Krahe Michelle A, Baker Stephanie, Woods Leeanna, Larkins Sarah L
College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia.
College of Science and Engineering, James Cook University, Cairns, Queensland, Australia.
Aust J Rural Health. 2025 Apr;33(2):e70045. doi: 10.1111/ajr.70045.
INTRODUCTION: Digital transformation can enhance health and healthcare delivery; however, its application in rural, regional, and remote (RRR) areas presents considerable, underexplored challenges. While the benefits of digital health for underserved areas are evident, we must understand and address the challenges to fully realise its impact. OBJECTIVE: To synthesise the evidence for factors influencing the implementation of digital health in RRR Australia and recommend implementation strategies to address barriers. DESIGN: An overview of existing reviews was conducted to identify relevant systematic and scoping reviews. Review quality was assessed using the AMSTAR-2 tool. Barriers and enablers to implementation were mapped using the Consolidated Framework for Implementation Research (CFIR), and strategies to address barriers were identified based on the Expert Recommendations for Implementation Change (ERIC). FINDINGS: Three reviews met the inclusion criteria; each was focused on telehealth and remote monitoring technologies. Influencing factors were identified across five CFIR domains, encompassing 16 barrier and 12 enabler constructs. While gaps in evidence on health outcomes were noted, the benefits of implementation, such as improved access to services, reduced travel, and enhanced patient satisfaction, were highlighted. The recommended implementation strategies involved tailoring interventions to local needs, fostering local leadership and advocacy, planning and structuring implementation, and mobilising resources. CONCLUSION: This study identified key influencing factors and recommended implementation strategies to mitigate barriers. These strategies, if employed, could facilitate the successful implementation of digital health in RRR Australia. TRIAL REGISTRATION: PROSPERO CRD42024512742.
引言:数字转型可以改善健康状况并提升医疗服务的提供;然而,其在农村、地区和偏远(RRR)地区的应用带来了诸多尚未得到充分探索的重大挑战。虽然数字健康对服务不足地区的益处显而易见,但我们必须了解并应对这些挑战,以充分实现其影响。 目的:综合有关影响澳大利亚RRR地区数字健康实施的因素的证据,并推荐应对障碍的实施策略。 设计:对现有综述进行概述,以确定相关的系统综述和范围综述。使用AMSTAR-2工具评估综述质量。使用实施研究综合框架(CFIR)绘制实施的障碍和推动因素,并根据实施变革专家建议(ERIC)确定应对障碍的策略。 结果:三项综述符合纳入标准;每项综述都聚焦于远程医疗和远程监测技术。在CFIR的五个领域中确定了影响因素,包括16个障碍和12个推动因素结构。虽然注意到健康结果证据方面的差距,但强调了实施的益处,如改善服务可及性、减少出行和提高患者满意度。推荐的实施策略包括根据当地需求调整干预措施、培养地方领导力和倡导、规划和构建实施过程以及调动资源。 结论:本研究确定了关键影响因素并推荐了减轻障碍的实施策略。如果采用这些策略,可能会促进数字健康在澳大利亚RRR地区的成功实施。 试验注册:PROSPERO CRD42024512742。
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