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Designing a Better Version of Remote Healthcare for the Patients Who Need It Most


Telehealth has proven to be a boon to older Americans, especially those with limited mobility. However, such services often aren’t developed with seniors in mind, leaving a gap in care that’s driving a new movement.

After decades of gradual progress in becoming an accepted alternative to in-person doctor visits, the COVID-19 pandemic catapulted telehealth into the mainstream.

With nationwide stay-at-home orders in place, insurance plans began widely covering remote health services. In the year that followed, tens of millions of U.S. patients finally gave it try — often out of necessity. Among the biggest users of telehealth during that time? People older than 65, according to data from the Centers for Disease Control and Prevention.

In 2020 alone, Medicare visits conducted through telehealth platforms increased 63-fold, jumping to nearly 53 million from 840,000 in 2019.

“The pandemic put extraordinary strain on our healthcare system, but it also accelerated the adoption of telehealth — notably among older adults who were the least likely to engage in remote care beforehand,” said Zia Agha, M.D., chief medical officer of West Health, the San Diego-based group of nonprofit organizations dedicated to lowering health costs and enabling successful aging.

As a result, telehealth is now woven into our country’s healthcare infrastructure, Agha said. When done right, it benefits patients, providers, and payers alike. Recent research shows telehealth enables faster physician referrals, fewer hospitalizations and ER visits, lower costs, reduced travel, and improved mental health for caregivers.

Optimizing for senior health

Yet, serious pain points endure among seniors who use remote care, Agha noted, citing patient surveys. Telehealth, typically conducted via a computer or mobile device, often isn’t amenable to patients with cognitive issues like dementia or physical challenges like hearing loss. Some older patients also struggle with low technical literacy.

“It has become clear over these past few years that telehealth isn’t optimized for older adults,” said Liane Wardlow, Ph.D., senior director of Clinical Research and Telehealth at West Health. “The healthcare industry must come together to ensure remote care is designed in a way that’s effective, safe, and efficient for all — including seniors, who are the biggest consumers of healthcare and, oftentimes, the most vulnerable patients.”

That is why West Health Institute assembled the Collaborative for Telehealth & Aging, a group of experts with diverse, interrelated specialties such as telemedicine, geriatrics, health system administration, and patient advocacy.

Best practices for telehealth and aging

Through an iterative process that kicked off just over a year ago, the group recently issued the first-ever best practices for telehealth and aging. In the coming months, it also will launch a Center for Excellence through which telehealth providers can pledge to adopt those best practices.

“At the core of our work is the belief that telehealth must remain a vital tool for older people who may be homebound, lack transportation, have mobility challenges, or live in rural areas where specialists are difficult to access,” Agha said. 

The Collaborative landed on three guiding principles, calling for telehealth to be: person-centered, accounting for patients’ individual goals and preferences; equitable and accessible regardless of patients’ abilities, socioeconomic status, technology literacy, or location; and integrated and coordinated with patients’ broader care plans with consideration to the patients’ support network and ability to obtain medicines. The group also calls for telehealth-specific training for providers.

Wardlow’s hope is that the principles will be widely embraced among telehealth providers, elevating the standard of care for older patients today and tomorrow.

“Whether you’re 34 or 74, there will come a time when you realize how important quality telehealth is for older patients,” Wardlow said. “We all grow older, as do our parents and friends. This is an issue that affects us all.” Learn more at

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