Abstract
Aim /objective: This review was aimed at exploring the experiences and perceptions of healthcare professionals' and patients' use of telehealth within rural communities in order to inform development of this mode of health service delivery.
Background: Rural health disparities are a major public health problem. Within the literature these disparities are acknowledged and viewed as primarily due to inequitable access to quality healthcare. For many years telehealth has been considered as a means of enabling those living in rural and remote localities and those servicing these communities to more conveniently manage timely access health advice and consultations. However, how receptive are they to this mode of healthcare delivery?
Method: To explore the experiences, an integrative review was carried out using Whittemore and Knalf's (2015) five stage process. A literature search was conducted in the following databases, three OVID databases; Emcare, MEDLINE and nursing database and the Cumulative Index to Nursing and Allied Health Literature (CINAHL). The keywords for the search were: telehealth, telemedicine, rural health, rural, rural population, healthcare, health services accessibility. Following a rigorous selection process, seventeen highly relevant articles on primary research were retrieved and subsequently all underwent quality appraisal using Joanna Briggs Institute (JBI, 2015) validated tools. All met the threshold and were included in data analysis. The Braun and Clarke (2006) six phase thematic analysis framework was used to analyse the findings of each article.
Results/Findings: Three themes emerged; personal preferences; increased access to healthcare; technology issues. Each theme has two subthemes exploring the themes in greater depth. Findings indicated that there were differences between patients and healthcare professionals(HPs) views on telehealth depending on whether they had personally experienced the modality or had yet to use it. There were also differences between patients and healthcare providers preferences. However, the saving of travel costs, time and expediting consultations with urban based specialists were viewed as a positive feature of telehealth by those who had used it.
Future development of telehealth should focus on barriers to the use of technology, as well as ensuring patients and HPs' have positive exposure to telehealth in order to encourage its use. Future research should focus on, how telehealth can improve patient health outcomes. Overall, once the reliability of the medium was more consistent, telehealth was viewed as having the potential to provide an acceptable service for specific health related activities.