Conceptualising the impact of telehealth on rural workforce sustainability using system dynamics and the Gartner Hype Cycle

Abstract Clinician-to-clinician emergency telehealth addresses healthcare access barriers in Australia, yet its impact on workforce sustainability remains poorly understood. This study operationalises the Gartner Hype Cycle through system dynamics modelling to examine telehealth’s impact on rural workforce recruitment and retention. Grounded in stakeholder interviews, expert workshops, and published literature, we developed a system dynamics model capturing delays between recognising benefits and emerging limitations, incorporating three mechanisms through which telehealth affects rural on-site medical position attractiveness: tacit knowledge sharing, medicolegal implications, and clinical support access. Testing 75 parameter scenarios revealed only 15% maintained sustainable on-site staffing long-term. These scenarios involved conservative initial telehealth allocation, realistic expectation management, and scale-specific strategies recognising smaller facilities’ vulnerability. Varying expectations about telehealth limitations versus benefits yielded three telehealth staffing patterns following the trough of disillusionment: complete collapse, recovery to stable levels, or bypassing the trough entirely. This study provides a customisable framework, offering evidence-based guidance for successful telehealth implementation.