Smart Healthcare vs. the Silver Digital Divide
As global populations age, digital solutions are often presented as a means to ease healthcare burdens. But is that truly the case? How do older adults—the primary end users of many of these services—actually experience the growing use of digital tools in everyday care?
Background
By 2050, one in six people worldwide will be over 60 [1], making equitable healthcare access increasingly urgent. At the same time, staff shortages and bureaucracy strain healthcare systems. Digital transformation offers a promising response [2], with tools such as online appointment scheduling, electronic records, e-payments, and automated prescriptions deployed to boost efficiency and improve care delivery [3].
But is this transition genuinely serving older adults?
The evidence suggests otherwise. For example, more than 70% of seniors in China continue to queue for face-to-face registration and payment [3]. This illustrates what is often referred to as the Silver Digital Divide—a digital gap experienced by older adults across the globe, characterized by challenges in accessing, using, and understanding digital technologies. To contribute to the well-being of older adults and to help close this divide, Chen et al. (2025) call for fostering digital inclusion in healthcare. This approach emphasizes equitable access to, and meaningful use of digital technologies for older adults [3].
Mapping the Pathways to Digital Inclusion
In their qualitative study based on 27 semi-structured interviews with older outpatients, Chen et al. (2025) identified four individual factors that influence digital inclusion: physical ability, digital health literacy, attitudes toward digital technologies, and perceptions of technology (including perceived usefulness, ease of use, and risk). In addition, demographic variables as well as external conditions—such as system design and both technical and social support—also play an important role [3].
Building on these findings, the authors derived five key takeaways for improving digital inclusion:
- acknowledge age-related limitations and provide practical guidance to strengthen digital literacy;
- tailor systems with senior-friendly interfaces;
- integrate supportive, simplified workflows across all stages of healthcare;
- leverage family support to build digital self-efficacy;
- foster an inclusive digital culture that respects and empowers older adults.
Discussion: How Can Smart Healthcare Avoid Leaving Older Adults Behind?
The study by Chen et al. (2025) highlights the psychological and structural barriers older adults face when using smart healthcare [3]. From these insights, three important implications emerge for innovators and healthcare providers.
First, the challenge lies less in technology than in design. Systems built for tech-savvy users often neglect older adults, reducing engagement and forcing providers to maintain inefficient manual services. Healthcare organizations should therefore embed elder-friendly design requirements into procurement processes [5].
Second, although many older adults can use digital tools, they often lack confidence, motivation, or support. Digital inclusion therefore requires not just training but also psychological support, such as “learning buddy” programs, peer groups, family involvement, and intuitive feedback mechanisms [6].
Third, the silver economy is a largely untapped market. As the older population grows, so does demand for age-appropriate digital health solutions. Companies that bridge the Silver Digital Divide can target frequent, low-threshold use cases—such as chronic care, appointment navigation, or payment reminders—and design “lite” apps or features like “family-assisted mode” to support multigenerational caregiving.
In sum, smart healthcare can only succeed if older adults are included. Bridging the Silver Digital Divide requires not just innovation, but also thoughtful design, inclusive practices, and supportive environments so that progress translates into greater equity, access, and well-being.
Figure. Digital Inclusion Pathways and Influencing Factors Among Older Adults in Outpatient Settings
References
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[3] Chen Y, Yin Q, ZhouT*, et al.*Digital Inclusion Pathways and Influencing Factors Among Older Adults in Outpatient Settings: A Grounded Theory Study. Clin Interv Aging 2025; 20: 701–16
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[https://doi.org/10.3389/fpubh.2022.906089][PMID: 35991040]
[5] Lee EWJ, Bao H, Singh NB*, et al.Implementing an inclusive digital health ecosystem for healthy aging: a case study on project SingaporeWALK. JAMIA Open 2025; 8(1): ooae148. [6] Jiao D, Zhu Y, ZhuZ, et al.*The trajectory of functional status among older adults with chronic diseases and the association with social relationships. Front Public Health 2025; 13: 1492489
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