurance matters and research health conditions.
Researchers found that in 2011 few seniors used digital health tools, as only 16 percent obtained health information online, only 8 percent filled prescriptions online, 7 percent contacted clinicians and only 5 percent handled health insurance online. The study also found that 64 percent of these same seniors used computers and 76 percent used cell phones, but fewer used the Internet (43 percent) and 40 percent used email and texting. Few seniors used Internet for banking, shopping or social network sites (less than 20 percent).
And, researchers also found that variables associated with less use of any digital health tools were older age; black, Latino and other race/ethnicity; divorce and poor health, while variables includes with greater use included college education, higher annual income, taking medications and more comorbidities.
By 2014, use of digital health tools increased only slightly, according to the study. The proportion of seniors who used any digital health technology rose from 21 percent in 2011 to 25 percent in 2014. Use of 3 of 4 digital health technologies increased, the study found. Ten percent of seniors filled prescriptions online in 2014, up only 2 percentage points from 2011.
And, the study found that in 2011, 1.1 percent of seniors used all 4 digital health modalities compared with 1.8 percent in 2014. From 2011 to 2014, 14 percent of seniors increased the number of digital health modalities used and 10 percent decreased their use.
According to the study, seniors’ use of everyday technology was below that of the general population, as approximately 90 percent use the Internet and own cell phones and 60 percent search for health information. “Relying on everyday technology or generic internet use rates to estimate digital health use may be misleading,” the study authors wrote. “For example, although 63 percent used a computer and 43 percent used the Internet, only 10 percent filled prescriptions online.”
The study authors concluded that digital health is not reaching most seniors and is associated with socioeconomic disparities. And, this raises concerns about the ability of digital health tools to improve healthcare quality, cost and safety for seniors.
And, the study authors also recommended that future digital health technology innovations should focus on "usability, adherence and scalability to improve the reach and effectiveness of digital health for seniors.”