Over the last 3 months, the clinical team at MedMe Health reached out to hundreds of community pharmacists across Canada to understand their attitudes towards digital health.

We found that “super user” pharmacists have normalized virtual consults with their patients, while others have been hesitant. Particularly, they’re worried about the acceptance of technology use in their older patients. 

‍

Over the last decade, technology has made healthcare more accessible, cost-effective, and patient-centered. In fact, internet usage has grown in Canada over the past few years and 71% of Canadian seniors are now using the internet. This coincides with a growing interest in digital health amongst Canadians, where 76% say it can make accessing healthcare services easier. The availability of virtual visits is also expanding, as greater than ⅓ of Canadians are interested in having virtual visits with healthcare providers. Maintaining continuity of care during COVID-19 has further accelerated virtual care worldwide.

‍

As the world becomes digitized, we need to be mindful of the “digital divide”. This concept refers to gaps in accessing technology that leads to societal inequalities. Challenges manifest from the lack of physical and skill access to technology, and are influenced by “digital determinants of health”.

‍

‍

Canada has an aging population. Older adults are the fastest-growing group but least likely to adopt technology. Although many are considered “tech-savvy”, they are frequently at risk of digital exclusion. This term refers to the systematic exclusion from technology of individuals with physical and cognitive challenges that come with aging, such as changes to vision, hearing, mobility and memory. Although more seniors are embracing technology, there is still hesitation and even fear in adopting these approaches because of low digital literacy and physical barriers.

‍

This raises the question: What is the best approach to care for the aging population in our rapidly digitizing landscape?

‍

To address this question, here are 7 tips pharmacists can use to engage older adults with digital health technologies:

‍

1. Promote awareness of technologies

Older adults may be unaware of digital health interventions that can benefit their daily lives. Pharmacists can bring awareness and educate on available digital interventions. 

Examples of technologies aimed to support older adults include:

• GeriMedRisk: an interdisciplinary, technology-based geriatric pharmacology consultation service
• McMaster Optimal Aging Portal: collection of reliable information about health and social aspects of aging 
• Virtual care services
  

‍

2. Teach using multi-faceted approaches

Older adults are well capable of using health technology. They just need the chance to learn more about digital health interventions and ways to improve digital literacy. By educating and training older adults about digital health, pharmacists can empower them to use health technologies in their everyday lives. Pharmacists should consider teaching strategies like:

• Using visual resources (eg. brochures and videos) that provide detailed overviews of the digital intervention
• Providing simple and concise instructions - especially important for first-time users
• Group learning approaches - some older adults may prefer learning with peers
• Promoting self-directed learning (eg. encouraging older adults to play around with the new health technology at their own pace)
• Motivating older adults to practice newly learned skills, in order to gain familiarity and confidence in integrating these skills into daily life
  

‍

3. Create a supportive network with family, friends and/or peers

Family and friends are strong influencers for older adults to adopt new technologies. By having these supports, older adults can learn through observation and gain confidence to use technologies. This supportive network can also play an integral role in their health.

4. Personalize motivation that leverage the benefits of digital health‍

Most older adults may be skeptical of the benefits of digital health. Thus, it’s important to personalize your motivation strategies when encouraging older adults to try new technology. 

• Take the time to understand their concerns, perceptions and motivations
• Tailor your conversations to their personal health goals
• Show how digital health can provide an advantage over traditional methods 

5. Use technology designed to engage older adults

Aging brings upon changes to hearing, vision, mobility and cognition. These can all pose challenges to technology use in older adults. The design of technologies should consider elements that reduce these barriers.

• ‍Grindrod KA et al, 2014 suggests that interface diversity and multimodal reminder approaches can increase the usability of mobile health applications with older adults
• Examples: changeable font sizes, clear buttons, high-contrast text, fewer buttons and speech-activated tools
• Language barriers should be considered and language options are built-in

6. Ensure transparency of security risks and protect privacy

Older adults worry about being harmed by collected personal data and loss of privacy. Pharmacists can mitigate these concerns by:

• Ensuring transparency of potential security risks
• Implementing policies to protect privacy and address potential security breaches
• Using technologies that meet regulations for protecting personal health information (PHI) and obtaining informed patient consent 

7. Support from healthcare providers (you!)

Pharmacists are the most accessible healthcare providers, and patients value our advice. If you’ve assessed that your older patient can use and will benefit from digital health approaches, explore their perceptions, hesitations, and motivations before empowering them to adopt the new technology. Research has shown that digital health recommendations from a healthcare provider improves the rate of adoption, especially in older adults.

‍

Final Thoughts

The world of digital health can be a daunting place to navigate, especially with older adults. Pharmacists can be leaders in digital health. With support from pharmacists, it can make the process easier and optimize the health of our patients.

We would love to hear your experience and any approaches you have used to engage your older patients with technology! Share your stories with us by emailing  care@medmehealth.com

‍

Suggested Readings:

• Ontario Pharmacists Association. Guide to Providing Virtual Care to Patients. 2020. Available from: https://www.opatoday.com/professional/resources/for-pharmacists/tools-and-forms/virtual-care-services
• Dr. Kelly Grindrod’s Research: http://www.kellygrindrod.com/

References

1. Van Dijk JAGM. Digital Divide: Impact of Access. The International Encyclopedia of Media Effects [Internet]. 2017 March 8 [cited 2020 June]. Available from: https://doi.org/10.1002/9781118783764.wbieme0043
2. Risling T. Beyond the Divide: Exploring the Digital Determinants of Health.  Canada Health Infoway: Infoway Partnership Conference [Internet]. 2019 November 18 [cited 2020 June]. Available from: https://www.infoway-inforoute.ca/en/component/edocman/supporting-documents/partnership/3770-ipc2019-day02-1040-1110-tracie-risling-en-pdf?Itemid=101‍
3. Reed ME, Huang J, Graetz I. Patient characteristics associated with choosing a telemedicine visit vs office visit with the same primary care clinicians. JAMA [Internet]. 2020 [cited 2020 June]. 3(6):e205873. DOI: 10.1001/jamanetworkopen.2020.5873
4. Centers for Disease Control & Prevention [Internet]. Challenges developing material to match health literacy skills; 2019 October 17 [cited 2020 June]. Available from: https://www.cdc.gov/healthliteracy/developmaterials/audiences/olderadults/understanding-challenges.html‍
5. Centers for Disease Control & Prevention [Internet]. How older adults make health decisions; 2019 October 17 [cited 2020 June]. Available from: https://www.cdc.gov/healthliteracy/developmaterials/audiences/olderadults/understanding-decisions.html‍
6. O’Connor S, Hanlon P, O’Donnell CA, Garcia S, Glanville J, Mair FS. Understanding factors affecting patient and public engagement and recruitment to digital health interventions: A systematic review of qualitative studies. BMC Med Inform Decis Mak [Internet]. 2016 [cited 2020 June]. 16,120. Available from: https://doi.org/10.1186/s12911-016-0359-3‍
7. Tsai HS, Shillair R, Cotten SR. Social support and “playing around”: An examination of how older adults acquire digital literacy with tablet computers. J Appl Gerontol [Internet]. 2017 January [cited 2020 June]. 36(1):29-55. DOI: 10.1177/0733464815609440
8. Wang S, Bolling K, Mao W, Reichstadt J, Jeste D., Kim, H et al. Technology to support aging in place: Older adults’ perspective. Healthcare [Internet]. 2019 April 10 [cited 2020 June]. 7(2),60 Available from: https://doi.org/10.3390/healthcare7020060
9. Grindrod KA, Li M, Gates A. Evaluating user perceptions of mobile medication management applications with older adults: A usability study. JMIR Mhealth Uhealth [Internet]. 2014 March 14 [cited 2020 June]; 2(1):e11. Available from: https://mhealth.jmir.org/2014/1/e11/ DOI: 10.2196/mhealth.3048

‍

Graphics: Michelle Yee
Editors: Rui Su, May Zheng and Yifan Zhou

‍

Disclaimer: The contents of this blog is to be used for informational purposes only and is not intended to replace clinical guidelines or the advice of a health professional. Patients should contact a health professional for appropriate advice.

© 2020 MedMe Health Ltd. All rights reserved.