The Role of Digital Literacy Interventions in Improving Geriatric Patient Engagement with Telemedicine Services

Dr. Grace Uduak; Prof. Klaus Fischer; Dr. Ling Tan

Abstract

Background: While telemedicine offers significant benefits for elderly patients, particularly those with chronic conditions or mobility limitations, low digital literacy among this demographic can pose a substantial barrier to engagement. This study investigated the effectiveness of targeted digital literacy interventions in improving geriatric patients' ability and willingness to use telemedicine services. Methods: A randomized controlled trial was conducted with 350 geriatric patients (aged 65+) who had been offered telemedicine. The intervention group received a structured digital literacy training program (group workshops, one-on-one coaching) focused on telemedicine platform usage, while the control group received standard introductory materials. Primary outcomes included telemedicine appointment completion rates and self-reported confidence in using digital tools. Results: The intervention group showed a significant increase in telemedicine appointment completion (80% vs. 45% in control, p<0.001) and higher self-reported digital confidence (p<0.001). Age and prior technology exposure ceased to be significant barriers after intervention. Conclusion: Digital literacy interventions are crucial for unlocking the full potential of telemedicine in geriatric populations, enabling equitable access to digital health and significantly improving patient engagement and autonomy. These programs should be integrated into telemedicine rollout strategies.

Keywords: digital literacy, geriatric patients, telemedicine, patient engagement, health equity

The rapidly aging global population often faces multiple chronic conditions, mobility challenges, and social isolation, making regular in-person medical care difficult. Telemedicine offers a powerful solution to improve access and continuity of care for this vulnerable demographic. However, the potential of telemedicine for geriatric patients is often hampered by a significant digital divide, primarily due to low digital literacy and a lack of confidence in using technology. Targeted interventions are essential to empower older adults to engage effectively with digital health services, ensuring equitable access and maximizing the health benefits of telemedicine.

The aim of the study.

This study aimed to evaluate the impact of a structured digital literacy intervention program on geriatric patients' confidence, ability, and actual engagement (appointment completion rates) with telemedicine services for routine medical consultations.

Material and methods.

A prospective, unblinded, randomized controlled trial was conducted with 350 geriatric patients (aged 65 years and older) who had been offered a telemedicine appointment by their primary care provider across hospitals in Nigeria, Switzerland, and Singapore. Participants were randomized 1:1 into two groups. The intervention group (n=175) received a comprehensive 4-week digital literacy training program, including group workshops and personalized one-on-one coaching, focusing on smartphone/tablet usage, video call etiquette, troubleshooting common technical issues, and navigating the specific telemedicine platform. The control group (n=175) received standard written instructions and a brief introductory phone call. Primary outcomes were the telemedicine appointment completion rate within a 2-month follow-up period and change in self-reported digital confidence (measured using a 5-point Likert scale) from baseline to post-intervention. Secondary outcomes included patient satisfaction with telemedicine and perceived ease of use. Statistical analysis involved chi-square tests for completion rates and independent t-tests for continuous confidence scores, with significance set at p < 0.05.

The digital literacy intervention group demonstrated a significantly higher telemedicine appointment completion rate (80.0%) compared to the control group (45.3%) (p < 0.001). Self-reported digital confidence among patients in the intervention group increased by an average of 1.8 points on the Likert scale (from 2.2 to 4.0), significantly higher than the control group's increase of 0.4 points (from 2.5 to 2.9) (p < 0.001). Qualitative feedback from the intervention group highlighted improved feelings of autonomy and reduced anxiety regarding technology. Interestingly, after the intervention, baseline differences in age or prior technology exposure no longer significantly predicted telemedicine engagement within the intervention group. Patient satisfaction with the telemedicine experience was also significantly higher in the intervention group (mean 4.5 vs. 3.2 on a 5-point scale, p < 0.001).

Targeted digital literacy interventions are highly effective and indispensable for successfully integrating elderly patients into the digital health ecosystem. By addressing fundamental barriers related to technology proficiency and confidence, these programs significantly improve telemedicine engagement, thereby promoting equitable access to care for geriatric populations. Integrating such interventions as a standard component of telemedicine rollout strategies is crucial for unlocking the full benefits of digital health for older adults and fostering healthier, more autonomous aging.

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