Top Things to Know: Telehealth and Health Equity in Older Adults with Heart Failure
Published: November 01, 2023
Prepared by Paul St. Laurent, DNP, RN, National Senior Director, Science and Medicine
- Telehealth is the use of information and communication technologies to provide health care services remotely, such as phone calls, video visits, remote monitoring, and mobile apps.
- Telehealth has the potential to improve access to care, quality of care, and outcomes for older adults with heart failure (HF). It demonstrated its impact during the pandemic, but also faces many barriers and challenges.
- This statement reviews the literature on telehealth for older adults with HF, using a health equity lens, and provides an overview of the types, effectiveness, and limitations of telehealth interventions.
- This paper also discusses the patient, clinician, structural, and social determinants of health barriers to telehealth access and use, such as broadband inequality, low digital literacy, physical and cognitive impairments, privacy concerns, and reimbursement issues.
- It highlights the importance of involving patients, caregivers, and clinicians in the co-design of telehealth systems that are user-friendly, integrated with clinical care, and tailored to the needs and preferences of diverse populations.
- Novel interventions that pair telemedicine with in-person services such as community health workers, mobile clinics, and telehealth kiosks can mitigate existing barriers and structural inequities.
- More research is needed on telehealth interventions that address multiple comorbidities, social isolation, mental health, and caregiver support among older adults with HF.
- Effective and equitable implementation of telehealth among older adults with HF can play a key role in advancing better disease management and reducing disparities.
- The cardiovascular community is urged to advocate for policy changes that support digital health equity and sustainability of telehealth services beyond the COVID-19 pandemic.
Citation
Masterson Creber R, Dodson JA, Bidwell J, Breathett K, Lyles C, Still CH, Ooi S-Y, Yancy C, Kitsiou S; on behalf of the American Heart Association Cardiovascular Disease in Older Populations Committee of the Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; Council on Quality of Care and Outcomes Research; and Council on Peripheral Vascular Disease. Telehealth and health equity in olderadults with heart failure: a scientific statement from the American Heart Association [published onlineahead of print November 1, 2023]. Circ Cardiovasc Qual Outcomes. doi: 10.1161/HCQ.0000000000000123