How do digital health technologies get to older patients?

Many of the digital health technologies on the market today are wellness products used by the relatively younger segment of the population. Technologies that are focused on chronic diseases have found it much harder to reach their intended target audience for a variety of reasons. The market is right with regard to need, and the demand would be great were it not for significant barriers to adoption – namely, lack of awareness by providers and the public, lack of adequate business models and lack of proper patient portals with connectivity to EHRs.

Some may say that this is a chicken or egg situation. “Build it and they will come” has been a mantra for much of the digital health technology sector. While this might be best applicable to consumer-focused wellness smart phone apps, it is not a good strategy for more involved technologies targeted towards chronic disease management.

It is well known that only a minority of the 45+ age group in the United States own smartphones. People age 65 and older search the Internet for health information less than younger persons (PDF). Since these relatively easy access tools of communicating medical information are less used by older people, how can we best engage them in healthcare?

So how do we get digital health to the people who impact the system most – older patients with chronic diseases?

The easiest scenario will be at the point of contact in the healthcare system. That is, at the healthcare provider’s office or the hospital. In the office, a patient presents with a chief complaint, which may or may not be related to chronic underlying conditions. It would be intriguing to have recommended digital health technology diagnostic or disease management tool suggestions prompted by electronic review of pre-existing diagnoses or the input of a new one, as part of a clinical decision support. In the hospital, this would be in the pre-discharge period. An informatics program would determine, based on the patient’s diagnoses, medications, ancillary services required in the hospital, vital signs, procedures performed and types of consultations, an appropriate set of digital health monitoring assistance, medication adherence tools, telehealth applications and follow-up appointments.

Digital health technologies delivered in this manner will be easy to disseminate, connect to EHRs and patient portals and be appropriately targeted. Older patients can therefore be connected to digital health on the back end, without the industry fighting consumer-type barriers on the front end.

David Lee Scher is a former cardiologist and cardiac electrophysiologist and the owner/director of DLS Healthcare Consulting, LLC, focused on serving mHealth companies and companies, providers and institutions adopting mHealth technologies. He also blogs at and may be reached on LinkedIn or at .

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