Abstract
Background: The Southern Blood and Cancer Service covers the Southern region of New Zealand from Oamaru down to Stewart Island, providing services to largely rural based areas. Currently, those living rurally need to travel a distance to be reviewed in clinic by the oncologist between chemotherapy cycles.
Aim: The purpose of this research was to examine the available research literature to determine whether telehealth in the cancer care setting could improve access to care for rural oncology patients.
Design: An integrative literature review was undertaken using Whittmore and Knafl’s (2005) five step framework.
Methods: A literature search was conducted using three electronic databases. The collected data that met the review’s inclusion criteria were quality appraised using the Johanna Briggs Institute appraisal tools (Moola et al., 2020).
Findings: A total of 14 articles generated from the search strategy were quality appraised with 11 articles meeting the 70% or more criteria for acceptance. The key data was extracted using the Braun and Clarke (2006) six step analysis framework which generated four themes and six subthemes. Theme one discusses disparities in telehealth access with the subtheme’s telehealth barriers and areas for improvement. Theme two describes acceptance of telehealth with the subtheme’s satisfaction and positive experiences and benefits and cost/savings. Theme three explores the preference for mixed model of care. Theme four highlights a preference for local care with the subthemes building and strengthening relationships and support from family and friends.
Key implications: Telehealth has demonstrated significant potential in improving access to care for rural oncology patients, offering numerous benefits while highlighting barriers that must be addressed. This review emphasises the importance of mitigating these barriers to reduce health disparities and ensure equitable care. Integration of telehealth into oncology practice necessitates collaborative efforts, infrastructure development, and policy frameworks. Healthcare providers play a crucial role in promoting and integrating telehealth into routine care to enhance access and patient experience. For rural patients, telehealth expands access to specialist oncology services, addressing barriers like transportation and accommodation challenges. It supports comprehensive care through remote consultations for treatment management, survivorship planning, and palliative care. Embracing telehealth in rural oncology has the potential to significantly improve cancer care by improving quality of care and patient outcomes. Healthcare systems should adopt telehealth solutions proactively and resolve remaining barriers to achieve equitable care across all patient populations.
Conclusion: This integrative review examines telehealth's role in enhancing healthcare access for rural oncology patients. Synthesising extensive literature highlights telehealth's innovative potential while analysing barriers, acceptance rates, and delivery preferences. Key insights underscore the importance of reducing access disparities, ensuring satisfaction among patients and providers, and optimising a mixed model of care that combines telehealth and in-person consultations. Emphasising local support networks and tailored interventions for patient-centred care, the review acknowledges remaining gaps in care that must be addressed before widespread adoption of telehealth in New Zealand's rural oncology setting. Overall, this review offers a comprehensive perspective on the impact of telehealth, enriches current knowledge, and suggests directions for future research and practice.