IPA Bulletin: VOLUME 36, NO. 3 • SEPTEMBER 2019
Mary Sano, IPA President
Dear Colleagues and IPA members,
I am writing my last message as president of IPA with great excitement about our upcoming meeting in Santiago de Compostela. In reflecting on my tenure as President I have been so pleased to meet so many of you and to have been involved in our incredible programs. We have grown our membership, provided important educational and scientific work on sleep and agitation. We have partnered with colleagues at the Alzheimer Association, and our members have provided important insights to the latest ideas to the Long Term Care Alliance which includes 14 distinct international organizations along with IPA. We contributed to the New York Academy of Science’s symposium entitled “Psychiatric Symptoms in Alzheimer’s Disease and Dementia and we co-hosted a workshop with members of the International Association of Physical Therapists working with Older People (IPTOP). There are many other activities and alliances and there will be many more to come as the world becomes aware of the expertise of our members.
I am very comforted by knowing our new President, Dr. William Reichman, who will provide a smooth transition and opportunities for the exponential growth of IPA over the next two years.
Before I sign off, as always, I want to share with you the work that most invigorates and motivates me. The growth of technology to improve autonomy, mental health and quality of life for aging adults is one of the most encouraging trends in health care. Of note, recent reports indicate high penetration of mobile technologies and specifically smartphones among elders. It is reported that over 70 % of those age 60 to 70 uses smartphones . In many cases, this is higher than the use of computers and tablets. While we also know that poverty can reduce access, even low and middle-income countries are building infrastructure to maximize connectivity. However, other challenges occur with aging, including a slower pace of adoption of new technology and fear about loss of security and privacy.
A 2016 report from Kaiser Permanente, a managed health care consortium, which serves 12.2 million patients, described health portal use by elderly patients. They report that while more than 77% of those between the ages of 65 and 79 had registered for the healthcare portal, use was lower with each 5-year cohort. More important perhaps, Latino and Black individuals in the same age group had significantly lower use even if they had registered for the health portal. When it came to sending messages or using the portal for such activities as medication refills, the use among Latino and Black participants was only about half of those registered. Overall, lower use of the health portal was associated with high school education or lower, perceived fair or poor health and higher age. Approximately 26% of low users reported an interest in learning how to use it. These results suggest that there may be opportunities to increase the use of this digital approach if it was made more convenient or familiar .
This study also asked about preferences for communication on health conditions and across age and ethnic groups there was equal or greater preferences for telephone and email vs secure portal messaging. The preference survey also found high acceptance of the idea of video-visits with a health care practitioner.
Smart device use is also growing but formal studies of how best to use by seniors for management of health are few. In a recent scoping review (Kim & Lee; 2017) about research on the use of smart devices among older adults managing chronic conditions, 51 studies were identified during the period from 2010 onward with major growth in studies reported in 2014 or later. In this review, the authors summarized patient perspectives about smartphone use and described 3 groups of themes in the research. The most common theme in the literature was the recognition of benefit including noting that patients had a sense of being in control of their information, increased motivation to track health and better connections to the health system. There were also persistent themes of insufficient training and insufficient knowledge about how to interpret the information from the smart device. Further, this was associated with anxiety about using technology. Finally, there were recurring themes that smart devices were not appreciated if the condition it managed was not a significant problem . Together these reports tell us of the great potential that technology may have, keeping us connected, providing us with access to better health care and hopefully more autonomy. Better training and support for senior learners, tailoring to specific needs and addressing the anxieties about change for our older patients can provide them with many new resources. These are the aspects of the future digital world, to which I hope we will stay open. As I pass the baton and become “Past President” I hope you will join me as advocates of future progress and hope.
For Further Reading:
- Pew Research Center: Mobile Fact sheet 2019 (https://www.pewinternet.org/fact-sheet/mobile/)
- Gordon NP, Hornbroock MC. Differences in Access to and Preferences for Using Patient Portals and Other eHealth Technologies Based on Race, Ethnicity, and Age: A Database and Survey Study of Seniors in a Large Health Plan. J Med Internet Res. 2016 Mar 4;18(3):e50.
- Kim BYB, Lee J. Smart Devices for Older Adults Managing Chronic Disease: A Scoping Review. JMIR Mhealth Uhealth. 2017 May; 5(5): e69.