Implementation Considerations for Telehealth Programs Serving Older Adults

Telehealth can be an important tool for ensuring that older adults living in rural communities can age in place while still meeting their healthcare needs. For example, telehealth can facilitate the ability of older adults to receive care in their homes, help older adults adhere to their medication regimen, and connect caregivers of older adults to support and advice.

Many rural communities are also implementing telehealth programs for older adults in skilled nursing facilities in order to decrease hospitalizations and increase access to care for older adults with complex healthcare needs. Successful implementation of telehealth programs in skilled nursing facilities requires ensuring that facility leadership support the telehealth program, training clinical staff to use telehealth equipment, and integrating telehealth into existing policies and workflows. One approach to facilitating implementation is to pilot new telehealth programs with a few high-utilizers of healthcare services. These individuals can provide feedback on the process and allow clinical staff to put their training into practice.

Engaging caregivers can be critical to the success of telehealth programs for older adults. Rural telehealth programs may need to allocate funds to train both caregivers and patients about telehealth technologies. For example, remote patient monitoring programs may need to engage caregivers to ensure that devices are working correctly and transmitting the necessary data to telehealth program staff. Rural communities may also consider using telehealth to ease caregiver burden. For example, the evidence-based STAR-Caregiver training program in Oregon uses telehealth in order to increase engagement of rural caregivers of patients with dementia.

When creating telehealth programs for older adults, rural communities may need to assess their target population in order to understand and address concerns about telehealth. For example, while program planners may assume that older adults will have reservations about using new technology, participants may actually be most concerned about the privacy and security of their health information.

Resources to Learn More

Health Care in Rural America: Focus on Internet and Telehealth Use
Document
Provides detailed figures on the state of internet access and use, and ownership of technology devices by older rural adults. Discusses their telehealth use and concerns regarding healthcare in a virtual environment rather than an in-person appointment.
Organization(s): American Association of Retired Persons (AARP)
Date: 10/2021

How to Provide Telehealth to Older Adults
Document
Offers telehealth providers tips and strategies to consider when working with older adults. Covers age-related sensory, motor and cognitive changes, opportunities to provide technology support, and techniques to engage older adults in their care through telehealth.
Organization(s): American Psychological Association Committee on Aging
Date: 8/2020

Impact of After-Hours Telemedicine on Hospitalizations in a Skilled Nursing Facility
Document
Describes the impact of an after-hours physician intervention for patient assessment and treatment via telehealth in a skilled nursing facility.
Author(s): Chess, D., Whitman, J., Croll, D., & Stefanacci, R.
Citation: American Journal of Managed Care, 24(8), 385-388
Date: 8/2018

Integrated Telehealth and Telecare for Monitoring Frail Elderly with Chronic Disease
Document
Presents the findings of a telemonitoring program that collects the vital signs and activity-level information of elderly individuals living alone with chronic disease. Includes discussion on integrated monitoring technologies to improve timely care for elderly populations.
Author(s): Gokalp, H., de Folter, J., Verma, V., et al.
Citation: Telemedicine Journal and e-Health, 24(12), 940-657
Date: 12/2018