Place-based provider perspectives of rural provider-to-provider telehealth in country Western Australia: A qualitative study

IntroductionRural provider-to-provider telehealth (RPPT) is an emerging model of care that uses digital technologies to support collaborative patient care between place-based and virtual providers. Since 2012, the WA Country Health Service Command Centre has delivered an RPPT model of care across country Western Australia. This study explored the contextual factors influencing the implementation and use of RPPT services.MethodsSemi-structured interviews were conducted with 28 nurses, doctors and midwives from across country WA. Interviews were guided by the Practical Implementation Sustainability Model (PRISM) framework. Data were analysed independently by two researchers using reflexive thematic analysis to generate inductive insights, which were then mapped to PRISM domains.ResultsTwelve themes were identified and mapped to PRISM domains, reflecting key contextual influences on RPPT implementation. Themes identified service strengths, interpersonal dynamics, shifting paradigms, perceived patient perspectives, local capacity and capability, organisational systems and practice, situational awareness, patient characteristics, implementation and infrastructure, gaps and growth, external service integration and resourcing.ConclusionThis study identified a range of contextual factors influencing RPPT implementation and use in country WA. Beyond established factors such as resource availability and access to knowledge, the findings highlight the importance of complex system integration, situational awareness, communication and shared understanding and shifting roles and responsibilities. These findings contribute to a broader understanding of RPPT implementation and provide insights for optimising telehealth-enabled models of care in geographically dispersed health systems.