Enhancing telehealth clinical services and chronic disease self-management for older adults during covid-19

Abstract During the pandemic, providers shifted to telemedicine to ensure patient safety. Under a federally funded cooperative agreement, the Florida State University College of Medicine’s Department of Geriatrics partnered with a Federally Qualified Health Center to assess rural older adults’ perceptions about telehealth and identify potential barriers. The quality improvement study used a convenience sample to survey patients aged ≥ 65 (n=62) at one rural clinic. 54.8% of respondents indicated they would not use telehealth for any care or preferred to receive most or all care in person. Conversely, 32.8% indicated a willingness to receive some care via telehealth. The survey also assessed the need for self-management devices, including blood pressure cuffs. There was not a consistent positive relationship between persons requesting devices and those who were telehealth willing. Devices were distributed to enhance telehealth visits and at-home monitoring. Clinic staff provided patients hands on training for device use and connection to EMR. Informal qualitative reports suggest patients are more empowered to utilize telehealth services and self-manage conditions. COVID-19 also limited access to community blood pressure screenings. The Tallahassee Senior Center and FSU Physician Assistant program distributed devices to community-dwelling older adults. PA students provided hands on training to aid in device familiarity and digital connectivity. Almost all older adult participants aged >60 strongly agreed “after the presentation I feel ready to use the blood pressure cuff at home.” Clinical and community-based activities can help older adults who lack digital fluency feel more confident in using telehealth services and self-management devices.