Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, North Ryde, Australia.
The Daffodil Centre, Sydney, Australia.
J Med Internet Res. 2024 Aug 27;26:e57848. doi: 10.2196/57848.
Despite more than 2 decades of telehealth use in Australia and the rapid uptake during the COVID-19 pandemic, little is known about its unintended consequences beyond its planned and intended outcomes.
The aim of this review was to synthesize evidence on the unintended consequences of telehealth use in Australia to clarify its impact beyond its planned and intended outcomes.
We conducted a search of 4 electronic databases: Ovid MEDLINE, Ovid Embase, EBSCO CINAHL, and Scopus. A critical interpretive synthesis approach was adopted for its flexibility and interpretive nature. We extracted data about study characteristics and the types and models of telehealth services. The extracted unintended consequences were coded and mapped into the domains and dimensions of the Australian Health Performance Framework.
Of the 4241 records identified by the search, 94 (2.22%) studies were eligible for data extraction and analysis. Of these 94 studies, 23 (24%) reported largely positive unintended consequences of telehealth associated with health status, while 6 (6%) noted a potential negative impact of telehealth on socioeconomic status. The findings of 4 (4%) of the 94 studies highlighted societal and financial consequences of telehealth beyond the health system. Almost all studies (93/94, 99%) reported unintended consequences under the 5 dimensions of the Australian Health Performance Framework.
Our synthesis offers a framework for understanding the unintended consequences of the use of telehealth as an alternative to in-person care in Australia. While we have documented many unintended benefits of telehealth use, our findings also shed light on many challenges of delivering care via telehealth across different domains and dimensions. These findings hold significant practice and policy-making implications for ensuring safe and high-quality care delivery via telehealth.
尽管澳大利亚已经将远程医疗应用了二十多年，并且在 COVID-19 大流行期间迅速普及，但除了计划和预期的结果外，人们对其意外后果知之甚少。
本综述旨在综合澳大利亚使用远程医疗的意外后果的证据，以阐明其在计划和预期结果之外的影响。
我们对 4 个电子数据库进行了搜索：Ovid MEDLINE、Ovid Embase、EBSCO CINAHL 和 Scopus。采用关键解释性综合方法是因为其灵活性和解释性。我们提取了有关研究特征以及远程医疗服务类型和模式的数据。提取的意外后果被编码并映射到澳大利亚健康绩效框架的领域和维度中。
通过搜索共确定了 4241 条记录，其中有 94 项（2.22%）研究符合数据提取和分析的条件。在这 94 项研究中，有 23 项（24%）报告了与健康状况相关的远程医疗的主要意外后果，而 6 项（6%）则指出远程医疗对社会经济状况可能产生负面影响。在这 94 项研究中，有 4 项（4%）的研究结果强调了远程医疗对医疗体系之外的社会和经济后果。几乎所有研究（94/94，99%）都报告了澳大利亚健康绩效框架的 5 个维度下的意外后果。
我们的综合研究为理解澳大利亚将远程医疗作为替代面对面护理的使用的意外后果提供了一个框架。虽然我们已经记录了远程医疗使用的许多意外好处，但我们的研究结果也揭示了在不同领域和维度通过远程医疗提供护理的许多挑战。这些发现对通过远程医疗确保安全和高质量的护理服务具有重要的实践和决策意义。
