Tag Archives: patient medical portals

Closing the Senior Broadband Gap

An article in Telecompetitor cites statistics from AARP that show there is still a substantial broadband gap among seniors. According to data from the Older Adults Technology Services (OATS) organization that is part of AARP, 19 million seniors didn’t have a home broadband connection in 2023. That’s not a big improvement over the 22 million seniors who didn’t have home broadband in 2018. The article cites a statistic from AARP that only 61% of seniors over 75 have a home broadband connection.

AARP notes that the reasons seniors don’t have home broadband are similar to the reasons affecting other demographics. For example, only 53% of seniors with less than a high school education have broadband compared to 68% of seniors with a high school or higher education. Incomes also matter, and seniors with incomes under $25,000 struggle to afford broadband. AARP notes some improvement in senior use of broadband from 2018 to 2023. They noted that more seniors are using large-screen devices in 2023. The biggest improvement for seniors was an improvement in the use of smartphones and mobile services.

Interestingly, the AARP statistics didn’t consider 5G home internet or 5G mobile plans as broadband access. AARP believes that 5G has issues like unreliable service, data caps, and other problems, which means that a 5G connection isn’t reliable for some of the services that seniors need, like medical monitoring. 5G capabilities are improving.

The big cell carriers have been adding spectrum and making electronics upgrades, which are bringing faster and more reliable speeds. However, one of the issues that isn’t discussed enough is that fast cellular broadband speeds are only good within about two miles of a cell tower. Most urban households are within a mile of a cell tower and can receive download 5G speeds over 100 Mbps, and often much faster. But in rural areas, a lot of people live more than two miles from a cell tower. In rural areas, there are still large swaths of areas with little or no cellular broadband coverage. Cellular service is also engineered by the big three carriers to have relatively slow upload speeds, and it’s not unusual, even in urban areas, for upload speeds to be under the 20 Mbps definition of broadband set by the FCC. It’s possible that AARP will eventually bless 5G as acceptable broadband, but even then, only for customers within a few miles of a cell tower.

The senior broadband gap is significant since seniors are increasingly reliant on broadband. Seniors are like the rest of us and are seeing essential services moving online. Money and banking have largely moved online. Local, state, and federal governments are moving forms and portals online, and often as the only way to communicate. Homebound seniors need access to online shopping. Businesses everywhere are converting to online portals. For example, portals are being used to communicate with mortgage companies, veterinarians, dentists, plumbers, etc.

The biggest need for home broadband for seniors is increasingly becoming health care. Healthcare providers are almost universally shifting to the use of online portals to communicate with patients. The portals are used to schedule visits, communicate results of medical tests, and answer patient questions. Anybody without the skill or ability to access medical portals is at a major disadvantage.

Seniors are also increasingly reliant on telemedicine, where they can have virtual visits with physicians without having to make an office visit. Broadband is also needed for monitoring medical devices that are increasingly used to track at-risk patients who suffer from diabetes or heart issues, and for general monitoring after patients are released from surgery.

I’ve talked to a lot of digital equity folks in the last year, and a lot of them are focused on seniors. These groups help seniors find affordable broadband connections and take advantage of any discounts or subsidies that can help pay for a connection. Digital equity folks are helping seniors obtain computers, tablets, and smartphones and teaching them how to use them. I find myself repeatedly ruing that the federal government decided to nix a lot of the grant funding to help with this effort. Luckily, a lot of the folks engaged in this work are finding ways to continue the effort without the federal funding assistance.

A Telehealth Success Story

I’ve been hearing for years about how good broadband can open access to telemedicine. It’s certainly something that is increasingly needed as rural hospitals and clinics are closing across the country. But telehealth is not just a rural issue, and a recent article by Sean Gonvales points out a successful telehealth program in San Francisco.

The SF Tech Council, a collaboration of government and nonprofit entities, undertook an effort to train patients on how to use patient medical portals. Patient portals are online systems that allow patients to communicate with doctors, manage appointments, check lab results, or ask for refills on prescriptions. I’ve been using a portal with my own family doctor, and it’s a great tool for handling things that used to require phone calls or even a doctor visit. A well-run portal makes life easier for patients and physicians.

What the group in San Fransico realized is that a lot of patients were unfamiliar with portals and didn’t understand how to establish a portal connection or use a portal. Using funding from a State digital inclusion grant, the group created a hands-on training effort to help patients learn how to navigate a portal. In San Francisco, the training has been aimed at low-income patients, those with low computer literacy skills, or the many people in the community who speak Chinese or Spanish.

I found this story to be intriguing because it demonstrates the need for hands-on digital skills training. Portals are being increasingly used because they allow the entities we communicate with online verify who they are talking with. In addition to medical portals, portals are used to communicate with an increasing number of federal, state, and local government agencies like FEMA and Social Security. Portals are being used by banks, credit card companies, mortgage companies, and student loan processors.

The folks in San Francisco realized that people were leaving a doctor visit with instructions to follow up through the portal, but then never made the digital connection. The grants funded the ability to establish a hands-on session with a digital navigator who walked people through using a portal in a 45-minute training session.

The feedback was that nearly all participants in the training walked away knowing how to establish and navigate a portal. It’s likely that this training will also give folks more confidence in using the increasing number of other kinds of portals. The feedback was that once people knew how to use a portal, they saw the benefits and were eager to use it.

Every time I read about one of these success stories, I’m saddened that the federal government backed out of funding for digital skills training. This particular success story comes from a State grant, and States can certainly fill in some of the gap created by the cancelled federal funding. However, the federal grant funding for these kinds of training efforts was only going to last for a few years, so there was already going to be a need to establish ongoing programs for these kinds of training efforts.

One thing that the opportunity for federal funding for digital inclusion did was to get a lot of people interested in establishing local digital equity efforts. Hopefully, this momentum will mean these efforts will move forward without the federal funds. At the local level, there are a lot of government agencies and nonprofits that might offer basic skills training like this one. Perhaps a coalition of doctors and hospitals might take on the role to make sure that patients know how to use the needed digital tools. It would make sense if insurance companies would embrace this – they all acknowledge that preventive care saves money, and making sure that patients follow-up visits through a portal is part of the preventive care process.