JMIR Publications

ABSTRACT

Background:

Despite more than two decades of utilisation in Australia and the rapid uptake following the COVID-19 pandemic, little is known about the unintended consequences of telehealth beyond its planned and intended outcomes.

Objective:

The aim of this review was to synthesize evidence on the unintended consequences of telehealth use in Australia to clarify its impact beyond its planned and intended outcomes.

Methods:

A search of four electronic databases (OVID Medline, OVID Embase, EBSCO CINAHL, Scopus) was conducted. A critical interpretive synthesis (CIS) approach was adopted for its flexibility and interpretive nature. We extracted data about study characteristics and the types and models of telehealth services. Extracted unintended consequences were coded and mapped into the Australian Health Performance Framework’s (AHPF’s) domains and dimensions.

Results:

Of the 4241 records identified by the search, 94 studies were eligible for data extraction and analysis. Twenty-three studies (25%) reported largely positive unintended consequences of telehealth associated with health status. Six studies (6%) noted a potential negative impact of telehealth on socioeconomic status. The findings of four studies (4%) highlighted societal and financial consequences of telehealth beyond the health system. Almost all studies (99%) reported unintended consequences under the five dimensions of the AHPF.

Conclusions:

Our synthesis offers a framework for understanding the unintended consequences of telehealth as an alternative to in-person care in Australia. While we have documented many unintended benefits to telehealth use, our findings also bring light to many challenges of delivering care via telehealth across different domains and dimensions. These findings hold significant practice and policymaking implications for ensuring safe and high-quality care delivery via telehealth.