Abstract
Background: Gradually, society has shifted more services online, with COVID-19 highlighting digital
inequalities in access to services such as healthcare. Older adults can experience such digital
inequalities, yet this group is also more likely to need medical appointments, compared to younger
people. With the growing digitalisation of healthcare, it is increasingly important to understand how
older people can best use communicative e-health services to interact with healthcare services. This
is especially if older adults are to access, and actively interact with health professionals/clinicians due
to their general health decline. This review aims to synthesise older adults’ experiences and
perceptions of communicative e-health services and, in turn, identify barriers and facilitators to using
communicative e-health services.
Methods: A meta-ethnography was conducted to qualitatively synthesise literature on older adults’
experiences of using communicative e-health services. A systematic search, with terms relating to
‘older adults’, ‘e-health’, ‘technology’, and ‘communication’, was conducted on six international
databases between January 2014 and May 2022. The search yielded a total of 10 empirical studies for
synthesis.
Results: The synthesis resulted in 10 themes that may impact older adults’ perceptions and/or
experiences of using communicative e-health services. These were: 1) health barriers, 2) support
networks, 3) application interface/design, 4) digital literacy, 5) lack of awareness, 6) online security,
7) access to digital devices and the internet, 8) relationship with healthcare provider(s), 9) in-person
preference and 10) convenience. These themes interlink with each other.
Conclusion: The findings suggest older adults’ experiences and perceptions of communicative e-health
services are generally negative, with many reporting various barriers to engaging with online services.
However, many of these negative experiences are related to limited support networks and low digital
literacy, along with complicated application interfaces. This supports previous literature identifying
barriers and facilitators in which older adults experience general technology adoption and suggests a
greater emphasis is needed on providing support networks to increase the adoption and usage of
communicative e-health services.