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Cited by 295Telemedicine and Telehealth ImplementationTechnology Use by Older AdultsMobile Health and mHealth Applications

Utilization Barriers and Medical Outcomes Commensurate With the Use of Telehealth Among Older Adults: Systematic Review

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Kruse, Clemens, Fohn, Joanna, Wilson, Nakia, Nunez Patlan, Evangelina, Zipp, Stephanie, Mileski, Michael·2020·JMIR Medical Informatics
DOI 10.2196/20359PMC PMC7450384

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Abstract

Background: Rising telehealth capabilities and improving access to older adults can aid in improving health outcomes and quality of life indicators. Telehealth is not being used ubiquitously at present. Objective: This review aimed to identify the barriers that prevent ubiquitous use of telehealth and the ways in which telehealth improves health outcomes and quality of life indicators for older adults. Methods: This systematic review was conducted and reported in accordance with the Kruse protocol and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Reviewers queried the following four research databases: Cumulative Index of Nursing and Allied Health Literature (CINAHL), PubMed (MEDLINE), Web of Science, and Embase (Science Direct). Reviewers analyzed 57 articles, performed a narrative analysis to identify themes, and identified barriers and reports of health outcomes and quality of life indicators found in the literature. Results: Reviewers analyzed 57 studies across the following five interventions of telehealth: eHealth, mobile health (mHealth), telemonitoring, telecare (phone), and telehealth video calls, with a Cohen κ of 0.75. Reviewers identified 14 themes for barriers. The most common of which were technical literacy (25/144 occurrences, 17%), lack of desire (19/144 occurrences, 13%), and cost (11/144 occurrences, 8%). Reviewers identified 13 medical outcomes associated with telehealth interventions. The most common of which were decrease in psychological stress (21/118 occurrences, 18%), increase in autonomy (18/118 occurrences, 15%), and increase in cognitive ability (11/118 occurrences, 9%). Some articles did not report medical outcomes (18/57, 32%) and some did not report barriers (19/57, 33%). Conclusions: The literature suggests that the elimination of barriers could increase the prevalence of telehealth use by older adults. By increasing use of telehealth, proximity to care is no longer an issue for access, and thereby care can reach populations with chronic conditions and mobility restrictions. Future research should be conducted on methods for personalizing telehealth in older adults before implementation. Trial Registration: PROSPERO CRD42020182162; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020182162. International Registered Report Identifier (IRRID): RR2-10.2196/15490

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  • Multiple studies have raised concerns about using LLMs for healthcare scenarios due to their inconsistency, potential errors, and bias in clinical work.

    “multiple studies have raised concerns about using LLMs for healthcare scenarios, due to their inconsistency, potential errors, and bias in clinical work [17,55,64]”

    From Talk2Care: An LLM-based Voice Assistant for Communication between Healthcare Providers and Older Adults (2024) · cites this paper as [64]

    The Methods section on risk of bias and the Results section on bias within studies discuss the quality and selection bias of telehealth studies, not LLMs. Searches for LLMs and for clinical AI errors or bias found no passage addressing the cited claim. (LLM, conf=0.76)

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References 76 · Cited by 295

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Authors
Kruse, C., Fohn, J., Wilson, N., Nunez Patlan, E., Zipp, S., & Mileski, M.
Affiliations
Texas State University (US)
Corresponding author
Kruse, Clemens
ORCID
Venue
JMIR Medical Informatics
Publisher
JMIR Publications Inc.
Published
2020-08-12
Volume
8
Issue
8
Pages
e20359
ISSN
2291-9694 (ISSN-L)
DOI
10.2196/20359
PMC
PMC7450384
OpenAlex
W3040316091
Cited by
295
References
76
Citations by year
2026: 41 · 2025: 50 · 2024: 45 · 2023: 60 · 2022: 59 · 2021: 36 · 2020: 4
FWCI
6.64
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • JMIR Medical Informatics (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
  • Social Sciences › Demography › Technology Use by Older Adults
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Keywords
telemedicine, older adults, barriers to telehealth, health outcomes, quality of life, e-health, mobile health, remote patient monitoring, telecare, video calls, technological literacy, psychological stress, autonomy, cognitive function, health care access, chronic disease, mobility restrictions, cost barriers, telehealth implementation, telehealth adoption, telehealth utilization

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