Facilitators and Barriers Associated with Healthcare Providers’ Implementation of Telehealth Programs to Support People Living with Diabetes: A Scoping Review

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Authors

Hussain, Armish

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thesis

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eng

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Telehealth , Healthcare provider , Implementation , Diabetes , Consolidated Framework for Implementation Research , Scoping Review

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Background: The prevalence of diabetes mellitus is a major concern globally and produces burden at the individual, system, and economic levels. Diabetes requires self-management and has been noted to be well-suited to be managed via telehealth programs. The responsibility for managing diabetes is shared between patients and healthcare providers, where researchers have devoted significant attention to understanding patients' perceptions toward using telehealth to manage their condition. It is equally important to consider healthcare providers' perspectives on implementing telehealth, for which an extent or breadth of literature remains unclear. Studies in the field of telehealth reflected implementation failures leading to wasted resources, partial health outcomes, and under-utilization of technology. Therefore, an exploration was needed to investigate healthcare providers’ reported facilitators and barriers while implementing telehealth to support people living with diabetes. Objectives: To map the reported facilitators and barriers underlying healthcare providers’ implementation of telehealth for managing diabetes using the Consolidated Framework for Implementation Research (CFIR). Methods: A scoping review was conducted following the Joanna Briggs Institute methodology. A search of electronic databases and grey literature sources was performed to identify the eligible studies based on the inclusion criteria. Two authors independently assessed eligibility and extracted data. The PRISMA- ScR guideline was used to guide the transparent, and consistent reporting of findings. Results: The review found 102 facilitators and 103 barriers across 24 studies. Considering the five domains of the CFIR, the largest number of facilitators and barriers were reported for intervention characteristics (100%), followed by inner setting (75%), outer setting (63%), process (58%), and Characteristics of individuals (38%) respectively. Conclusion: Using the CFIR, the study illuminated valuable facilitators and barriers for health care providers’ implementation of telehealth which can be used to support successful implementations. Our study results concluded that there are many barriers which prevent healthcare providers from effectively iii implementing telehealth. To overcome barriers, the CFIR can be utilized to identify organization and disease-specific implementation drivers. This approach may help reduce implementation failures, partial health outcomes, and wasted resources. Findings of this study can assist healthcare planners in identifying the areas that require capacity building, while also providing preliminary insights to inform best practice and policymaking.

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