Spread and Scale-Up of a Region-Wide Telehealth Navigation Service in a Rural Context: Qualitative Process Evaluation

Our findings emphasized how rural contextual factors influenced the spread, scale-up, and future sustainability of Patient Watch and provided a greater understanding of implementing and adapting a metropolitan model in a rural context. Future research should acknowledge health system complexity; prioritize ongoing adaptations in various contexts; and integrate a balance of distributed leadership to improve the spread, scale-up, and sustainability of telehealth case management interventions.