When the pandemic began, many healthcare providers made the switch from in-person care to telehealth to reduce disease exposure. This was not a problem for many patients, especially when they had the means to facilitate virtual visits. Other patient demographics, like seniors, may be underrepresented by telehealth visits, however.

It is startling to consider that half of people older than 65 living alone do not have the financial ability to cover essentials, let alone new devices or internet access needed for a telehealth visit[1]. Plus, more than one in three households lead by senior citizens lacked access to a computer, and more than half do not have a smartphone[2]. Without the same access to technology as higher-income counterparts, low-income seniors are significantly less prepared to make the transition to telehealth.

With doctor’s offices canceling in-person visits in favor of socially distanced alternatives, low-income seniors are at risk of missing out on crucial access to healthcare. While programs like social security have been effective at raising people out of poverty, 9.7% of people over 65 remain impoverished even with social security assistance[3]. A study found that nearly one in five people with the lowest incomes reported not knowing how to use devices that enable telehealth[4]. Not knowing how to use telehealth-enabling devices stems from the lack of accessibility to low-income populations.

Access to care is further hindered as many rural communities lack the high-speed internet connectivity required to facilitate telehealth visits. In areas with low broadband access, patients made 34% fewer telehealth visits[6]. Similar initiatives are trying to expand internet access to rural residents as well.

While improvements to internet infrastructure will not be immediate or address the concerns of patients unable to afford it in the first place, healthcare providers should look to implement outreach programs to lower-income patients. Even providing telehealth options without video can improve access to patients without a smartphone, tablet, or computer with a camera. While patients using audio-only options will not benefit from the face-to-face interaction with a provider, they can still speak with their provider to address any questions or concerns they may have.

While telehealth has tremendous potential to serve previously underserved populations, providers must keep in mind the limitations that some of their patients may experience. Especially with vulnerable populations such as the elderly, challenges with internet access, low income, and device accessibility can limit the adoption of telehealth to meet their needs. Addressing these challenges will help patients benefit from a more equitable ability to access telehealth opportunities.

[1] https://khn.org/news/technology-divide-between-senior-haves-and-have-nots-roils-pandemic-response/

[2] https://www.healthaffairs.org/do/10.1377/hblog20200505.591306/full/

[3] https://www.cbpp.org/research/social-security/social-security-lifts-more-americans-above-poverty-than-any-other-program

[4] https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2772162

[5] https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2739054

[6] https://www.govtech.com/health/growth-of-telemedicine-slowed-by-internet-access-challenges.html