Factors that influence the uptake of virtual care solutions in Australian primary care practice: a systematic scoping review

Abstract

Background The use of virtual care solutions in primary care settings has increased exponentially. Current evidence suggests high patient satisfaction with virtual care, but it is not without limitations. Research is needed to understand what factors influence the implementation of virtual care so that it can be delivered to the right patient, in the right clinical context at the right time as business-as-usual healthcare. Implementation science offers theories and models to assist with this, but none yet comprehensively address virtual care solution delivery. Methods A systematic scoping review was undertaken to identify empirical research studies that reported factors influencing the uptake of virtual care solutions within the Australian primary care setting. Searches were undertaken in Embase, PubMed, Scopus and Web of Science. The Consolidated Framework for Implementation Research (CFIR) was used to code factors influencing the implementation of virtual care solutions. Results 14 studies were identified as eligible for inclusion. A cluster of five common influencing factors were identified. Three were from the existing CFIR framework, and two were newly developed constructs. CFIR constructs included: innovation relative advantage, capability and information technology infrastructure. New constructs included accessibility and suitability. A further six new constructs were identified (trust, privacy, governance, unintended consequences, preference and choice) but they were not prominently mentioned. Conclusions There are common influencing factors among primary care settings that implemented virtual care. The CFIR assisted in conceptualising these but was not sufficient for capturing factors unique to virtual care. Newly developed constructs are noted to be of importance in the literature, but further primary research is needed to understand if they are applicable in multiple contexts.