Abstract
The COVID-19 pandemic has had a major impact on health and social service systems (HSSS) worldwide. It has put tremendous pressure on these systems, threatening access, continuity, and the quality of patient care and services. In Quebec (Canada), the delivery of care and services has radically changed in a short period of time. During the pandemic, telehealth has been widely deployed and used, notwithstanding the decades-long challenges of integrating this service modality into the Quebec HSSS. Adopting a narrative-integrative approach, this article describes and discusses Quebec's experience with the deployment and utilization of telehealth in the context of COVID-19. Firstly, we introduced the achievements and benefits made with the use of telehealth. Secondly, we discussed the challenges and concerns that were revealed or accentuated by the sanitary crisis, such as: (1) training and information; (2) professional and organizational issues; (3) quality of services and patient satisfaction; (4) cost, remuneration, and funding; (5) technology and infrastructure; (6) the emergence of private telehealth platforms in a public HSSS; (7) digital divide and equity; and (8) legal and regulatory issues. Finally, the article presents recommendations to guide future research, policies and actions for a successful integration of telehealth in the Quebec HSSS as well as in jurisdictions and countries facing comparable challenges.
Highlights
The COVID-19 pandemic was a “stress test” for health and social service systems (HSSS) around the world [1,2,3]
This paper addresses : [1] training and information; [2] professional and organizational issues; [3] quality of services and patient satisfaction; [4] cost, remuneration, and funding; [5] technology and infrastructure; [6] the emergence of private telehealth platforms in a public HSSS; [7] digital divide and equity; and [8] legal and regulatory issues
COVID-19 has stimulated the use of telehealth in the delivery of care and services in an unprecedented way in the HSSS
Summary
The COVID-19 pandemic was a “stress test” for health and social service systems (HSSS) around the world [1,2,3]. The thoughts in this paper derive from the literature and our collective expertise as researchers, practitioners, and/or experts in digital health, medicine and public health, health technology assessment, and health services and policy It adopts a narrative-integrative and critical perspective with the main “objective of stimulating and encouraging debate” on telehealth in the context of COVID-19 and beyond [8]. The article describes several issues that have persisted for years and that had, or could have had, an impact on the successful deployment and use of telehealth in the context of COVID-19 It offers several recommendations and avenues to guide future policies and actions for the successful integration of telehealth in Quebec as well as in jurisdictions and countries facing comparable challenges. It provides a basis for future in-depth empirical research on, and evaluations of the impacts of the use of telehealth in HSSS and conditions for success and sustainability
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