Abstract
BackgroundTelehealth, as other information and communication technologies (ICTs) introduced to support the delivery of health care services, is considered as a means to answer many of the imperatives currently challenging health care systems. In Canada, many telehealth projects are taking place, mostly targeting rural, remote or isolated populations. So far, various telehealth applications have been implemented and have shown promising outcomes. However, telehealth utilisation remains limited in many settings, despite increased availability of technology and telecommunication infrastructure.MethodsA qualitative field study was conducted in four remote regions of Quebec (Canada) to explore perceptions of physicians and managers regarding the impact of telehealth on clinical practice and the organisation of health care services, as well as the conditions for improving telehealth implementation. A total of 54 respondents were interviewed either individually or in small groups. Content analysis of interviews was performed and identified several effects of telehealth on remote medical practice as well as key conditions to ensure the success of telehealth implementation.ResultsAccording to physicians and managers, telehealth benefits include better access to specialised services in remote regions, improved continuity of care, and increased availability of information. Telehealth also improves physicians' practice by facilitating continuing medical education, contacts with peers, and access to a second opinion. At the hospital and health region levels, telehealth has the potential to support the development of regional reference centres, favour retention of local expertise, and save costs. Conditions for successful implementation of telehealth networks include the participation of clinicians in decision-making, the availability of dedicated human and material resources, and a planned diffusion strategy. Interviews with physicians and managers also highlighted the importance of considering telehealth within the broader organisation of health care services in remote and rural regions.ConclusionThis study identified core elements that should be considered when implementing telehealth applications with the purpose of supporting medical practice in rural and remote regions. Decision-makers need to be aware of the specific conditions that could influence telehealth integration into clinical practices and health care organisations. Thus, strategies addressing the identified conditions for telehealth success would facilitate the optimal implementation of this technology.
Highlights
Telehealth, as other information and communication technologies (ICTs) introduced to support the delivery of health care services, is considered as a means to answer many of the imperatives currently challenging health care systems
In order to better understand the conditions promoting or limiting telehealth integration, this study explored telehealth's effects on several dimensions related to the practice of health care professionals in rural and remote regions of Quebec
Perceived telehealth benefits For a majority of physicians and managers, telehealth was perceived as a powerful tool to improve healthcare services for populations living in remote areas
Summary
Telehealth, as other information and communication technologies (ICTs) introduced to support the delivery of health care services, is considered as a means to answer many of the imperatives currently challenging health care systems. Telehealth is considered a major innovation at the technological, social, and cultural levels[1]. This technology has the potential to increase access to, and quality of, health care services and to lower health system expenditures[2,3]. Introducing telehealth as a tool to support the delivery of health care services implies numerous changes for providers, organisations, and the health system as a whole that must be accounted for during the implementation process[4]. Results from a majority of the reviewed studies support telehealth over other traditional modes of health services delivery. Other studies have reported telehealth benefits with respect to continuity of patient care and coordination of clinical activities between various health care organisations and levels of care [7,8,9,10]
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