Patient and provider perspectives on eHealth interventions in Canada and Australia: a scoping review

Autor: S. Petrie, Dean B. Carson, Saambavi Paskaran, Paul A. Peters, Michele LeBlanc
Rok vydání: 2020
Předmět:
Rural Population
Canada
Emergency Medical Services
Telemedicine
Health (social science)
020205 medical informatics
lcsh:Special situations and conditions
education
Population
Psychological intervention
Medicine (miscellaneous)
02 engineering and technology
Telehealth
Health Services Accessibility
patient perspectives
telehealth
primary care
03 medical and health sciences
0302 clinical medicine
Nursing
Health care
0202 electrical engineering
electronic engineering
information engineering

eHealth
Humans
030212 general & internal medicine
Referral and Consultation
Physician-Patient Relations
education.field_of_study
Primary Health Care
business.industry
lcsh:RC952-1245
lcsh:Public aspects of medicine
Australia
Public Health
Environmental and Occupational Health

Health technology
lcsh:RA1-1270
Patient Acceptance of Health Care
Family life
Business
Zdroj: Rural and Remote Health, Vol 20 (2020)
ISSN: 1445-6354
DOI: 10.22605/rrh5754
Popis: Introduction: Despite the promises of universal health care in most developed countries, health inequities remain prevalent within and between rural and remote communities. Remote health technologies are often promoted as solutions to increase health system efficiency, to enhance quality of care, and to decrease gaps in access to care for rural and remote communities. However, there is mixed evidence for these interventions, particularly related to how they are received and perceived by health providers and by patients. Health technologies do not always adequately meet the needs of patients or providers. To examine this, a broad-based scoping review was conducted to provide an overview of patient and provider perspectives of eHealth initiatives in rural communities. The unique objective of this review was to prioritize the voices of patients and providers in discussing the disparities between health interventions and needs of people in rural communities. eHealth initiatives were reviewed for rural communities of Australia and Canada, two countries that have similar geographies and comparable health systems at the local level. Methods: Searches were performed in PubMed, Scopus, and Web of Science with results limited from 2000 to 2018. Keywords included combinations of 'eHealth', 'telehealth', 'telemedicine', 'electronic health', and 'rural/remote'. Individual patient and provider perspectives on health care were identified, followed by qualitative thematic coding based on the type of intervention, the feedback provided, the affected population, geographic location, and category of individual providing their perspective. Quotes from patients and providers are used to illustrate the identified benefits and disadvantages of eHealth technologies. Results: Based on reviewed literature, 90.1% of articles reported that eHealth interventions were largely positive. Articles noted decreased travel time (18%), time/cost saving (15.1%), and increased access to services (13.9%) as primary benefits to eHealth. The most prevalent disadvantages of eHealth were technological issues (24.5%), lack of face-to-face contact (18.6%), limited training (10.8%), and resource disparities (10.8%). These results show where existing eHealth interventions could improve and can inform policymakers and providers in designing new interventions. Importantly, benefits to eHealth extend beyond geographic access. Patients reported ancillary benefits to eHealth that include reduced anxiety, disruption on family life, and improved recovery time. Providers reported closer connections to colleagues, improved support for complex care, and greater eLearning opportunity. Barriers to eHealth are recognized by patient and providers alike to be largely systemic, where lack of rural high-speed internet and unreliability of installed technologies were significant. Conclusion: Regional and national governments are seen as the key players in addressing these technical barriers. This scoping review diverges from many reviews of eHealth with the use of first-person perspectives. It is hoped that this focus will highlight the importance of patient voices in evaluating important healthcare interventions such as eHealth and associated technologies.
Databáze: OpenAIRE