The COVID-19 pandemic has abruptly changed healthcare service delivery.1 In a few weeks, clinicians and patients were asked to transition from face-to-face contacts to ‘digital-first’ solutions (that is, telephone, video, online) wherever possible.
However, there is a real risk that innovation entrenches inequalities in care access, delivery, and patient safety.2 The adoption of digital technologies is known to happen unevenly across different groups, therefore contributing to the so-called ‘digital divide’.3 Older people seem to be particularly underserved: evidence shows that increased age is associated with less access to technology and lower digital literacy,3,4 which may contribute to lower adoption, less sustained use, and less access to care and treatment. Paradoxically, this same group was identified as high risk and is more likely to have comorbidities, physical disabilities, and be shielding,5 and, therefore, they have most to gain from the regular and remote care that digital technologies can offer.
For these reasons, it is critical to work with a diverse group of older people, particularly from seldom heard groups. GPs and other healthcare providers, researchers, designers, and relevant voluntary and community organisations must come together to explore the main barriers and enhancers to access remote and digital care, and find innovative ways to translate these findings into high-quality solutions to improve the experience both for providers and patients — in order to deliver high-quality, patient-centred care that leaves no one behind.
Competing interests
Ana Luisa Neves, Anna Lawrence-Jones, and Erik Mayer are supported by the Imperial National Institute for Health Research (NIHR) Patient Safety Translational Research Centre, with infrastructure support from the NIHR Biomedical Research Centre. Geva Greenfield is supported by the NIHR Applied Research Collaboration Northwest London. The views expressed in this publication are those of the authors and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care.
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