Telehealth for Seniors

Telehealth is probably here to stay at some level, and that will likely be beneficial for older adults in the long run. Here is what you should know:

What is telehealth?

Telehealth refers to using communications technologies – a computer, tablet, or smartphone – to receive health care remotely. Telehealth is also referred to as telemedicine, remote patient monitoring, virtual visits, and tele-doc.

Common examples of telehealth include:

• A video chat or phone call with your doctor or another health care provider
• Messaging your doctor through an electronic health record (EHR) system, email, or a secure file exchange
• Remote monitoring, in which your doctor checks your vital signs at your home

Other examples of medicine:

• Sensors that alert caregivers if someone with dementia leaves the house
• Receiving an electronic message reminding you it’s time for a screening
• A surgeon using robotic technology to perform surgery from a remote location
• Watching an online video from your doctor instructing you how to use a medical device, such as a CPAP machine

Telehealth and Medicare

Before COVID-19, explains the Association of American Medical Colleges, “Medicare covered telemedicine only for rural patients – and only if they traveled to certain health care sites. But during the federal COVID-19 PHE, the Centers for Medicare & Medicaid Services (CMS) made a dramatic change: It allowed Medicare coverage of telehealth for any patient, anywhere, as well as payment equal to in-person visits.”

This change in telemedicine regulations, under a declared public health emergency, was to be updated every 90 days. The most recent Health and Human Services renewal on Jan. 16, 2022, extended through April 16, 2022.

A report released in December 2021 from the U.S. Department of Health and Human Services (HHS) shows a substantial increase in the use of telehealth by Medicare recipients during the pandemic. The report indicates that the number of Medicare visits through telehealth increased 63-fold, from 840,000 in 2019 to 52.7 million in 2020.

Another recently announced change: Medicare will now pay for mental health visits furnished by Rural Health Clinics and Federally Qualified Health Centers via interactive video-based telehealth, including audio-only telephone calls (currently extended through Dec. 31, 2023). In 2020, telehealth visits made up a third of total visits to behavioral health specialists, resulting in a 32-fold increase.

What are the primary benefits of telehealth for seniors?

Telehealth gives patients the ability to receive care in their home. This is especially useful for seniors with mobility issues, those who live at great distances from medical care, and those who may be at greater risk of catching an infection in public settings. During a live, face-to-face telehealth visit, the patient can ask questions, talk about their physical issues, and even show the doctor their injuries or symptoms. Here are some other ways telehealth specifically benefits older adults:

• Fewer visits to the ER: By providing for early intervention through telehealth visits, there is less chance of a condition becoming an emergency. Providers can see early signs of a change in your condition and respond with the appropriate interventions long before a trip to the ER becomes necessary.
• Preventing caregiver burnout: Many older adults reach a point where they can no longer drive, have mobility issues, or struggle with activities like cooking and bathing. These situations result in them needing a caregiver, often family members. Telehealth offers relief from the stress of caregiving by providing convenient access to a medical support system.
• Monitoring chronic conditions: Seniors are more prone to chronic illnesses that require monitoring and managing the symptoms. Patients and caregivers can work remotely with the doctor to evaluate symptoms and conditions that include high blood pressure, diabetes, heart issues, pain, depression, and checking for medication side effects.

Are there downsides to telehealth for seniors?

Some seniors have difficulty accessing telehealth because of disabilities or inexperience with technology. They may not have the knowledge or resources to get online, operate the equipment, or communicate without in-person cues.

Physicians also note the benefits of in-person interactions for picking up on subtleties of a patient’s health or life circumstances, and that sometimes a hands-on examination is required.

In addition, some medical visits may still require going to an office, especially when diagnosis or treatment requires imaging or other specialized equipment.

Despite the downsides, the advantages of telehealth for seniors far outweigh these shortcomings, and as seniors become comfortable with it, there is little doubt that they will embrace it.

What’s the future of telehealth for seniors?

Will telemedicine continue, even as pandemic concerns wane? Both providers and patients have appreciated the convenience of remote care and are hoping the benefits will continue.

Unfortunately, says the AAMC, “Many states are stopping emergency regulations, including those that allowed doctors to provide remote care across state lines. And federal agencies that relaxed payment and platform rules may again curtail how telemedicine is delivered.” This can also affect insurance payments, use of user-friendly platforms such as Skype and FaceTime, and acceptable use of audio-only visits.

On the other hand, the federal Infrastructure Investment and Jobs Act, passed in November 2021, includes $65 billion “to help ensure that every American has access to reliable high-speed internet through a historic investment in broadband infrastructure deployment. The legislation will also help lower prices for internet service and help close the digital divide, so that more Americans can afford internet access,” the White House explained.

Telehealth has not replaced in-person doctor visits, but it has provided patients with a safer and more convenient option. The technology is in place for this health care option to continue, if regulations, Medicare and Medicaid, and insurance companies support it. Jorge Rodriguez, MD, a telemedicine researcher at Boston’s Brigham and Women’s Hospital, hopes patients and health care leaders will speak up about the value of telemedicine. He tells the AAMC, “It’s crucial for patients’ voices to be heard, especially those who are marginalized, to make sure we do right by them. We talk a lot about meeting patients where they are, and telemedicine literally does that.”