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Why Healthcare Technology Still Needs a Human Off-Ramp
My mother is 86 years old. She is a retired English teacher, still intelligent, articulate, independent, and very capable of advocating for herself.
But she no longer comfortably interacts with her pharmacy.
At her local CVS, the familiar process of walking to the counter and speaking with a pharmacy employee who knows her has changed. Now, a point-of-service tablet mounted on a post is required before she reaches the counter.
For many customers, that may seem like a small efficiency. For my mother, it has become a real barrier.
The first time she encountered it, she asked a pharmacy clerk she knew for help. The clerk was "too busy" behind the counter. After a brief hello, the store manager told her the tablets had nothing to do with the store, that they were "only the pharmacy."
She has not asked for help since. She simply avoids the interaction.
Now she relies on mail-order prescriptions, with the potential for delays in starting new therapies and without the same immediate, familiar pharmacist-to-patient interaction.
That is what digital exclusion in healthcare can look like. It does not always involve someone who lacks intelligence, education, a smartphone, or internet access. Sometimes it looks like a capable older adult quietly withdrawing from a healthcare interaction she previously managed successfully.
And that matters, because a pharmacy interaction is not simply a retail transaction. It can be an opportunity to ask a question, clarify instructions, mention a side effect, discuss a missed dose, or report a change that could affect medication safety.
Efficiency Is Not the Same as Accessibility
Healthcare technology is often designed to remove friction. Patient portals reduce phone calls. Online scheduling reduces staff workload. Digital registration speeds check-in. Remote monitoring allows more care to happen at home. All can improve access.
But we should ask: friction for whom? A process that removes work for an organization can unintentionally transfer that work to the patient.
My mother provides another example. She can competently use a digital blood pressure cuff. The technology itself is not difficult for her. But successful home monitoring requires much more than pressing the start button. She must remember proper positioning and posture, measure at a consistent time of day, interpret small variations, record the result, and remember how that information affects instructions about whether or when to take her medication. That is a significant cognitive burden.
I am a registered nurse with decades of healthcare experience, and I speak with my mother multiple times a day. Even with that support, the process frustrates her. Recently, she told me she was not going to check her blood pressure anymore because it stresses her out.
This illustrates a distinction we often miss: being able to operate a device is not the same as being able to manage the healthcare workflow surrounding it.
The Barrier We May Never See
Older adults may never tell us when technology has excluded them. Pride matters. So does embarrassment. A person who spent decades teaching students, building a career, running a household, or caring for others may have no desire to say, "I don't know how to do this."
Instead, they may stop asking questions, delay a refill, fail to record a reading, miss information, or let someone else take over a task they once handled independently.
From the organization's perspective, the technology may be working exactly as designed. From the patient's perspective, access may have quietly disappeared.
Technology Needs a Human Off-Ramp
This is not an argument against healthcare technology. Emerging technologies have extraordinary potential to improve access, especially for people who are geographically isolated, living with disabilities, managing chronic illness, or coordinating complicated care.
But accessible technology must be designed around the entire task, not simply the device or interface. Every digital-first healthcare process should have what I think of as a human off-ramp: an obvious, dignified way to say, "I'd rather talk to a person." No embarrassment. No penalty. No maze of screens before assistance becomes available.
We should stop measuring accessibility solely by whether a technology is available or whether a patient can physically operate it. The better question is: can the person successfully complete the healthcare task the technology was intended to make easier?
If the answer is no, we have not increased healthcare access. We may simply have built a newer barrier.
The future of healthcare should absolutely be digital. But if we want that future to be truly accessible, it must remain human, too.