JMIR Publications

ABSTRACT

Background:

Digital health has become an increasingly important component of contemporary health-care delivery. In rural, regional and remote (RRR) communities, technologies such as telemedicine, mobile health applications and remote patient monitoring offer opportunities to improve access to care, continuity of care and health equity. However, implementation is affected by infrastructure limitations, affordability, digital literacy, workforce capacity, governance, privacy, equity and cultural appropriateness.

Objective:

To review global evidence on the usefulness of digital health technologies in RRR communities and identify policy and implementation approaches that can support equitable and sustainable digital health delivery.

Methods:

Evidence was reviewed from Cochrane reviews, systematic reviews and individual clinical and health-services studies examining digital health interventions, including telemedicine, mobile health applications and remote patient monitoring. The evidence was examined in relation to access to care, continuity of care, health outcomes, equity, implementation barriers and the requirements for evaluating digital health interventions.

Results:

The evidence indicates that digital health can improve access to health-care services and support continuity of care for people living in RRR communities, particularly where geographic distance and limited availability of health professionals create barriers to conventional care. However, benefits are not uniformly distributed. Infrastructure limitations, affordability, digital exclusion and literacy, workforce capacity, privacy and governance requirements, and cultural appropriateness can constrain implementation and may reinforce existing health inequalities. These findings highlight the need for policy approaches that address both technological access and the broader social, economic and health-system conditions influencing digital health use.

Conclusions:

Digital health has considerable potential to improve health-care access and equity in RRR communities, but successful implementation requires more than technological availability. A policy framework should incorporate infrastructure and workforce capacity, affordability and digital inclusion, governance and privacy, cultural safety, and community engagement. Evaluation should combine patient and health-care outcomes with economic evaluation to assess effectiveness, equity, value and sustainability.