Optimising implementation of telehealth in oncology: A systematic review examining barriers and enablers using the RE-AIM planning and evaluation framework

Stella Bu; Allan 'Ben' Smith; Anna Janssen; Candice Donnelly; Ann Dadich; Lisa J Mackenzie; Andrea L Smith; Alison L Young; Verena S Wu; Sarah J Smith; Ursula M Sansom-Daly

doi:10.1016/j.critrevonc.2022.103869

Optimising implementation of telehealth in oncology: A systematic review examining barriers and enablers using the RE-AIM planning and evaluation framework

Crit Rev Oncol Hematol. 2022 Dec:180:103869. doi: 10.1016/j.critrevonc.2022.103869. Epub 2022 Nov 7.

Authors

Affiliations

¹ Psycho-Oncology Research Group, Ingham Institute for Applied Medical Research, Australia; South West Sydney Clinical Campuses, University of New South Wales, Liverpool, NSW, Australia.
² Psycho-Oncology Research Group, Ingham Institute for Applied Medical Research, Australia; South West Sydney Clinical Campuses, University of New South Wales, Liverpool, NSW, Australia. Electronic address: ben.smith@unsw.edu.au.
³ Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
⁴ School of Business, Western Sydney University, Parramatta, NSW, Australia.
⁵ Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia.
⁶ The Daffodil Centre, a joint venture of Cancer Council NSW and the University of Sydney, Sydney, NSW, Australia.
⁷ School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia.
⁸ Faculty of Medicine, The University of New South Wales, Port Macquarie, NSW, Australia.
⁹ School of Women's and Children's Health, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW, Australia; Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia; Sydney Youth Cancer Service, Prince of Wales Hospital, Randwick, NSW, Australia.

PMID: 36356701
DOI: 10.1016/j.critrevonc.2022.103869

Abstract

Telehealth facilitates access to cancer care for patients unable to attend in-person consultations, as in COVID-19. This systematic review used the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework to evaluate telehealth implementation and examine enablers and barriers to optimal implementation in oncology. MEDLINE, PubMed, CINAHL, and the Cochrane Database of Systematic Reviews were searched between January 2011-June 2022. Eighty-two articles representing 73 studies were included. One study explicitly used the RE-AIM framework to guide study design, conduct, or reporting. Reach (44%) and implementation (38%) were most commonly reported, maintenance (5%) least commonly. Key telehealth implementation enablers included professional-led delivery, patient-centred approaches, and positive patient perceptions. Key barriers included patient discomfort with technology, limited supporting clinic infrastructure, and poor access to reliable internet connection and videoconferencing. While a patient-centred and professional-supported approach enables telehealth implementation, technology and infrastructure constraints need surmounting for sustained implementation beyond the COVID-19 pandemic.

Keywords: Health care; Implementation evaluation; Oncology; Systematic review; Telehealth.

Publication types

Review
Systematic Review

MeSH terms

COVID-19* / epidemiology
Humans
Medical Oncology
Pandemics
Telemedicine*