SINGAPORE – When security guard Joseph Mathew was invited by Ng Teng Fong General Hospital last year to see his specialist about his varicose veins during a video call, he refused, preferring instead to keep his go to the hospital.

“Suddenly switching to telemedicine, video conferencing and Zoom is very new to me, and I’m not ready for it,” said Mr. Mathew. Although the 59-year-old has attended meetings on Zoom, he finds it difficult.

“There are some things the doctor needs to look at in person … And I’m not very tech savvy,” he added. He’s not the only one who feels this.

A survey by the Singapore Eye Research Institute (Seri) during last year’s Breaker found that about 55% of 520 people aged 60 and over were unlikely to use digital medical services if the pandemic of Covid-19 continues.

Although half of the respondents agreed that telemedicine would be helpful in reducing non-essential contact in clinics and hospitals, 77% of them said they were uncomfortable with artificial intelligence (AI ) to interpret their medical results.

But the study, which was conducted during the breaker when telemedicine services became more mainstream, found that older people with higher income and education levels were more likely to use digital health services.

The findings underscore the need to improve digital health acceptance and adoption among older people as healthcare evolves to a new standard of safe distance, the study concluded, which was published in May in Scientific Reports, a journal published by Nature.

“More needs to be done to engage and allay fears, worries and skepticism about digital health services, for patients who have never tried them before,” said Professor Cheng Ching-Yu, head of the research group. in Ocular Epidemiology and Data Science Unit at Seri, and co-principal investigator of the study.

“It is difficult to involve the older group, unfortunately the group that we have to involve, because they are the ones who suffer the most from eye diseases.”

Empathy with seniors

Online health care research has become a more popular option in the wake of the pandemic.

In May alone, more than 8,000 teleconsultations were carried out by institutions under the National University Health System (NUHS), said Peter Forbes, NUHS Group Digital Manager.

Before coming up with solutions to engage more older people in telemedicine, there is a need to better empathize with them, said Professor Josip Car, director of the Center for Population Health Sciences at the Lee Kong Chian School of Medicine of Nanyang Technological University.

“We can do more research on the barriers to technology adoption … By analyzing the statistics and understanding the experience of older people and their needs, the better we can tailor our solutions,” added Professor Car. .

“It would be arrogant of us to assume that just because something works for a particular demographic, technology, or environment, it works for everything and everyone.”

This is what the Singapore National Eye Center (SNEC) is working on.

By the fourth quarter of this year, the center will embark on quarterly digital patient readiness workshops, said clinical associate professor Anna Tan, clinical director of SNEC’s low vision service.

Additionally, as the survey was conducted during the blackout period last year, Seri researchers plan to re-engage all 520 participants during this year and find out how their perceptions of telemedicine have changed, a said Assistant Professor Tham Yih Chung.

Professor Tham, Principal Clinical Investigator at Seri and the study’s other co-principal investigator, added: “I hope digital acceptance and readiness among older people is now better than they are. were not a year ago. Otherwise, we would. need to identify the gaps. “

Physiotherapy on Zoom

Telemedicine isn’t just about video consultations with doctors, phone calls, chatbots, and AI.

Physiotherapy, rehabilitation and even audiology services are performed on Zoom.

For example, the audiology department of Ng Teng Fong General Hospital offers tele-audiology services, which include connecting to a patient via video call and connecting to the patient’s hearing device so that the audiologist can adjust the patient’s hearing aid remotely.

Dr Gary Lee, head of the hospital’s audiology department, said patients aged 60 and over were seven times less likely to opt for tele-audiology sessions than younger patients.

“The most frequently cited reasons include overly complicated tele-audiology functionality, lack of technological skills and a general preference for face-to-face consultations.

“(Elderly) patients are more likely to find it difficult to understand the concept of tele-audiology and to manage the use of features independently.”

But Dr Lee has observed that live demonstrations in the hospital or clinic and technical support from caregivers make older patients feel more comfortable using tele-audiology during follow-up sessions.

Dr Teng Gim Gee, chronic program manager at Alexandra Hospital, said digital platforms or applications can be designed with older patients in mind, so that they are more receptive to telemedicine.

“(These include) the ease of access, the intuitive design, the larger font size, and the simplification of necessary steps. For example, many have issues turning on audio when launching Zoom.”

Professor Car added: “Telemedicine at this point should be about choice, convenience, and creating clear benefits for itself that go beyond simple infection control, although this is also important.”

He remains optimistic.

“The herd mentality and the ease of access will change the receptivity (of people) to these services. This is, in a similar way, how most people now understand what Google means something, or Facebook someone. , compared to when the services first landed. “