ATI Contributor: Rebecca Dittrich
On the day I became eligible to receive the COVID-19 vaccine, I sat down at my computer at 7:58 AM, ready to grab one of the many appointments I was naively optimistic would become available at 8:00 when my vaccine group opened up. I certified my eligibility, proceeded to the next screen, and –nothing. There must have been at least 50 locations showing no availability for appointments – neither for the next day, nor two months later. I’d been taught some tricks by a friend who had gotten appointments for nearly 100 eligible individuals up to that point, and I tried all of them. What followed was like the worst video game that I never wanted to play. I clicked “refresh” 100 times a minute. The few times I saw an available appointment flash on the screen, I chided myself that the flick of my wrist was never quick enough across the mouse to grab it before it was gone. Like many, I saw the “this appointment is no longer available” screen so many times I have it visually memorized. I bounced between eight vaccine enrollment websites. I read tips on Twitter. At one point I even brought out a second laptop. I still struggled to get an appointment.
And I’ve been using computers since I was 12.
If my experience signing up for a vaccine taught me anything, it’s how technologically-centered health systems and services are bound to (and do) fail older adults. Getting a vaccine appointment required (1) having access to a computer; (2) having access to internet; (3) being able to navigate that computer at lightening speed; (4) having sufficient digital literacy to navigate vaccine enrollment websites; (5) being physically agile enough to move as quickly as necessary; and (6) being able to take a first-available appointment often with no mind for its time or location (in my case, over an hour away). Anecdotally, we know that many older adults who successfully secured a vaccine appointment did so with the support of children, grandchildren, or friends – making the reality of the isolation created by the pandemic even harsher for any older adults without those relationships when it came time to register.
The vaccine roll-out has been an obvious but rude awakening about the complex relationship between older adults and technology, and the thoughtfulness that must be paid to the unique needs of that population when designing technological solutions. Digital health has tremendous potential to make aging more comfortable, more connected, safer, and easier– and many aging-focused technologies already do so. But top to bottom, the approach must be different than the roll out of digital health tools for any member of a younger generation. So how do we ensure that that mindfulness is duly paid?
A 2017 study performed by AARP found that 66% of older adults age 70+ use a desktop computer, 56% use a laptop, and 55% use a smartphone. That leaves a significant portion of individuals 70+ outside the bounds of computer technology use at all. Of those who do use a desktop or laptop, 73% surf the internet but only 24% take classes, webinars, or review tutorials, 34% manage or receive medical care, and only 6% track their health or fitness using apps. These numbers suggest that the pool of seniors currently willing and able to rely on computers for their health and wellbeing is quite small. And that’s just accounting for the seniors who have access to the internet, where most recent reports find that nearly 22 million older Americans lack broadband access entirely. If we look specifically to the population of individuals dually eligible for Medicare and Medicaid, 36% of those beneficiaries don’t use the internet at all. So if we hope to learn from the COVID-19 vaccine roll-out, we can do so by ensuring that age tech tools and resources benefit more than just the digitally-literate, internet-equipped few.
A BLOG SERIES FOCUSED ON THE INTERSECTION OF DIGITAL HEALTH AND AGING
ATI Advisory (ATI) is pleased to announce the launch of its four-part digital health and age tech blog series. The series will address several critical topics that age tech developers and funders should consider when designing and investing in technologies to maximize access and usefulness, and that researchers and policymakers should bear in mind when considering how age tech fits in the future of aging infrastructure. Topics include:
- Mapping the landscape of age tech. A profile of the digital health resources currently available, from remote patient monitoring platforms, to personal emergency response systems, to caregiver support tools, and more.
- Evaluating the consumer. A hard look at how to identify an age tech’s obtainable market, when the caregivers who might benefit from the resources aren’t always aware that they or their loved ones need them, and where older adults are often uninclined to turn to technology to solve a problem.
- Understanding who pays. Critical financing and reimbursement considerations to explore, including tips to becoming a covered benefit. Reliance on private pay places a significant cap on a technology’s market potential (and limits the technology to the wealthiest few), and understanding how to expand beyond private pay requires a sophisticated understanding of how (and when) Medicare and Medicaid pay.
- Spotlighting privacy. An important examination of the privacy protections applicable to digital health, and whether we should hold age tech to a higher standard when the population is less likely to understand the fine print or know how to protect themselves online.
America has moved into a phase where COVID-19 vaccines are (thankfully) more widely available, but lest we forget the time when it felt nearly impossible to get vaccines into the arms of the frail older adults who needed them most. This is our opportunity to learn how to create a symbiotic relationship between older adults and age tech, because here’s what we don’t want to happen: a younger generation defaults to developing technology on the basis of making life easier for an older population, when that older population experiences the introduction of technology as creating challenges.
 AARP Research. (December 2017). Technology Use and Attitudes Among Mid-Life and Older Americans, available at https://www.aarp.org/content/dam/aarp/research/surveys_statistics/technology/info-2018/atom-nov-2017-tech-module.doi.10.26419%252Fres.00210.001.pdf.
 Older Adults Technology Services (OATS). (January 2021). Press Release: Report: 22 Million U.S. Seniors Lack Broadband Internet Access; First Time Study Quantifies Digital Isolation of Older Americans as Pandemic Continues to Ravage Nation, available at https://oats.org/aging-connected-press-release/.