As long as there have been people of different generations, there have been divides between them.
In the mid-to-late 1990s, as the World Wide Web was becoming a mass consumer phenomenon, technology also became something of a culprit. As the young marveled in email and information that never disappeared, many older adults were content with landline telephone conversations and talking to others before making decisions that every consumer must make, including those about their health care.
But today many older Americans are technology savvy, and the earlier generational divide is much less pronounced. Smartphone users ages 60-69 lead the way in managing their medical care using their smartphones, and Medicare beneficiaries have used a central website to choose a prescription drug or Medicare Advantage plan during open enrollment every year since the mid-2000s.
Obstacles to digital health for older adults
Despite so much progress, there are essentially two challenges that remain.
First, with more healthcare data posted online every day, people suffer from content overload and uncertainty about which resource is accurate or right for them.
Second, having more data online doesn’t necessarily help people make better decisions about their health. The hard reality is that there is too much purported data and not enough well-vetted, easy to find information out there. When you search a health care topic what comes up first? The best, most informative resource? Or, the slick pay to play site masquerading as reliable, independent information?
Guiding people to better decisions
What’s needed most is a virtual Sherpa — a guide to help people cut through digital clutter and see the best options for them. We can help people make better healthcare decisions, but only through greater acceptance and use of technologies that consider complex information about individuals. We need smart tools that consider things like health status, medications, and insurance eligibility, and align patient needs and preferences with targeted, appropriate options.
Medicare has made some inroads delivering personalized health coverage information, which can be a basis for good consumer decision making. For example, Medicare.gov generates prescription drug plan options based on information a beneficiary provides: drug names, dose frequency, current cost to the patient, etc.
We need to further develop the next generation of online tools to help Americans make the health care decisions that are right for them. This could be most important for the 9 million older adults dually eligible for both Medicare and Medicaid, programs with vastly different objectives, coverage requirements and benefit offerings.
Dually eligible individuals – those enrolled in both Medicare and Medicaid – have unique challenges. They typically face multiple chronic conditions that are physically and emotionally draining with different aspects of their care supported by different programs. It’s particularly important for dual eligibles to have clarity around their best care options, but that clarity has been notoriously difficult to obtain. No ombudsman program, aging advice line, health care exchange, or managed health care consumer protection office sees the dually eligibles as their responsibility. Yet duals are most in need of much more accessible trustworthy tools, and much, much better information.
Available options for personalized care
As an example of the type of tools that could help nationwide, My Care, My Choice is changing the decision-making landscape for Californians eligible for both Medicare and Medicaid for the better. Beneficiaries can use this tool to generate personalized options tailored to their unique circumstances. The tool undergoes routine consumer testing and improvement, making it clear and responsive to those it is designed to help.
Regardless of who creates them, healthcare decision support tools have come a long way from the early days of the Internet. Gone are the days of worrying about whether people could or would use an online tool. Choosing health care options are among the most important decisions people make in their lifetime, and this is especially true for older adults.
More must be done to help people make informed healthcare decisions, and personalized technology tools can help bridge the next-generation gap.
Dr. Bruce Chernof, is president and CEO of the SCAN Foundation, a nonprofit dedicated to transforming care for older adults.
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