Telemedicine preparation for older adults with type 2 diabetes - during the covid-19 pandemic, many primary care appointments were converted to telemedicine

Telemedicine appointments may be especially beneficial for patients who are at high risk for covid mortality, such as older adults, african americans, and patients with type 2 diabetes. Numerous studies have found telemedicine can be an effective venue for diabetes care. Unfortunately, such interventions often assume that patients already have internet-capable devices, reliable internet service, and basic digital skills. Many patients, especially older patients and african americans, lack the digital skills needed for telemedicine. Unfortunately, the net result is that those at highest risk for chronic diseases and their complications are often least able to take advantage of telemedicine. We propose a digital skills training intervention comprising essential basic skills to participate in a telemedicine appointment for older (age 50-70 years) mostly african american primary care patients with type 2 diabetes who already own an internet-capable device but have never had a telemedicine appointment. The intervention's goal is to prepare patients to have a successful telemedicine appointment. Patients will first be assessed for skills and then receive customized digital skills training through a community-based organization. Participants will also be scheduled to have a virtual diabetes management appointment within 6 months. For specific aim # 1, we will measure whether or not patients referred to the telemedicine training intervention complete a telemedicine appointment within 6 months. In specific aim # 2, we will interview patients and analyze interview transcripts to assess their experience with telemedicine. Patients who successfully completed a telemedicine appointment will be asked about their satisfaction with both the telemedicine training intervention and their telemedicine appointment. Patients who enrolled in the telemedicine training intervention but either did not complete a telemedicine appointment and/or did not complete telemedicine training will be asked about their barriers and how the telemedicine training intervention could better meet their needs.