Telehealth Experience Research Articles

Telehealth for HIV care and management among people living with HIV in Australia: results from an online survey.

Background The aims of this study were to evaluate the experiences of telehealth for routine HIV care and identify preferred models of HIV routine care for the future. Methods Anonymous, online questionnaire among people living with HIV aged 18years or older. This survey was advertised via posters with a QR code in six sexual health clinics and one community organisation as well as on social media from November 2021 to December 2022. Results Of 89 participants, the majority were males (80/89, 89.9%), between 36 and 55years old (49/89, 55.1%), spoke English at home (74/89, 84.1%), had been living with HIV for >5years (68/89, 76.4%) and reported having a telehealth consultation since the COVID-19 pandemic began (69/89, 77.5%). The top three liked aspects of telehealth were: the convenience of not leaving home or work (50/69, 72.5%); less travel time (48/69, 69.6%); and avoiding contact with other people (30/69, 43.5%). The top three dislikes of telehealth were: they could not be screened for sexually transmitted infections (STIs) or have a physical examination at the same time (29/69, 42.0%); it was an impersonal experience (20/69, 29.0%); and it was more difficult to discuss health concerns (18/69, 26.1%). Among all participants, the preference for future consultations was to have a mix between in-person and telehealth (40/89, 44.9%); however, nearly one-quarter prefer in-person consultations only (20/89, 22.5%). Conclusions Use of telehealth during COVID-19 has been evaluated positively among people living with HIV that participated in this survey. Participants support the use of telehealth for routine care in conjunction with in-person consultations.

Tracking Telehealth Needs for Individuals With Sickle Cell Disease Through the COVID-19 Pandemic: A Cross-Sectional Survey Study.

Pervasive disparities characterize sickle cell disease (SCD) care, including limited access to SCD specialists. Rapid deployment of remote healthcare provision and support during the COVID-19 pandemic provides an opportunity to understand telehealth barriers/facilitators for SCD. We aimed to evaluate telehealth experiences and satisfaction for routine visits among adults and caregivers of children with SCD within a US regional collaborative. 151 adults ≥ 18 [median (IQR) = 36 (28, 43) years], and 94 caregivers [median child age (IQR) = 12 (7, 14) years] completed a 30-item online survey in 2021 assessing systems issues such as reliable Internet; health information sharing; and consumer focus (e.g., visit started on time). A multivariable logistic regression model was used to evaluate relations between independent variables and the outcome overall satisfaction with telehealth. Patients were primarily diagnosed with sickle cell anemia (60.8%) and prescribed hydroxyurea (57.6%). Satisfaction with telehealth was high (> 90%), but 60.6% of caregivers gave the highest rating compared with 44.9% of adults (p = 0.02). Few accessibility/technical issues were cited, however, caregivers reported more often having home support for telehealth (80.9% vs. 63.6%, p = 0.003). In multivariable analyses, participants seen in large centers (> 200) were more likely to give the highest satisfaction ratings compared with those in smaller centers (< 100, aOR: 2.33; 95% CI: 1.21, 4.48, p = 0.01); however, those who needed help from a telehealth navigator were less likely to give the highest telehealth experience rating versus those who did not need help (aOR: 0.37; 95% CI: 0.19, 0.71, p = 0.003). Views of telehealth were favorable, although caregivers reported greater satisfaction and resources compared with adults with SCD. It remains important to identify factors related to telehealth utilization and efficacy for SCD populations in varied geographies and settings, to ensure equity in access.

Investigating patient satisfaction with a hand therapy telehealth service during COVID-19.

Throughout the COVID-19 pandemic, outpatient hand therapy services were restricted. The use of telehealth was adopted to continue to provide care to patients with hand injuries. This survey aims to investigate patient satisfaction with hand therapy delivered via telehealth in a NSW public tertiary referral metropolitan setting and explore whether this differs for specific hand injury/conditions and treatments offered. Patients using hand therapy services via telehealth between 28 June 2021 and 27 May 2022 responded to a bespoke electronic survey. Participants were grouped depending on their particular injury/condition and treatment received. Analysis was conducted using MS Excel, and correlations were determined by using Fisher's exact test. No consumers were involved in the study design or analysis. Sixty-eight of 262 patients responded to the survey (26% response rate). Overall results showed high patient satisfaction (n = 55, 81%) with hand therapy delivered via telehealth with most patients agreeing that telehealth should be offered going forward (n = 59, 87%). Benefits reported by patients included convenience, reduced travel time and parking issues, and time saving. Patients receiving therapy for 'finger thumb bony injury with K wires' demonstrated a statistically significant association of lower satisfaction with telehealth (n = 3, 43%, P = 0.02). Patients receiving wound care over telehealth were just as satisfied with their experience (n = 15, 82%) as overall results (n = 55, 81%). The survey suggests that patients are satisfied with their experience of telehealth for hand therapy. Patients with finger thumb bony injuries with k wires may be less suitable for telehealth. Wound care appears to be well received over telehealth in a hand therapy population. There is little evidence to guide hand therapists in which conditions or injuries patients find can be managed well with telehealth. Patients who answered a survey about their experience with telehealth for their hand therapy management overall reported satisfaction with the experience. Some patients had undergone surgery for broken fingers and thumbs using wires to hold the bone together while it healed. These patients were less likely to find telehealth satisfactory for their hand therapy care. Most patients requiring wound care over telehealth found this satisfactory.

Examining the Relation Between Telehealth Experiences in Early Intervention and Rurality Among Families of Young Children With Developmental Disabilities

The Individuals with Disabilities Education Act (IDEA, 2004) governs the Early Intervention (EI) system for families of children aged zero to three with developmental delays and disabilities. As a result of the COVID-19 pandemic, many states offer telehealth as a way for families to receive their EI services. Given the limited EI providers in rural areas, it seems that telehealth may especially help rural families to access EI services. However, little research has been done in relation to family use and satisfaction with telehealth in relation to rurality. To this end, we conducted a statewide survey of 256 families of children in EI about their use of EI services via telehealth. There was a negative correlation between family satisfaction with telehealth and rurality, with rural families being more dissatisfied with telehealth. Implications for practice and research are discussed.

Teledialysis: The First Northeast Italy Experience of Telehealth in Peritoneal Dialysis

Teledialysis: The First Northeast Italy Experience of Telehealth in Peritoneal Dialysis

Obstacles and enablers for using telehealth services online in nursing practice: A systematic review

Background: Comprehensive reporting on the barriers and enablers to telehealth adoption in industrialized nations has identified a wide range of significant factors. We aimed to get the important research information on the elements that nurses found most beneficial and hindering when using online telehealth services for nursing practice, we conducted a systematic review study. Method: This systematic review study was conducted in accordance with PRISMA principles. We searched for articles that discussed the aspects of using telehealth services for nursing practicum that nurse practitioners found most helpful and inconvenient. The international electronic databases that were used were Web of Science, Scopus CINAHL, and PubMed. The search was conducted for articles published in the period from 2011 and 2023. Only research that were written in English and published were considered. Results: We considered 7 articles in our systematic review analysis, totaling 3729 participants. Inadequate resources (time, money) were mentioned as barriers relevant to both organizational and patient issues. Negative attitudes, a lack of telehealth experience, and inadequate training and support were considered to be impediments to the use of telehealth (3). According to the findings of the Kleib et al., 2018 study, the following variables affect user competency and proficiency: age; Prerequisites for qualifying include prior knowledge of information technology and a sufficient, early, and continual informatics education. Conclusion: Numerous facilitators and obstracles were identified. In addition to administrative support, health professionals and information technology specialists must come to local agreements when transitioning from traditional face-to-face nursing practice to telehealth utilization.

Evaluation of telehealth in delivering diagnostic developmental assessments for children in South Western Sydney during the COVID-19 pandemic: Clinician and family perspectives.

Children with neuro-developmental disorders faced significant challenges in accessing services during the COVID-19 pandemic. Telehealth has been adopted by health services globally to facilitate access to clinical services. Our aims were to evaluate the utility of the telehealth modality for providing developmental assessment services and explore enablers and barriers to using telehealth, in a culturally diverse and socioeconomically disadvantaged population in Sydney. We reviewed telehealth developmental assessments in South Western Sydney conducted between 1 April and 30 June 2020. Data were collated on demographics; telehealth modality; diagnostic formulation; recommendations; and requested follow up. We conducted retrospective semi-structured telephone interviews with 79 families and 11 clinicians about their telehealth experience. Thematic analysis was carried out on the open text responses. Of 205 children assessed across six sites, median age was 48 months; 45% were assessed with video and 55% with telephone only. Diagnostic formulation and therapeutic recommendations were provided for 203 (99%) children and 138 (67%) were asked to come for face-to-face follow-up. The majority of families (76%) were satisfied or extremely satisfied with telehealth. Median clinician satisfaction was 3.5 out of 5, whilst clinician confidence with diagnostic formulation was 4 out of 5. Qualitative data revealed a range of barriers and enablers. Telehealth was a successful modality for contributing to the assessment journey for children with neuro-developmental disorders in our culturally, linguistically and socioeconomically diverse clinical population in the context of a pandemic lockdown. We discuss the potential for telehealth modalities in child developmental assessments beyond the pandemic.

Telehealth development in the WHO European region: Results from a quantitative survey and insights from Norway

BackgroundThe COVID-19 pandemic sent shock waves through societies, economies, and health systems of Member States in the WHO European Region and beyond. During the pandemic, most countries transitioned from a slow to a rapid adoption of telehealth solutions, to accommodate the public health and social measures introduced to mitigate the spread of the disease. As countries shift to a post-pandemic world, the question remains whether telehealth’s importance as a mode of care provision in Europe continues to be significant. ObjectiveThis paper aims to present, synthesize, and interpret results from the Telehealth Programmes section of the 2022 WHO Survey on Digital Health (2022 WHO/Europe DH Survey). We specifically analyze the implementation and use of teleradiology, telemedicine, and telepsychiatry. Norwegian telehealth experiences will be used to illustrate survey findings, and we discuss some of the relevant barriers and facilitators that impact the use of telehealth services. MethodsThe survey tool was revised from the 2015 WHO Global Survey on eHealth, updated to reflect recent progress and policy priorities.The 2022 WHO/Europe DH Survey was conducted by WHO and circulated to Member States in its European Region from April to October 2022. ResultsThe data analysis revealed that teleradiology, telemedicine, and telepsychiatry are the telehealth services most commonly used in the WHO European Region in 2022. Funding remains the most significant barrier to the implementation of telehealth in the Region, followed by infrastructure and capacity/human resources. The survey results highlighted in this study are presented in the following sections: (1) telehealth strategies and financing, (2) telehealth programmes and services offered by Member States of the WHO European Region, (3) barriers to implementing telehealth services, and (4) monitoring and evaluation of telehealth. ConclusionBased on WHO’s 2022 survey, the use of telehealth in the WHO European Region is on the rise. However, merely having telehealth in place is not sufficient for its successful and sustained use for care provision. Responses also uncovered regional differences and barriers that need to be overcome. Successful implementation and scaling of telehealth requires rethinking the design of health and social care systems to create robust, trustworthy, and person-centred digital health and care services.

"It's a Very Good Second Option": Older Adults' Experience of Telehealth.

The growing ability to provide online services has enabled the proliferation of exercise-based telehealth interventions; however, adoption in older adults may be impacted by low digital literacy and "technophobia." The aim of this study was to explore the experience of community and aged-care dwelling older adults following exercise-based telehealth services to provide insights that could guide future telehealth exercise delivery. Semi-structured interviews for qualitative analysis. Participants (age ≥60) who had completed at least one online exercise session from a registered health professional were recruited through a combination of purposeful and snowball sampling methods via their exercise facility or provider. A semi-structured interview guide was used by 2 interviewers to investigate participants' experiences and a "critical friends" approach used to identify common themes. Thirteen interviews with 21 participants were conducted from 2 different facilities. Analysis identified meaning units within 3 themes and subthemes. Technology subthemes related to digital confidence prior to telehealth and changes during interventions, as well as the usability of technology for telehealth. Clinical practice subthemes described the different motivations to exercise, perceived benefits of telehealth, important implications for practitioners, and perceptions of safety. The social connection theme related to the social benefits of telehealth. Older adults in our sample were technologically confident and capable of performing exercise sessions delivered via telehealth. They notice benefits from this form of exercise delivery however, prefer face-to-face exercise delivery.

Crisis Response in Nursing Education: An Integrative Review of Nursing Program Adaptation to COVID-19.

This integrative review sought to systematically examine and synthesize published research on crisis response to identify ways in which undergraduate nursing education programs in various countries adapted to the coronavirus disease 2019 (COVID-19) pandemic. A computerized search of CINAHL, Science Direct, and Web of Science databases was performed. The literature search, review, and data extraction process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) format of identification, screening, eligibility, and inclusion. Digital learning technology platforms were used in undergraduate nursing education in various ways to adapt to the teaching and learning challenges of the COVID-19 pandemic. Teaching and learning methodologies identified included online lectures and webinars; interactive virtual learning experiences, such as videos, presentations, quizzes, games, and other web-based interactive forms of multimedia files and textual content; and virtual simulations for nursing skills and tele-health experience. [J Nurs Educ. 2024;63(7):445-451.].

Standardizing Competencies and Enhancing Professionalism Through a Telepresenter Certificate Program

Background: Telehealth researchers frequently identify barriers to telehealth delivery, but often their literature does not propose change management strategies to improve access to care through telehealth. Systematic reviews support findings that education and training are lacking to ensure high-quality telehealth delivery. Curriculum that addresses technical skills, provides a clinical perspective for addressing digital health care, and proposes best practices can build the foundation for a competent telehealth workforce — most crucially, telepresenters. Objective: Recognizing an unmet need for standardized training for telepresenting health care professionals, the U.S. Department of Veterans Affairs’ Office of Connected Care (VA OCC) built on its prior telehealth experience to create a Telepresenter Certificate Program (TCP) in partnership with the University of Florida College of Nursing (UF CON). This paper describes the program’s curriculum, the educational methods used, and learners’ responses to a summative survey that evaluated the TCP’s impact. Methods: VA OCC and UF CON created a curriculum encompassing two courses. The first course was an introduction to the current knowledge regarding digital health, including the role of clinical informatics, electronic health records, patient-generated health data, and trends in data use in health care. The second course helped learners understand required telehealth competencies through patient case scenarios and covered topics such as how to telepresent virtual medical exams and apply these skills in practice. Results: Over a total of four TCP cohorts, 909 learners completed the program. Among overall learners, 87% agreed or strongly agreed that “they will be able to apply the knowledge and skills learned to effectively assist telehealth providers in delivering patient care using telehealth technology.” On average, 94% of TCP completers were satisfied with the program. Discussion: VA OCC’s partnership with UF CON successfully created a novel curriculum to standardize competencies and enhance professionalism for the telepresenter role through the TCP. Learners positively endorsed their acquisition of skills and their satisfaction with the program. The TCP offers a viable model for other health care consortiums to standardize competencies and enhance professionalism for telepresenters, resulting in improved telehealth quality and increased health care access.

Experiences of telehealth during and after the COVID-19 pandemic and preferences for future care of people with systemic sclerosis: a cross-sectional study

Experiences of telehealth during and after the COVID-19 pandemic and preferences for future care of people with systemic sclerosis: a cross-sectional study

Exploring physicians’ expectations of telehealth services implementation in primary care: An application of the social cognitive theory

ABSTRACT Background: Understanding healthcare professionals’ expectations in telehealth is crucial for successful implementation. The present study used an adaptation of the antecedents-expectations model, supported by the social cognitive theory to evaluate physicians’ expectations regarding the implementation of telehealth in primary healthcare (PHC) and to investigate the potential influence, on expectations, of a prior telehealth experience (antecedents) during the Coronavirus disease 2019 (COVID-19) pandemic. Materials and Methods: A questionnaire-based survey was conducted online, targeting PHC physicians. Expectations covered four telehealth performance domains including public health and health promotion, Care Quality and Workflow Organization, Patient’s Convenience and Engagement and Providers’ Value and Training. Antecedents included six domains including gain in self-efficacy, gain in knowledge, gain in participation/engagement, gain in experience, enjoyment and satisfaction. Stepwise linear regression was performed to analyse the effect of antecedents on overall expectations. Results: A total of 54 physicians participated in the study. The mean expectation score was 114.15/154 (SD = 28.26), with highest expectations concerning cost-effectiveness, care timeliness and patients’ convenience. A previous experience with smart apps and dedicated telehealth platforms was associated with lower expectations scores. Expectations scores were positively correlated with antecedents scores; however, satisfaction was the sole independent factor of overall expectations (regression coefficient B = 4.40, 95%CI: 3.11–5.68). Conclusion: The findings highlight the significance of previous experience and various antecedents in shaping physicians’ expectations about telehealth. These insights can inform the development of strategies and interventions to enhance healthcare professionals’ expectations and facilitate the successful implementation of telehealth services.

The use of telehealth in attention-deficit/hyperactivity disorder: a survey of parents and caregivers.

The use of telehealth became widespread during the COVID-19 pandemic, including in child and adolescent attention-deficit/hyperactivity disorder (ADHD) services. Telehealth is defined as live, synchronous phone and video appointments between a healthcare provider and a parent and/or child with ADHD. There is a dearth of research on the use of telehealth within this population. The aim of this study was to examine parents' and caregivers' perceptions of telehealth for children and adolescents with ADHD. A cross-sectional survey design was employed. Recruitment of parents and caregivers of children and adolescents with ADHD was conducted online. The survey asked participants about their views of telehealth, previous experience, and willingness to use telehealth. Quantitative data were analysed using STATA. Qualitative data were analysed using content analysis. One hundred and twelve respondents participated in the survey. Participants were mostly female (n = 97, 86.6%) and aged between 45 and 54 (n = 64, 57.1%). Of the 61 (54.5%) participants with experience of telehealth, the majority reported that that they were at least satisfied with telehealth visits (n = 36, 59%), whilst approximately half rated their quality more poorly than in-person visits (n = 31, 50.8%). The majority of respondents (n = 91, 81.3%) reported that they would be willing to use telehealth for their child's future appointments. Most common reasons selected for wanting to use telehealth included saving time, improvements to the family routine, and reducing costs. Reasons selected for not wanting to use telehealth included not being able to receive hands-on care, belief that the quality of care is poorer than in-person consultations, and distraction of the child during telehealth visits. The study demonstrates that parents recognise deficits and benefits of telehealth, suggesting a need to build their trust and confidence in remote ADHD care.

Telehealth Experience Among Patients With Limited English Proficiency

This cross-sectional study assesses the implication of patients’ English language skills for telehealth use and visit experience.

Humanism during the COVID-19 pandemic: video call as a strategy to satisfy the communication needs of Intensive Care Unit patients and their family members.

Background: Patients affected by the COVID-19 pandemic required physical/social isolation due to the transmissibility of SARs CoV-2; those hospitalized in healthcare facilities often suffered loneliness due to a complete separation from their loved ones through visitor restrictions.(1) Human contact and movement were restricted to contain the spread of disease. When this kind of restriction must be employed, the “Guidance for Managing Ethical Issues in Infectious Disease Outbreaks”, states that it is necessary to provide people with “effective alternative communication strategies”. (2) Methods: This is an observational descriptive study that uses qualitative variables to analyze information obtained by virtual focus groups consisting of either medical professionals or family members of hospitalized patients in the ICU of the Eugenio Espejo Hospital (EEH) in Quito, Ecuador. Each video call allowed us to assess anonymous opinions concerning communication methods utilized during the delivery of daily clinical updates in the ICU. By focusing on a patient-and family-centered model, this study aims to minimize the impact of social isolation in hospitalized patients through the implementation of regular doctor-led video conference calls with family members, as well as video calls between the patient and family members when feasible.(1) Results: This study evaluates the increased satisfaction of family members and medical professionals with the implementation of video calls when compared to traditional telephone calls. A contrast between the time before implementing the telehealth team and the time afterward was observed in at least five positive characteristics: 1) the general telehealth experience, 2) the clarity of the messages, 3) the quality of care, 4) the sense of comfort, and 5) the improvement of communication. Conclusions: There was a positive effect on communication quality for both family members and medical professionals, increasing their satisfaction in terms of finding new methods to reduce the social isolation enforced by the current pandemic. Nevertheless, the future role of virtual communication remains undefined as we return to individualized face-to-face meetings.

Telehealth Education in Allied Health Care and Nursing: Web-Based Cross-Sectional Survey of Students' Perceived Knowledge, Skills, Attitudes, and Experience.

The COVID-19 pandemic has highlighted the growing relevance of telehealth in health care. Assessing health care and nursing students' telehealth competencies is crucial for its successful integration into education and practice. We aimed to assess students' perceived telehealth knowledge, skills, attitudes, and experiences. In addition, we aimed to examine students' preferences for telehealth content and teaching methods within their curricula. We conducted a cross-sectional web-based study in May 2022. A project-specific questionnaire, developed and refined through iterative feedback and face-validity testing, addressed topics such as demographics, personal perceptions, and professional experience with telehealth and solicited input on potential telehealth course content. Statistical analyses were conducted on surveys with at least a 50% completion rate, including descriptive statistics of categorical variables, graphical representation of results, and Kruskal Wallis tests for central tendencies in subgroup analyses. A total of 261 students from 7 bachelor's and 4 master's health care and nursing programs participated in the study. Most students expressed interest in telehealth (180/261, 69% very or rather interested) and recognized its importance in their education (215/261, 82.4% very or rather important). However, most participants reported limited knowledge of telehealth applications concerning their profession (only 7/261, 2.7% stated profound knowledge) and limited active telehealth experience with various telehealth applications (between 18/261, 6.9% and 63/261, 24.1%). Statistically significant differences were found between study programs regarding telehealth interest (P=.005), knowledge (P<.001), perceived importance in education (P<.001), and perceived relevance after the pandemic (P=.004). Practical training with devices, software, and apps and telehealth case examples with various patient groups were perceived as most important for integration in future curricula. Most students preferred both interdisciplinary and program-specific courses. This study emphasizes the need to integrate telehealth into health care education curricula, as students state positive telehealth attitudes but seem to be not adequately prepared for its implementation. To optimally prepare future health professionals for the increasing role of telehealth in practice, the results of this study can be considered when designing telehealth curricula.

Development of a Telehealth Simulation Using Intraprofessional Collaboration.

Telehealth allows access to high-quality, holistic patient care, including diagnosis, interventions, treatments, monitoring, and patient education. As the use of telehealth continues to increase, faculty considered the need for entry-level nursing students to be introduced to telehealth and its services. Faculty from the medical-surgical II and mental health courses developed a learning experience for students that blends concepts from both courses, as patients often present with multiple problems. The telehealth experience helped students utilize assessment skills, learn delegation, and connect concepts from two courses to provide care for a patient remotely.

Patient factors associated with telehealth quality and experience among adults with chronic conditions.

To evaluate patient-reported experiences of telehealth and disparities in access, use, and satisfaction with telehealth during the COVID-19 pandemic. We examined data from the fifth wave of the COVID-19 & Chronic Conditions (C3) study conducted between December 2020 and March 2021. Of the 718 participants, 342 (47.6%) reported having a telehealth visit within the past 4months. Participants who had a recent telehealth visit were younger, reported worse overall health and chronic illness burden, and living below poverty level. Among participants who had a telehealth visit, 66.7% reported telephone visits and most participants (57.6%) rated telehealth quality as better-or-equal-to in-person visits. Inadequate health literacy was associated with lower likelihood of reporting telehealth quality and usefulness. In multivariable analyses, lower patient activation (adjusted odds ratio (AOR) 0.19, 95% CI, 0.05-0.59) and limited English proficiency (AOR 0.12, 95% CI, 0.03-0.47) were less likely to report telehealth as being better than in-person visits; lower patient activation (AOR 0.06, 95% CI, 0.003-0.41) and income below poverty level (AOR 0.36, 95% CI, 0.13-0.98) were associated with difficulty remembering telehealth visit information. Most participants reported usefulness and ease of navigating telehealth. Lower socioeconomic status, limited English proficiency, inadequate health literacy, lower educational attainment, and low patient activation are risks for poorer quality telehealth. The COVID pandemic has accelerated the adoption of telehealth, however, disparities in access and self-reported visit quality persist. Since telemedicine is here to stay, we identify vulnerable populations and discuss potential solutions to reduce healthcare disparities in telehealth use.

Therapist perspectives on telehealth-based virtual reality exposure therapy

Virtual reality (VR) can enhance mental health care. In particular, the effectiveness of VR-based exposure therapy (VRET) has been well-demonstrated for treatment of anxiety disorders. However, most applications of VRET remain localized to clinic spaces. We aimed to explore mental health therapists’ perceptions of telehealth-based VRET (tele-VRET) by conducting semi-structured, qualitative interviews with 18 telemental health therapists between October and December 2022. Interview topics included telehealth experiences, exposure therapy over telehealth, previous experiences with VR, and perspectives on tele-VRET. Therapists described how telehealth reduced barriers (88.9%, 16/18), enhanced therapy (61.1%, 11/18), and improved access to clients (38.9%, 7/18), but entailed problems with technology (61.1%, 11/18), uncontrolled settings (55.6%, 10/18), and communication difficulties (50%, 9/18). Therapists adapted exposure therapy to telehealth by using online resources (66.7%, 12/18), preparing client expectations (55.6%, 10/18), and adjusting workflows (27.8%, 5/18). Most therapists had used VR before (72.2%, 13/18) and had positive impressions of VR (55.6%, 10/18), but none had used VR clinically. In response to tele-VRET, therapists requested interactive session activities (77.8%, 14/18) and customizable interventions components (55.6%, 10/18). Concerns about tele-VRET included risks with certain clients (77.8%, 14/18), costs (50%, 9/18), side effects and privacy (22.2%, 4/18), and inappropriateness for specific forms of exposure therapy (16.7%, 3/18). These results reveal how combining telehealth and VRET may expand therapeutic options for mental healthcare providers and can help inform collaborative development of immersive health technologies.