PART IV. TECHNOLOGY EVALUATION, SELECTION, AND DEPLOYMENT

The Telewellness Program is fundamentally about virtual care, or the distribution of mental health content through technology. Older adult access to digital tools is an important component to developing a mental health program at a community, whether it involves use of a personal device to connect with a mental health professional, or the ability to participate in a mental health webinar through a large screen monitor. A wide array of opportunity opens up for older adults when addressing mental health and social connection needs through technology: educational videos on common topics such as anxiety and depression, video chat applications with friends and loved ones, mental wellness and meditation apps, zoom calls with health providers, and social chat platforms.

Keep in mind that technology is just a tool, a means to an end—and needs to reflect a balance between what needs you are trying to meet and what resources you have available. If your aim is to connect older adults to a friend, family member, or a virtual doctor, perhaps an iPad or some other tablet on a loaner basis would be appropriate. If you want to conduct a live Zoom workshop by a community health worker for a roomful of older adults, a large screen monitor or projector attached to a laptop may be a fitting approach.

Broadband/ Wi-Fi connectivity support

One of the greatest barriers to telehealth implementation and operation in affordable housing is the need for the right infrastructure. Reliable and accessible broadband connectivity is crucial to the success of the Telewellness Program’s goals to address older adult social isolation and mental wellbeing through technology-enabled connections with case workers/managers, service providers, friends/neighbors, and families. Broadband connectivity will also ultimately support and improve residents’ access to social services, food, transportation, health/wellness services, and related programs.

While full-building, in-home resident Wi-Fi is the most ideal broadband infrastructure for your Telewellness program, we are keenly aware that such connectivity is far from affordable, nor the norm, in affordable housing communities. Developing and installing resident Wi-Fi in affordable housing is out of the scope of this playbook, but if Wi-Fi installation is an option, LeadingAge has developed a helpful white paper on the installation and deployment of building-wide Wi-Fi for affordable housing operators.

When evaluating basic broadband needs for your Telewellness program to support in-room virtual counseling sessions, there are some low-cost options that can provide sufficient bandwidth to support most telehealth applications and virtual communications. The costs of these services will range, depending on the need to purchase equipment and monthly data caps.

Mobile hot spots. These devices use a cell phone network to create an instant Wi-Fi network for a tablet or laptop device. Monthly plans for residents can start as low as $30 per device per month, and may require an upfront equipment purchase of about $100.
Data-enabled computer devices. Many laptops and tablet computers have data plan options available, with costs running between $30 to $50 per month.

An important resource to consider is the FCC’s Affordable Connectivity Program. This federal subsidy is designed for low income consumers to access internet services, and covers the majority of monthly subscription costs, as well as for a large portion of a computer device. The OATS AgingConnected campaign has made available a helpful guide for older adults to enroll in the ACP program.

Device selection/ adoption

When researching devices, keep in mind that the Telewellness program is an investment that will promote telehealth, social engagement/connectivity, health education, and access to programs and services; but with the right level of support and creativity, the project can open many additional opportunities for engagement and well-being.

If you are working with residents who don’t own devices, consider having a device loaner or check-out system. This approach may require setting up a system that will keep track of the device (sign in/out sheet) and identify individuals responsible for managing it (troubleshooting, keeping it secure).

Your resident device selection will depend on an array of factors such as cost. Multiple options are available such as laptops/Chromebook, tablets (iPad or Android), and screen-based voice first devices (such as the Amazon Echo Show or Google Nest Hub). But some important hardware and software considerations should account for some of the unique needs of your community, especially as they relate to older adult users. Screen size (for low vision), high-quality speakers or a headset attachment (for low hearing), cover protectors with stands (for hands-free use), and/or multi-lingual software capabilities should be important factors in your research.

The resident adoption of devices plays a critical role in the successful implementation of your Telewellness Program. Device user manuals are too often complicated or, conversely, insufficient in providing adequate instructions. You may want to consider creating your own simple, step-by-step guide specific to a task—perhaps ask a student volunteer to create a cheat sheet. Here is an example of our Quick iPad User Guide.

How we did it...

Video conferences have been a core part of our Telewellness Program education campaign at our affordable housing communities. Webinars were integral to our goals to increase mental health awareness, reduce mental health stigma, serve as an outreach strategy for residents to enroll in therapy services, and to increase their comfort level with and exposure to a virtual counselor.

Through a grant program to promote telehealth services, we used video conference carts equipped with large screen monitors and computers to connect to the internet, and simultaneously broadcast the content to community meeting rooms at several of our affordable housing communities. For our community health partners, the live virtual delivery of workshops was a cost-effective approach to scaling their programs in what otherwise required multiple in-person presentations at each site location.

When FPCIW embarked upon our Telewellness pilot at two affordable housing communities, the locations we selected didn’t have Wi-Fi available to residents in their homes—access to the internet for residents to conduct video chat sessions in their apartments were crucial to maintaining patient privacy. Following a simple cellular connectivity survey of the buildings, in which we used a cell phone to measure connection strength in resident hallways, we purchased a data-enabled iPad for each of our two communities made possible through another small grant.

After scheduling their telemental health sessions with the resident service coordinators, the resident went to the service coordinators’ office to pick up the iPad, and returned the device upon completion of the 1-hour session. When a resident needed assistance with using the device to connect to a therapist, the resident service coordinator often brought the iPad to the resident’s room to initiate the connection, and later returned the device to the office.