According to recent estimates, seniors aged 65 and older rank as the sickest, most expensive, and fastest growing segment of the United States population.

“In recent years, there has been increasing desire to use digital health technology as a means to improve healthcare quality, cost, and safety,” says David M. Levine, MD, MA. “However, few studies have provided information about how digital health is being used by seniors in the U.S.” To address this data gap, Dr. Levine and colleagues published a research letter in JAMA.

For the study, researchers examined data from the National Health and Aging Trends Study (NHATS), an annual in-home, computer-assisted survey that is given to community-dwelling Medicare beneficiaries aged 65 and older. “This is a nationally-representative data set that is drawn from the Medicare enrollment file through a complex sampling design,” says Dr. Levine. Each year, NHATS asks the same respondents about a variety of topics, including their daily use of non-health technology and how they use digital health to fill prescriptions, contact a clinician, address insurance matters, and/or research health conditions. The study by Dr. Levine and colleagues looked specifically at variables associated with digital health use.

Key Trends

“Our study showed seniors used digital health at low rates, with only modest increases from 2011 through 2014,” Dr. Levine says. Although cell phone and computer use were stable, small statistically significant increases were noted in other everyday technologies. The proportion of seniors who used any digital health increased from 21% in 2011 to 25% in 2014.

The authors also found that seniors used everyday technology at a level that was below that of the general population. About 90% of the general population used the internet and owned cell phones, but only 60% used technology to search for health information. About 63% of seniors used a computer and 43% used the internet, but only 10% filled prescriptions online. The findings indicate that relying on everyday technology to estimate digital health use may be ineffective.

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“Digital health does not appear to be reaching most seniors,” says Dr. Levine. “Nor is it reaching all seniors equally, with large socioeconomic disparities in use. For example, blacks and Latinos have half the odds of digital health technology use than whites. This raises concerns about the ability of digital health technology to improve quality, costs, and safety of healthcare.”

Looking Ahead

According to Dr. Levine, future innovations should focus on usability, adherence, and scalability to improve the reach and effectiveness of digital health for seniors. “We may need to look for ‘outside the box’ strategies to better harness the possibilities of digital health,” he says. “We need to screen seniors for digital technology use before we expect them to jump on board. It might also be beneficial to work with the caregivers of older patients and involve them in the use of digital health technology.” Dr. Levine adds that healthcare professionals should consider teaming with digital health technology developers in the design of their programs in order to improve usability.

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