There are certainly major strides being made when it comes to developing consumer health applications to engage patients in taking an active role in their own care. The latest, as noted by Healthcare Informatics Senior Editor Gabe Perna this week, comes from Apple, which, during its iOS8 presentation, announced its Health app and HealthKit system that allow various health apps to be integrated and to communicate. Apple has also reached collaboration agreements with Mayo Clinic and, reportedly, with Epic Systems as well.
That’s great news, and should allow users to share their health data with their providers more easily. Yet I am concerned that the current wave of healthcare apps and mobile platforms is bypassing one large and growing segment of the patient population—the elderly.
I recently listened to a webinar, presented by the Centers for Medicare and Medicaid Services (CMS) on meaningful use Stage 2 reporting options and data submission processes for eligible professionals. One of the requirements under Stage 2 is that at least 5 percent of patients view, download or transmit their health information to a third party.
During the Q&A session following the presentation, one provider located in Florida called in to say that in her community, 80 percent of the patients are age 65 or older, and that 90 percent of those don’t have computers and don’t want them. “It’s going to be very difficult for us to meet that core measure,” she said. The group’s lack of success in reaching elderly patients has not been from lack of trying. It has offered incentives to get patients to sign up to its portal, and has tried to recruit the patients' family members to get them to sign up, without much success.
The CMS official who took her question acknowledged the concern, noting that the agency lowered the threshold to 5 percent in response to public comments, and that there is an exemption available for areas with low broadband access. She also noted anecdotal evidence that some providers have tried to help patients by assisting them to log on and see their information, so they can understand what they can do on a portal.
Still, this is an uphill battle, especially for providers located in areas with large populations of elderly patients who have the desire and ability to live independently or with their families. This is a population that is often not computer savvy and may not own or have access to computers.
The kicker is that the elderly, as a group, often have a special need of better care, yet the technology that can make that happen is slipping ever further from their reach. This may actually be a dilemma that cannot really be addressed by technology at all, but that requires “live” intermediaries—family members, providers or social workers—who can bring these health apps within reach of those who can really benefit.