Table I.

Suggestions for optimizing virtual care for older patients

Suggestion for optimizing care	Helpful tips
Present all available options∗	•Do not assume a patient's age will dictate willingness or ability to engage in virtual care. •Many older patients are familiar with video chat. •For patients uncomfortable with a live video visit, consider digital photographs complemented by telephone discussion. •For those without internet/smartphone access, telephone-only encounters can still be effective.
Reduce the steps to connect	•Ensure there is a simple workflow alternative. •Avoid apps that require patients to sign up for an account and enter excessive information. •Look for telemedicine platforms that can be accessed directly within browsers patients may already use. •Send invitations at the appointment time via text message or e-mail containing a direct link to the encounter.
Provide clear, step-by-step instructions	•Swap ambiguous/technical jargon for descriptive terms. •More words or pictorial instructions may be required, because this leaves less room for missteps. •A brief demonstration video or screenshots can also be helpful.
Offer a trial run	•Trained staff members familiar with the platform can prepare patients for virtual visits. •Briefly testing the platform in advance of the appointment will build patient confidence and prevent technical delays during live virtual visits.
Encourage ergonomic device use	•Larger touchscreen tablets can make visual acuity less of a barrier. •For those with limited dexterity or tremor, a mounted webcam that can be detached may be better than a handheld device. •Encourage use of speakerphone, which frees the patient's hands to write down recommendations.
Use multiparty encounters	•Use teledermatology platforms that permit simultaneous communication between more than 2 parties, so older patients can conduct virtual visits with a trusted advocate. •Advocates may offer assistance with historical information and record treatment instructions.

^∗No matter the platform used, patient privacy and data security should remain a priority, and limitations of these methods should be discussed with the patient.