Some Multidimensional Unintended Consequences of Telehealth Utilization: A Multi-Project Evaluation Synthesis

Author:

Alami Hassane12ORCID,Gagnon Marie-Pierre123ORCID,Fortin Jean-Paul124ORCID

Affiliation:

1. Institute of Health and Social Services in Primary Care, Research Center on Healthcare and Services in Primary Care, Laval University, Quebec City, QC, Canada.

2. Research Center of Quebec City University Hospital Center, St-François d’Assise Hospital, Quebec City, QC, Canada.

3. Faculty of Nursing Science, Laval University, Quebec City, QC, Canada.

4. Department of Social and Preventive Medicine, Faculty of Medicine, Laval University, Quebec City, QC, Canada.

Abstract

Background: Telehealth initiatives have bloomed around the globe, but their integration and diffusion remain challenging because of the complex issues they raise. Available evidence around telehealth usually deals with its expected effects and benefits, but its unintended consequences (UCs) and influencing factors are little documented. This study aims to explore, describe and analyze multidimensional UCs that have been associated with the use of telehealth. Methods: We performed a secondary analysis of the evaluations of 10 telehealth projects conducted over a 22-year period in the province of Quebec (Canada). All material was subjected to a qualitative thematic-pragmatic content analysis with triangulation of methodologies and data sources. We used the conceptual model of the UCs of health information technologies proposed by Bloomrosen et al to structure our analysis. Results: Four major findings emerged from our analysis. First, telehealth utilization requires many adjustments, changes and negotiations often underestimated in the planning and initial phases of the projects. Second, telehealth may result in the emergence of new services corridors that disturb existing ones and involve several adjustments for organizations, such as additional investments and resources, but also the risk of fragmentation of services and the need to balance between standardization of practices and local innovation. Third, telehealth may accentuate power relations between stakeholders. Fourth, it may lead to significant changes in the responsibilities of each actor in the supply chain of services. Finally, current legislative and regulatory frameworks appear ill-adapted to many of the new realities brought by telehealth. Conclusion: This study provides a first attempt for an overview of the UCs associated with the use of telehealth. Future research-evaluation studies should be more sensitive to the multidimensional and interdependent factors that influence telehealth implementation and utilization as well as its impacts, intended or unintended, at all levels. Thus, a consideration of potential UCs should inform telehealth projects, from their planning until their scaling-up.

Publisher

Maad Rayan Publishing Company

Subject

Health Policy,Health Information Management,Leadership and Management,Management, Monitoring, Policy and Law,Health(social science)

Reference70 articles.

1. Ministère de la Santé et des Services sociaux. Table ministérielle en télésanté: vision, orientations et stratégies de développement de la télésanté au Québec. Quebec: Ministère de la Santé et des Services sociaux; 2001:116.

2. Telemedicine for clinical management of diabetes – a process analysis of video consultations

3. Effect of tele-emergency services on recruitment and retention of US rural physicians;Potter AJ;Rural Remote Health,2014

4. Population health management outcomes obtained through a hospital-based and telehealth informatics-enabled telecare service

5. Exploring factors associated with the uneven utilization of telemedicine in Norway: a mixed methods study

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