Emergency Physician Perspectives on Using Telehealth with Older Adults during COVID-19: A Qualitative Study
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OBJECTIVES: Emergency medicine physicians have played a pivotal role throughout the coronavirus disease 19 (COVID-19) pandemic through in-person and remote management and treatment. Our primary objectives were to understand emergency medicine physicians' experiences using telehealth throughout the pandemic, any facilitators/barriers to successful usage, lessons learned during implementation, and successful/abandoned strategies used to engage with older adults. METHODS: Using a semi-structured interview guide, we conducted 30-min interviews. We used purposeful sampling to recruit emergency medicine physicians from all United States regions, rural-urban settings, and academic and community practices, who reported caring for patients 65 years or older in-person or virtually during the pandemic. Interviews were audio-recorded, transcribed, double-coded, and analyzed for emergent themes using framework analysis. RESULTS: A total of 15 in-depth interviews were completed from September to November 2020. Physicians had a median age of 37 years, 7 were women, and 9 had experience with telehealth before the pandemic. We identified several themes: (1) there were various motivations for telehealth use; (2) telehealth was used primarily to supplement, not replace in-person care; (3) most platforms were easy to use; (4) patients and caregivers had high acceptability of telemedicine; and (5) older adults with sensory and cognitive impairments often relied on caregivers. Emergency medicine physicians played a critical role during primary care office closures during the first wave-dispelling misinformation about COVID-19, triaging patients to testing and treatment, and providing care that would otherwise have been deferred. CONCLUSIONS: Our data show that telemedicine gained acceptability among emergency medicine physicians and provided options to patients who may have otherwise deferred care. These findings can inform future healthcare delivery for acute care needs or pandemic responses.
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The lack of remote physical exams, like abdominal assessments and vital checks, can create significant challenges in telemedicine, as essential clinical signals can be missed in video or phone consultations.
“The lack of remote physical exams, like abdominal assessments and vital checks, can create significant challenges in telemedicine, as essential clinical signals can be missed in video or phone consultations [241].”
From Toward Safer Diagnoses: A SEIPS-Based Narrative Review of Diagnostic Errors (2026) · cites this paper as [241]
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Self-citation
- Authors
- Davoodi, N. M., Chen, K., Zou, M., Li, M., Jiménez, F., Wetle, T. F., & Goldberg, E. M.
- Affiliations
- Brown University (US)
- Corresponding author
- Goldberg, Elizabeth M.
- Venue
- JACEP Open
- Publisher
- Elsevier BV
- Published
- 2021-10
- Volume
- 2
- Issue
- 5
- Pages
- e12577
- ISSN
- 2688-1152 (ISSN-L)
- PMC
- PMC8516338
- OpenAlex
- W3206876620
- Cited by
- 22
- References
- 47
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 3 · 2023: 7 · 2022: 4 · 2021: 1
- FWCI
- 3.25
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of the American College of Emergency Physicians Open (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institute on Aging (K76AG059983)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Social Sciences › Demography › Technology Use by Older Adults
- Physical Sciences › Computer Science › Information Systems › Healthcare during COVID-19 Pandemic
- Keywords
- telemedicine, emergency physicians, older adults, COVID-19 pandemic, physician attitudes, barriers and facilitators, caregiver involvement, patient acceptability, delayed care, triage
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