Most older Americans had to use telemedicine during the COVID-19 pandemic. Many people are satisfied with it, but a new poll found that people continue to worry about issues such as technology, quality of care, and patient privacy .
According to a survey by the Associated Press-NORC Public Affairs Research Center, the comfort of remote care may vary depending on factors such as age, income level, or race.
With the outbreak of the pandemic in early 2020, doctors, hospitals, and other care providers had to cancel medical visits and operations, and suddenly switched to remote care. As coronavirus cases fade and flow in the ensuing waves, many patients follow their doctors online and continue to receive care in this way.
Telemedicine involves the remote connection of patients and care providers via computers, tablets or mobile phones. They often use video calls, but they can also trade emails or secure text messages. Sometimes both parties just talk over the phone without video.
An AP-NORC poll found that 62% of adults aged 50 and over have used some form of telemedicine since the beginning of the pandemic.
Patients most often use telemedicine for drug consultation, non-emergency health problems, health checkups, or continuous care to manage chronic diseases such as diabetes.
The convenience of finding an appointment or meeting with a specific provider and the opportunity to get an immediate response are the most common reasons for respondents to choose telemedicine. Approximately one-third said that each was a major factor, and another third said that they were minor factors.
Most people also list avoiding COVID-19 as the primary or secondary reason for seeking care through telemedicine, and about a quarter call it the main reason.
Rosa Bivens became a telecare switcher during the pandemic, partly because it helped her avoid the virus.
Bivens, 59, also likes how telemedicine allows her to keep in touch with doctors in Maryland during her temporary work in Germany. Bivens, a military family life consultant, said that the doctor she went home understands the stress she faces at work and how it affects her health.
“This kind of personal relationship is very important to me,” she said.
Opinion surveys found that people who receive care through telemedicine are generally satisfied with this. Approximately six in ten said that they may seek such remote care at least to some extent after the pandemic is over.
But there are still many concerns. The most important of these is the fear of receiving care that is not as effective as an in-person visit. About two-thirds of the elderly said they were at least a little worried about this.
Many people also worry about not having a personal relationship with the doctor, encountering information security or technical issues, and lack of privacy.
For example, Judy Ostrom did not use telecare during the pandemic and has no plans to start.
“You don’t know who is in and out of the doctor’s room,” said the 60-year-old La Pine, Oregon resident. “I love my family, but sometimes you want to keep your conversations with the doctor confidential.”
Some concerns are more concentrated among adults 65 and older. For example, these patients are more worried about not having a personal relationship with a doctor and not having suitable equipment than people between 50 and 64 years old.
Debra Nanez, 69, of Tucson, Arizona, said that she insisted on using audio-only telephone conversations with doctors during telemedicine. The retired nurse worried about the security of any health information she had to enter the website to perform other forms of telemedicine.
She also has no reliable way to make video calls.
“Sometimes my phone is interesting; it will work, and then suddenly the phone will shut down,” she said. “That’s why I only do it over the phone. I don’t have any questions about it.”
People with an income of less than $50,000 are about three times as likely as people with higher incomes to find that doctors provide the necessary equipment for telemedicine visits to be “very” or “very” helpful. The polls also found that people with lower incomes are more likely to say that if doctors provide help when using the technology, it will help.
Non-white respondents are particularly likely to view telemedicine as a way to avoid exposure to COVID-19. But they are also more concerned about the security of their health information than white respondents, whether it is telemedicine or face-to-face care.
Opinion polls found that older non-white Americans are also particularly worried about meeting with providers who don’t understand their cultural preferences.
Mei Kwong, executive director of the Connected Health Policy Center, said that education about telemedicine and the growing familiarity with this approach can help alleviate some lingering concerns of patients.
Kwong is a non-profit organization based in California that researches and promotes the use of virtual technology in healthcare. She pointed out that once the pandemic begins, the clinics and hospitals that have been most successful in transferring patients to remote care will take time to explain and even conduct trial runs before people actually go to see a doctor.
But Kwong, who has nothing to do with the AP-NORC poll, pointed out that this kind of education is not widespread.
“Before the pandemic, telemedicine was very niche,” she said. “Then when the pandemic hit, (patients) were basically just slapped by it.
“No one has really explained what it is.”