Barriers and challenges to telemedicine usage among the elderly population in Israel in light of the COVID-19 era: A qualitative study.

Background: Although there may still be many challenges to its adoption, telemedicine is becoming more and more popular for helping elderly people preserve their independence and continue to live in their own homes. We intended to investigate the challenges and barriers (if any) experienced by the elderly population when using telemedicine services in Israel. Methods: Fourteen elderly people were recruited for the study and interviewed in person using a semistructured interview protocol, using a qualitative technique. Participants' replies were evaluated and analyzed thematically. The participants were questioned regarding their usage of telehealth services, the benefits they perceive in them, any potential difficulties or hurdles to use, and suggestions they had for making these services more readily available and simpler to use for the elderly. Results: Most participants recognized the advantages of telehealth services, particularly for the elderly population during pandemics and normal times. However, most of them also expressed various challenges that face the elderly population in using these services. Many participants were concerned that the quality of telemedicine sessions may not be good enough compared to in-person sessions, and expressed a lack of confidence in telemedicine services, and frustration from the absence of in-person interaction and communication. Many participants highlighted the technological challenges in the use of computers and applications in general and in the context of healthcare, in particular, in addition to physiological and literacy difficulties. Finally, the participants suggested several ways to increase the accessibility and usage of telemedicine solutions by elderly people. Conclusions: A proactive approach to identifying and resolving telehealth barriers can maximize virtual interactions for the older population and alleviate care inequities. In addition to identifying barriers that impede older patients from using telemedicine, there is a need to increase awareness of the availability, benefits, and uses of each telehealth service in comparison to in-person consultations.

Using the social structure of markets as a framework for analyzing vaccination debates: The case of emergency polio vaccination.

The framework of the social structure of markets was used to analyze an online debate revolving around an emergency poliovirus vaccination campaign in Israel. Examination of a representative sample of 200 discussions revealed the activity of three parties: authoritative agents promoting vaccinations, alternative agents promoting anti-vaccination, both representing sellers, and the impartial agents, representing the customers-the general public deliberating whether to comply with vaccination or not. Both sellers interacted with consumers using mechanisms of luring and convincing. The authoritative agents conveyed their message by exhibiting professionalism, building trust and offering to share information. The alternative agents spread doubts and evoked negative emotions of distrust and fear. Among themselves, the alternative agents strived to discredit the authoritative agents, while the latter preferred to ignore the former. Content analysis of discussions conducted by the general public reveal reiteration of the messages conveyed by the sellers, implying that the transaction of pro and anti-vaccination ideas indeed took place. We suggest that the framework of the market as a social structure can be applied to the analysis of other vaccination debates, and thereby provide additional insights into vaccination polemics.