JMIR Publications

ABSTRACT

Background:

The multi-disciplinary life course theory emphasizes the relation between a person’s choices and their socio-economic context and their capacity to make decisions within existing opportunities/constraints. Older age is particularly characterized by social and environment conditions that may impact people’s use of technology and eHealth applications.

Objective:

This research aims to present an overview of eHealth applications use among older Canadian adults and examine the relationship between eHealth use and social and health care (HC) system engagement determinants.

Methods:

We conducted a national cross-sectional survey of 2000 older adults in Canada assessing their technology (e.g., tablets, computers etc.) and eHealth applications (e.g., mApps, fall detection and telemonitoring technologies, Internet etc.) use, social determinants (e.g., socio-demographic characteristics, living conditions etc.) and aspects related to HC system engagement and use (e.g., home care, hospitalizations etc.).

Results:

Findings indicate technological readiness (85% owned computers, 74% used Internet daily/weekly, 90% used e-mail) among older Canadian adults, although it does not translate into eHealth applications use. Internet use to connect with HC professionals, access results/patient portals, or book medical appointment was limited. The use of wearables, telemonitoring, and fall detection technologies was low (11.9%, 9.4%, 4.2%, respectively). A digital divide exists within the older adults population that is underscored by significant associations between eHealth use and social determinants and HC system engagement. This raises concerns about whether those with higher needs and limited resources (e.g., cannot benefit from home care services, cannot acquire FDT, are unable to afford living in a retirement home) have access to and are capable of benefitting from eHealth applications.

Conclusions:

The results establish a baseline for ongoing eHealth monitoring that can be used for international comparisons and benchmarking. Evidence-informed eHealth policies should focus on the older adults population and eHealth programs that consider social determinants and engagement with the HC system to improve health equity, reach and access to care.