Telehealth-Based Services During the COVID-19 Pandemic: A Systematic Review of Features and Challenges

Abstract

Background: As an ever-growing popular service, telehealth catered for better access to high-quality healthcare services. It is more valuable and cost-effective, particularly in the middle of the current COVID-19 pandemic. Accordingly, this study aimed to systematically review the features and challenges of telehealth-based services developed to support COVID-19 patients and healthcare providers.Methods: A comprehensive search was done for the English language and peer-reviewed articles published until November 2020 using PubMed and Scopus electronic databases. In this review paper, only studies focusing on the telehealth-based service to support COVID-19 patients and healthcare providers were included. The first author's name, publication year, country of the research, study objectives, outcomes, function type including screening, triage, prevention, diagnosis, treatment or follow-up, target population, media, communication type, guideline-based design, main findings, and challenges were extracted, classified, and tabulated.Results: Of the 5,005 studies identified initially, 64 met the eligibility criteria. The studies came from 18 countries. Most of them were conducted in the United States and China. Phone calls, mobile applications, videoconferencing or video calls, emails, websites, text messages, mixed-reality, and teleradiology software were used as the media for communication. The majority of studies used a synchronous communication. The articles addressed the prevention, screening, triage, diagnosis, treatment, and follow-up aspects of COVID-19 which the most common purpose was the patients' follow-up (34/64, 53%). Thirteen group barriers were identified in the literature, which technology acceptance and user adoption, concerns about the adequacy and accuracy of subjective patient assessment, and technical issues were the most frequent ones.Conclusion: This review revealed the usefulness of telehealth-based services during the COVID-19 outbreak and beyond. The features and challenges identified through the literature can be helpful for a better understanding of current telehealth approaches and pointed out the need for clear guidelines, scientific evidence, and innovative policies to implement successful telehealth projects.

Changes in Access to Health Services during the COVID-19 Pandemic: A Scoping Review

“…While a plethora of scientific papers have been published on COVID-19 since the start of the pandemic, studies on its impact on access to health services have not been so plentiful. A few literature reviews have been found that summarize changes in health services due to the pandemic, focusing mainly on the adoption of telemedicine [28][29][30][31][32] and the impact of the pandemic on different aspects, among others, the use of certain specific services, such as maternal and child health care [33], child vaccination [34], or chronic diseases [35,36], in the initial stages of the pandemic. Although we are still at the pandemic management stage, a synthesis of the scientific evidence accumulated to date on the impact on access to health care in different contexts, in addition to detailed monitoring of the performance of services, may help decision makers to make healthcare systems more resilient in current and future emergencies and protect public health and access to health care.…”

The efficacy of an online anger management program for justice‐involved youth

“…Although the use of telehealth mental health services varies across age, gender, and geographical location, some studies indicate that telehealth services are more likely to be accepted by some groups (Knechtel & Erickson, 2021) and individuals 45 years and younger are more likely to utilize video conferencing than telephone telehealth services (Jayawardana & Gannon, 2021). Although the literature indicates that telehealth‐based services have been useful for individuals including clients, patients, and healthcare providers (Khoshrounejad et al., 2021), the majority of individuals value face‐to‐face therapy more than online therapy (Knechtel & Erickson, 2021). Barriers for deployment of telehealth services include less favorable perceptions of telehealth services (Knechtel & Erickson, 2021), audiovisual challenges (Kneeland et al., 2021), technology acceptance and user adoption (Khoshrounejad et al., 2021), concerns with data privacy and security (Knechtel & Erickson, 2021), ethical and legal considerations (Langarizadeh et al., 2017), insurance policies and reimbursement (Uscher‐Pines et al., 2019), establishing and maintaining therapeutic alliance (Kneeland et al., 2021), and inequalities in care access (Peng & Park, 2021).…”

“…Although the literature indicates that telehealth‐based services have been useful for individuals including clients, patients, and healthcare providers (Khoshrounejad et al., 2021), the majority of individuals value face‐to‐face therapy more than online therapy (Knechtel & Erickson, 2021). Barriers for deployment of telehealth services include less favorable perceptions of telehealth services (Knechtel & Erickson, 2021), audiovisual challenges (Kneeland et al., 2021), technology acceptance and user adoption (Khoshrounejad et al., 2021), concerns with data privacy and security (Knechtel & Erickson, 2021), ethical and legal considerations (Langarizadeh et al., 2017), insurance policies and reimbursement (Uscher‐Pines et al., 2019), establishing and maintaining therapeutic alliance (Kneeland et al., 2021), and inequalities in care access (Peng & Park, 2021). Benefits to telehealth care services include lower costs (Lazur et al., 2020) and reduced barriers to care access (Khoshrounejad et al., 2021).…”

“There is Just a Different Energy”: Changes in the Therapeutic Relationship with the Telehealth Transition

“…In their qualitative investigation, Mishna et al ( 2021 ) described how the creative use of communication technologies (not teletherapy alone) allowed social workers to remain flexibly connected with their clients in the early days of (or more specifically 6 weeks into) the pandemic. Another common finding among general health and mental health providers (Khoshrounejad et al, 2021 ) and psychotherapists (Heiden-Rootes et al, 2021 ; McKenny et al, 2021 ) addressed how technological glitches like buffering and telehealth’s inappropriateness for some forms of assessment and intervention added to a sense of fatigue when using videoconferencing. Notably, students’ perspectives about maintaining the TR in e-therapy in the context of the pandemic were more positive.…”