Extending Health Services to Geriatric Patients in Rural Areas Using eHealth Tools

 Extending Health Services to Geriatric Patients in Rural Areas Using eHealth Tools


Lately, there has been mounting awareness of the social repercussions of old age. While globally there is a marked increase in life expectancy, particularly due to technological advances which have led to significant improvement in early detection of diagnosis and effective treatment of chronic diseases, the fertility rates are declining, and, as a result, communities are confronted with an aging population (Hage, Roo, van Offenbeek, & Boonstra, 2013; United Nations Department of Economic and Social Affairs, 2017). An increasing number of geriatric population is not only intensifying the demand for healthcare services, and, consequently, escalating medical costs, but also imposing long-term effects on every aspect of human life, including social and economic spheres. Specifically, rural communities are affected by this issue due to “in-migration” of retirees from cities and “out-migration” of young adults from villages to metropolises (Baernholdt, Yan, Hinton, Rose, & Mattos, 2012).

Hage et al. (2013) explain that owing to the marked demographic shift there is a need to promote healthy lifestyle among geriatrics patients, e.g. encourage them to follow a  proper diet and do physical exercises that can help to curb diabetes, obesity, cardiac conditions, hypertension, and premature death. Nonetheless, despite the known value of healthy lifestyles, the elderly often prefer sedentary behaviors. Therefore, the purpose of this paper is to explain how eHealth tools could assist elderly people in rural areas.

Literature Review

eHealth

eHealth is an umbrella term for a broad array of healthcare services, which are provided via information and communication applications, like health information systems, electronic health records (EHRs), health data analytics, tools for self-management, and consultative services such as telecare, telemedicine, and telehealth (Barbabella, Melchiorre, Quattrini, Papa, & Lamura, 2016). For the aging population, eHealth can enhance the delivery of medical services and provide new ways to access care without the necessity to walk long distances to hospitals, which are often located in urban areas. In addition, it could make health providers and policymakers integrate and coordinate the detection, management, and treatment of diseases by facilitating interaction and sharing of information between medical staff and the geriatric patients via electronic EHRs or mobile eHealth tools (mHealth) (Barbabella et al., 2016).

e-Health Tools Promote Self-Management

            Type 2 diabetes mellitus (DM2) is a pervasive condition among the elderly, which can be concomitant with multiple co-morbidities. It is also linked to several complications such as frequent urination, hunger, thirst, tingling and numbness in the extremities, as well as blurred vision (Kirk et al., 2015). In rural areas, eHealth approaches have been found to be effective mechanisms for supporting self-management attempts to curb DM2-associated complications. For instance, Schrader et al. (2014) conducted a pilot study to investigate the acceptability and feasibility of eHealth program for controlling chronic diseases in the countryside. The authors created a virtual self-management system that integrated Flinders Chronic Condition Management’s content and espoused goACT software, an existing application that can be accessed by health care workers and patients via Internet-enabled devices. The application helps the elderly people to be conscious of the indications of the present conditions, including DM2 and hypertension, and communicate any marked changes in their wellbeing, thereby facilitating prompt and early control. eHealth measures also allow nurses to recognize the determinants of patients’ health seeking practices, including perceived risk factors for diseases, health consciousness, and the ability of Internet users to search for medical-related information, and, subsequently, aid in the formulation of relevant health promotion interventions.

Parker et al. (2018) conducted a systematic review to evaluate the benefits of utilizing digital, mobile, and telehealth applications, as well as to establish the mechanisms through which the aforementioned tools influence self-management and self-efficacy among vulnerable individuals. The authors used CINAHL, Medline, PsychINFO, and EMBASE and identified eighteen clinical trials published between 2009 and 2018, which focused on the effectiveness of eHealth interventions in the management of chronic diseases. The included studies showed that telemedicine improved self-efficacy and self-management practices among patients by inspiring them to follow healthy lifestyles and try self-care activities. Notably, the respondents who adopted telehealth approaches to interact with their primary caregivers and health providers said that they are supported and have a sense of purpose (Chon