Clinician Perspectives of Telehealth Pre–COVID-19: A Systematic Review and Qualitative Metasynthesis

Abstract

Purpose: The purpose of this study was to describe clinicians' attitudes and beliefs about telehealth prior to the COVID-19 pandemic and establish a baseline measure for change. Method: This study is a qualitative systematic review and metasynthesis, using the Enhanced Transparency in Reporting the Synthesis of Qualitative Research guideline. Seven databases were searched. Studies were included if they used interviews or focus groups, included at least one or more rehabilitation professions in the sample, and addressed attitudes toward telehealth as a service delivery model. Results: Nine studies met the inclusion criteria. Data were extracted and coded by the first author using thematic synthesis. Six primary themes were formed: (a) constant comparison of telehealth with in-person guides attitude and acceptance, (b) telehealth presents barriers and opportunities for communication, (c) lack of telehealth education and training impacts clinician confidence, (d) the flexibility of telehealth changes service delivery options and access for patients, (e) the telehealth environment creates challenges with safety and engagement, and (f) technical components and support are influential to the telehealth delivery process. Discussion: This study provides evidence that clinician perceptions of telehealth are similar across disciplines within rehabilitation and other allied health fields. Views were generally positive. However, less experienced clinicians were more likely to have reservations about telehealth, indicating a need for more education and training. Clinical, research, and educational implications are discussed. It is recommended that these themes be utilized to support methods for increasing clinician acceptance of telehealth and achieving sustainable telehealth programs. The overall strength of the recommendation is moderate. Supplemental Material: https://doi.org/10.23641/asha.21992576