An initial full search was conducted in March 2020. The complete search strategy is provided in Multimedia Appendix 3. Individualized search strategies were formulated for each selected database with various Medical Subject Headings and searchable terms combined with Boolean operators. However, clinical outcomes (eg, mental health status, shielding status, and number of examinations) were also extracted in Multimedia Appendix 2 if they were available. Clinical outcomes outside the scope outlined per the NQF telehealth measures were not analyzed in detail in this systematic review because of the lack of available data. However, to our knowledge, this is the first systematic review to focus on what visit types in primary care are suitable for telehealth based on studies where data were collected during the COVID-19 pandemic.Ī modified population, exposure, and outcome strategy was used, with population corresponding to primary care general practice clinicians and patients exposure as the exposure to telehealth as a replacement of in-person consultation and outcomes as benefits and drawbacks of telehealth, which are assessed according to the National Quality Forum (NQF) Telehealth Framework, namely, access to care, effectiveness, experience, and financial impact or cost. A previous systematic review by Snoswell et al aimed to synthesize literature on the clinical effectiveness of telehealth for specific medical conditions from 2010 to 2019. A systematic review by Shah and Badawy evaluated the feasibility, accessibility, satisfaction, and treatment outcomes related to telehealth services among pediatric populations, with findings suggesting telehealth to be a suitable alternative to in-person care. Identifying which in-person encounters are appropriate to be supported by telehealth consultation is one of the critical questions facing today’s health care delivery.Ī cross-sectional study conducted by Donaghy et al explored the acceptability and suitability of telehealth for specific encounters, where they reported telehealth as suitable for a range of patient visit types and concerns such as prescription refills, discussion-based activities, nonsensitive test results, and patients with chronic conditions with established diagnoses. Most telehealth systems were rolled out rapidly without much research into the risks (eg, lack of patient choice, missed diagnoses, challenges to the patient-clinician relationship, and inequality experienced by those affected by the digital divide). As the rapid adoption of telehealth and other forms of remote care is witnessed, its limitations need to be examined. However, the current model of telehealth may not be fit to sustain the long-term delivery of primary care. There is potential for telehealth in primary care in nonpandemic settings. Several countries (eg, Australia, the United States, and the United Kingdom) have introduced long-term funding for telehealth in primary care because of the pandemic. Some patients and GPs have advocated for the long-term use of telehealth beyond the COVID-19 pandemic, for example, in the form of hybrid models of care. A survey conducted by the Royal Australian College of General Practitioners (RACGP) involving >420 Australian GPs saw 1 in 5 respondents report 61% to 80% of their patients requesting a telehealth consultation during the COVID-19 pandemic. In particular, some general practitioners (GPs) and patients welcomed telehealth in primary care general practice settings during the pandemic. Telehealth during the pandemic was used across many medical specialties such as internal medicine, psychiatry, preventative medicine, surgery, neurology, dermatology, pediatrics, and infectious diseases. Before the COVID-19 pandemic, telehealth provided convenience, specifically for patients living in rural or remote settings, but was not routinely used in health care settings. Telehealth, defined as telecommunications, videoconferencing, or other digital modes, is used to remotely deliver health-related services to patients. The COVID-19 pandemic has radically disrupted all aspects of health care, notably the rapid adaption of telehealth within routine care.
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