Osman Sagda, Churruca Kate, Ellis Louise A, Braithwaite Jeffrey
Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, North Ryde, Australia.
J Eval Clin Pract. 2025 Feb;31(1):e14270. doi: 10.1111/jep.14270.
Telehealth has been consistently viewed as a viable solution for addressing healthcare inaccessibility and mitigating the impact of health workforce shortages in rural areas. However, despite high utilisation in rural areas, little is known about the unintended consequences of telehealth in terms of unexpected benefits and drawbacks.
This study aimed to investigate the unintended consequences of telehealth in rural Australia.
A qualitative exploratory design was employed. Semi-structured interviews were conducted to examine the views of various stakeholders across Australia. Twenty participants were interviewed across Australia, including six telehealth consumers, six providers, six state government representatives and two primary health network representatives.
Findings on the unintended consequences of telehealth fell under three overarching themes with both reported unexpected benefits and drawbacks across each theme: (1) person-centred healthcare, (2) safety and quality of healthcare and (3) sustainability of rural healthcare. Under these themes, nine sub-themes were identified.
This study provides insights into the unintended consequences of telehealth. While telehealth has improved certain aspects of healthcare in rural areas such as the improved support for rural clinicians and the reduced disruption to patients' daily routines, it has also introduced unforeseen challenges such as the transfer of medicolegal burden to local clinicians in rural emergency care facilities to compensate for the absence of physical examinations. These findings feed into decision-making useful for informing and improving telehealth implementation in rural Australia to maximise unexpected benefits, minimise risks, and ensure the long-term viability of telehealth services.
远程医疗一直被视为解决医疗服务不可及问题以及减轻农村地区卫生人力短缺影响的可行方案。然而，尽管在农村地区利用率很高，但对于远程医疗在意外益处和弊端方面的意外后果却知之甚少。
本研究旨在调查澳大利亚农村地区远程医疗的意外后果。
采用定性探索性设计。通过半结构化访谈来考察澳大利亚各地不同利益相关者的观点。在澳大利亚各地对20名参与者进行了访谈，包括6名远程医疗消费者、6名提供者、6名州政府代表和2名初级卫生网络代表。
关于远程医疗意外后果的研究结果分为三个总体主题，每个主题都报告了意外的益处和弊端：（1）以患者为中心的医疗服务，（2）医疗服务的安全性和质量，（3）农村医疗服务的可持续性。在这些主题下，确定了九个子主题。
本研究深入探讨了远程医疗的意外后果。虽然远程医疗改善了农村地区医疗服务的某些方面，如加强了对农村临床医生的支持以及减少了对患者日常生活的干扰，但它也带来了一些意想不到的挑战，如在农村急诊设施中将法医学负担转移给当地临床医生以弥补体格检查的缺失。这些研究结果有助于决策，为澳大利亚农村地区远程医疗的实施提供信息并加以改进，以最大限度地实现意外益处、最小化风险并确保远程医疗服务的长期可行性。
