The University of Michigan’s IHPI survey uncovers a critical gap in communication among older adults embracing direct-to-consumer (DTC) mHealth services. While 7.5% of individuals aged 50 to 80 utilize DTC platforms, a staggering one-third neglect to inform their primary care physicians (PCPs). Motivations include convenience, but 55% still prefer the overall quality of care from their PCPs. Dr. Mark Fendrick emphasizes the urgency for providers to inquire about DTC engagements routinely. As the online care landscape expands, bridging this communication gap is vital for maintaining care continuity, minimizing risks, and ensuring patient safety.
The healthcare paradigm is shifting, with direct-to-consumer (DTC) mobile health services gaining traction, particularly among older adults seeking convenience. A University of Michigan IHPI survey delves into this trend, revealing that while 7.5% of adults aged 50 to 80 engage with DTC healthcare, a significant one-third fail to disclose this information to their primary care physicians (PCPs). Motivations for DTC adoption range from convenience to limitations in accessing traditional providers. Dr. Mark Fendrick underscores the need for heightened attention to patient usage patterns in this evolving landscape. The survey sparks a critical conversation about the impact of DTC services on patient safety, care quality, and the necessity of improved communication between patients and providers.
Carried out by NORC at the University of Chicago on behalf of IHPI, the survey reached 2,657 adults aged 50 to 80 between July and August 2023. Among them, 168 individuals reported using DTC healthcare services, encompassing online telehealth providers, e-prescription platforms, subscription-based mHealth apps, and services offered by membership-based organizations and retailers like Costco.
The survey’s findings shed light on the prevalence and implications of DTC mHealth service usage among older adults. While 7.5 percent of individuals aged 50 to 80 have engaged with online-only DTC healthcare providers, those between 50 and 64 are over twice as likely as their older counterparts to utilize these services. Disturbingly, 47 percent of adults over 65 admit to being unaware of DTC companies altogether.
The primary motivations for adopting DTC healthcare services vary, with 55 percent citing convenience. However, 20 percent each expressed limitations in accessing their regular healthcare provider, lacking a regular healthcare provider, and needing a service outside their provider’s availability. Surprisingly, only 10 percent mentioned discomfort in discussing sensitive health topics with their primary providers as a driving factor for seeking DTC alternatives.
Of those who turned to DTC healthcare services, 62 percent sought prescriptions, 12 percent addressed mental health concerns, 15 percent tackled sexual health issues, and 9 percent sought assistance with skin care. Weight management, hair loss, and pain management each accounted for nearly 5 percent.
Dr. Mark Fendrick, director of the University of Michigan’s Center for Value-Based Insurance Design and a primary care physician at Michigan Medicine, underscores the urgency for providers, insurers, and regulators to monitor the impact of patients using DTC services on care quality and safety. He emphasizes that as online care expands, individuals must inform their regular clinicians, and providers should routinely inquire about prescriptions or diagnoses received online to ensure comprehensive patient care.
One of the survey’s alarming revelations is that a significant portion of older adults using DTC healthcare services fail to communicate this information to their regular PCPs. A third of respondents did not disclose their DTC engagement, and an additional third did not inform their PCPs when receiving a prescription through such services. This omission poses a risk of care fragmentation and patient safety concerns.
Dr. Fendrick highlights the importance of communication between patients and their regular clinicians in the context of the expanding online care landscape. He advocates for incorporating inquiries about DTC prescriptions and diagnoses into standard healthcare practices, similar to questioning patients about supplements and over-the-counter medications.
Despite the growth of DTC healthcare services, the majority of older adults still strongly prefer receiving care from their regular physicians. Over 55 percent of respondents affirmed that the overall quality of care from their PCPs surpassed that from DTC providers. This sentiment aligns with prior research indicating that 72 percent of telehealth users accessed virtual appointments through their doctor or health insurance, while only 17 percent opted for on-demand telehealth services.
While acknowledging the need for safeguards to protect patients using DTC healthcare services, it is evident that older adults value the continuity and trust built with their regular healthcare providers. As the healthcare landscape continues to evolve, ensuring open communication between patients and providers becomes paramount for delivering comprehensive and safe care.
The IHPI survey paints a vivid picture of the evolving relationship between older adults, primary care physicians (PCPs), and direct-to-consumer (DTC) healthcare services. Uncovering that a substantial one-third of users keep their PCPs uninformed highlights potential pitfalls in patient care and safety. Dr. Mark Fendrick’s call for providers to routinely inquire about DTC engagements signals a crucial shift in healthcare practices. As online care continues its rapid expansion, ensuring open communication becomes paramount for comprehensive, patient-centric care. The survey underscores the enduring preference for PCP-driven care among older adults. Bridging the communication gap is imperative for navigating the complexities of a changing healthcare landscape while safeguarding patient well-being.