Factors That Influence Digital Health Implementation in Rural, Regional, and Remote Australia: An Overview of Reviews and Recommended Strategies

IF 1.9 4区医学 Q2 NURSING

Australian Journal of Rural Health Pub Date : 2025-04-09 DOI:10.1111/ajr.70045

Michelle A. Krahe, Stephanie Baker, Leeanna Woods, Sarah L. Larkins

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引用次数: 0

Abstract

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

Abstract Image

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影响澳大利亚农村、地区和偏远地区数字医疗实施的因素：综述和建议策略

导言：数字化转型可以加强卫生和医疗服务的提供；然而，其在农村、区域和偏远地区（RRR）的应用却面临着巨大的、尚未充分探索的挑战。虽然数字医疗对服务不足地区的益处显而易见，但我们必须了解并应对挑战，才能充分发挥其影响力。目标综合影响澳大利亚偏远地区数字医疗实施的因素的证据，并提出应对障碍的实施策略。设计对现有综述进行概述，以确定相关的系统性综述和范围界定综述。使用 AMSTAR-2 工具对综述质量进行评估。使用 "实施研究综合框架"（CFIR）绘制了实施障碍和促进因素图，并根据 "实施变革专家建议"（ERIC）确定了解决障碍的策略。研究结果有三篇综述符合纳入标准；每篇综述都侧重于远程医疗和远程监控技术。影响因素涉及五个 CFIR 领域，包括 16 个障碍和 12 个推动因素。虽然在健康结果的证据方面存在差距，但实施的益处，如改善服务的可及性、减少旅行和提高患者满意度，都得到了强调。建议的实施策略包括根据当地需求调整干预措施、加强地方领导和宣传、规划和组织实施工作以及调动资源。结论本研究确定了关键的影响因素，并推荐了减少障碍的实施策略。如果采用这些策略，将有助于在澳大利亚区域研究与培训中心成功实施数字医疗。试验注册 PROSPERO CRD42024512742

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来源期刊

Australian Journal of Rural Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

2.30

自引率

16.70%

发文量

122

审稿时长

12 months

期刊介绍： The Australian Journal of Rural Health publishes articles in the field of rural health. It facilitates the formation of interdisciplinary networks, so that rural health professionals can form a cohesive group and work together for the advancement of rural practice, in all health disciplines. The Journal aims to establish a national and international reputation for the quality of its scholarly discourse and its value to rural health professionals. All articles, unless otherwise identified, are peer reviewed by at least two researchers expert in the field of the submitted paper.