Regulating Digital Health Care for the Cognitively Impaired

Abstract

Americans are living longer, and delivering high-quality, effective, and cost-efficient health care remains critically important, especially as the number of older adults with cognitive impairment increases. Relatedly, a growing number of older adults are preferring to “age in place” and receive care in their homes. This preference aligns with advances being made in digital health technologies (e.g., remote patient monitoring devices, telehealth) and Medicare coverage for in-home virtual health care services. However, efforts to integrate digital health care into the lives of older adults living with cognitive impairments present unique barriers and challenges due to their confused mental state or fluctuating capacity, which can limit their ability to provide meaningful informed consent; their vulnerability to privacy violations regarding their health data; their lack of digital health equity; difficulties operating the technology, navigating online platforms and applications; and effectively communicating with their providers. These challenges usually result in this particular demographic being far less likely to participate in the digital health ecosystem compared to their younger counterparts. This Article will address those challenges and their related regulatory and legal hurdles and will propose reforms for emerging models of digital health care that address the current shortcomings in caring for older adults with cognitive impairment.