Digital Health: Access to Care and the Generational Divide

The COVID-19 pandemic has created many new challenges within healthcare. Some of these challenges include shortages in critical care beds, daily strain across nursing and physician groups, delays to elective surgeries, and heightened patient-access restrictions to care facilities.

Technology—both existing and new—has played a critical role in overcoming some of these obstacles, and during the pandemic has accelerated the evolution of digital health and virtual care. But what impact does digital health technology have across the different generations in terms of equity of access to care? In this article, I explore that question.


The Need to Adapt to Change

The ability to adapt to new technologies can expose a significant generational divide, especially as Generation Z was born between 1997 to 2012, while the Silent Generation was born between 1928 and 1945. When new technologies and growing demands align with a generation that embraces or even expects advancements, the new technology takes off. Most millennials and Gen Zers, often referred to as digital natives, are hungry for the latest technologies in music, gaming, smartphones and social media. In fact, technological advances can’t happen fast enough for these tech-savvy generations.

Conversely, when new technologies misalign with a generation it requires a “push” and innovative solutions. A person from the Silent Generation, for instance, may resist digital technologies and look for something more familiar and dependable to them instead of interacting with a tablet or a smartphone. Personal banking is a good example of this. Just stand outside your local bank and see who walks in. More often than not, it’s someone from an older generation.

Although it may be a more familiar experience for older adults to visit a brick-and-mortar bank, it’s hardly convenient. The entire process of leaving home, driving to the bank during business hours, parking the car, entering the bank, filling out a deposit slip, interacting with a teller, completing the transaction, and then finally leaving the bank with a paper receipt in hand is a low-tech, old-school exercise that may not be available in the future.

Alternatively, making the same transaction digitally offers greater access and convenience when the technology interface isn’t an obstacle. But for many in the Silent Generation, the thought of overcoming the barriers to digital technology to use online banking can be extremely daunting and easier to avoid rather than conquer.

Reversing the Obstacle Through Innovation

The rise of digital health spurred by COVID-19 has forced primary and secondary care facilities to adopt solutions into their practices—including virtual consultations, telemedicine, connected devices, digital health platforms and health apps—that allow patients to receive continued access to care. For the generations more confident in their digital skills this is easier, and certainly more accessible, safe, and effective since their teleconsultation can be attended without the risk of exposure to COVID-19. For older adults not adept at using digital technology, however, this virtual access to care is analogous to their feelings about online banking.

Recently, I discussed digital health advances due to the COVID-19 pandemic via teleconference with Dr. Eyal Zimlichman, Chief Medical Director and Chief Innovation Officer of Sheba Medical Center, Israel’s largest hospital. I first met Dr. Zimlichman while in Israel in 2019 on a diplomatic exchange to learn more about the country’s medical system models. During the call, which brought together other prominent members of the medical community, including former U.S. Sen. from Tennessee Dr. Bill Frist, Dr. Zimlichman talked about the successes that he and his colleagues have experienced with digital health. He also discussed how the impracticality of patients going to the hospital during the pandemic has presented the opportunity to ramp up their care and diagnostics through digital means. This led me to share my concerns about the generational divide with digital health.

I asked Dr. Zimlichman if he felt that the older generation’s general reluctance to embrace digital health technologies could result in them being left out when it comes to accessing health professionals virtually. I was pleasantly surprised by his answer. Rather than posing an obstacle, he felt that digital health technology has the potential to improve access to primary and secondary care for older adults, and perhaps even be liberating for them—if simplified.

Dr. Zimlichman noted that many older adults, especially during the COVID-19 pandemic, are apprehensive to enter a large medical campus, and that driving to the hospital and navigating the complex wayfinding can be difficult or even intimidating for them. Moreover, he said: “It’s become appealing for this population to access care professionals via telehealth from the comfort of their own home. During the pandemic, we’ve seen an uptick in care visits for the elderly who are using their smartphones, computers and digital tablets.” His fresh, innovative perspective gave me hope that the perceived digital health generational divide can in fact be flipped.

If we are to do this, however, we first need to encourage the adoption of new technologies. By having older patients fully understand the true value and benefits of digital health, obstacles may be easier to overcome. These benefits include enhanced privacy protection and confidentiality, speaking virtually with a care professional (which eliminates risk of exposure to COVID-19 and other viruses), and the ability for doctors and nurses to answer any questions without the patient having to travel into a clinic or hospital. The opportunity to extend schedule times is yet another benefit of digital health.

Secondly, just as banks have helped seniors bridge the digital divide and leverage online banking to better manage their money, healthcare organizations need to help older adults leverage digital technology to better manage their health. Research shows that many seniors are eager to adopt new technologies and are willing to learn to use a tablet or mobile device, and that their main apprehension is related to a lack of clarity in instructions and support, as well as the complexity of technological devices.

For this reason, age-appropriate training and technical support needs to be made available for older adults. Likewise, the technology should be easy to use and set up. By helping this demographic adapt to digital technology, healthcare providers will not only make care more accessible to older adults but will also build trust with them—which is a win-win.

As healthcare designers, we need to recognize that the digital health revolution is here to stay and will continue to grow. Along with the challenges, it has also given us the chance to identify opportunities for innovation. If we choose to embrace these opportunities and apply innovation to this major shift in healthcare, it can rapidly reshape the traditional patient care model. Subsequently, the way we design healthcare facilities for our clients—both now and into the future—will need to respond accordingly.

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