Austin Tujuanna, Tahsin Farah, Larsen Darren, Baker Ross, Steele Gray Carolyn
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
Women's College Hospital, Toronto, Canada.
PLOS Digit Health. 2025 Jun 11;4(6):e0000893. doi: 10.1371/journal.pdig.0000893. eCollection 2025 Jun.
During the COVID-19 pandemic, virtual care has proven instrumental in ensuring the continuity of healthcare services. In the context of virtual care's growing prominence and continued use, understanding how and why virtual care interventions are sustained will help healthcare systems to better prepare for future crises. The objectives of this scoping review were to construct a conceptualization of of virtual care sustainability and to describe factors influencing the sustainability of virtual care, shedding light on the determinants that shape its longevity and continued use. Literature describing the sustainability of virtual care interventions was summarized. Details of the intervention, setting, methodology, description and evidence of sustainability, and synopsis of key findings were documented. The charted data were summarized to gain a descriptive understanding of the data collected and to establish patterns. A conceptualization of virtual care intervention sustainability focused on the concepts of fidelity and adaptability. Sustainability of virtual care interventions were conceptualized as the intervention's ability to continue to be used according to its initial design, the extent to which the intervention continued to achieve its intended outcomes (fidelity), and the ability of the intervention to evolve as the context in which it is used also evolves (adaptability). While there were various definitions of sustainability referenced, no included studies mentioned a definition of sustainability specific to virtual care. Commonalities in definitions included the continued use of virtual care and the continuation of the benefits of virtual care for some period of time. Findings indicate that there is no "one size fits all" approach to achieving sustainability of virtual care interventions, but instead identify factors that may support or hinder sustainability. Important to understanding sustainability of virtual care interventions, is the complexity of the interactions that influence it. Specifically, the factors of fidelity and adaptability are found to be important to understanding the sustainability of virtual care interventions.
在新冠疫情期间，虚拟医疗已被证明在确保医疗服务连续性方面发挥了重要作用。在虚拟医疗日益突出并持续使用的背景下，了解虚拟医疗干预措施得以持续的方式和原因，将有助于医疗系统更好地为未来危机做好准备。本范围综述的目的是构建虚拟医疗可持续性的概念，并描述影响虚拟医疗可持续性的因素，揭示塑造其长期存在和持续使用的决定因素。总结了描述虚拟医疗干预措施可持续性的文献。记录了干预措施的细节、背景、方法、可持续性的描述和证据以及主要发现的概要。对绘制的数据进行了总结，以获得对所收集数据的描述性理解并建立模式。虚拟医疗干预措施可持续性的概念侧重于保真度和适应性的概念。虚拟医疗干预措施的可持续性被概念化为干预措施按照其初始设计继续被使用的能力、干预措施继续实现其预期结果的程度（保真度），以及干预措施随着其使用背景的演变而演变的能力（适应性）。虽然引用了各种可持续性的定义，但纳入的研究均未提及特定于虚拟医疗的可持续性定义。定义中的共同之处包括虚拟医疗的持续使用以及虚拟医疗的益处持续一段时间。研究结果表明，实现虚拟医疗干预措施的可持续性没有“一刀切”的方法，而是确定可能支持或阻碍可持续性的因素。理解虚拟医疗干预措施可持续性的重要一点是影响它的相互作用的复杂性。具体而言，发现保真度和适应性因素对于理解虚拟医疗干预措施的可持续性很重要。
