Abstract
BACKGROUND: Access to healthcare significantly influences health outcomes, and rural, regional and remote populations face greater challenges in accessing healthcare than urban populations. Digital health tools, such as remote patient monitoring (RPM), have significant potential to address these healthcare challenges, yet there is little research on the facilitators and barriers of RPM in these regions. AIM: This study aims to identify and understand the facilitators and barriers healthcare staff face implementing RPM in rural and regional Australia, with focus on challenges that arose after the onset of the COVID-19 pandemic. METHODS: Semi-structured focus groups were conducted with healthcare professionals from publicly funded health services in western rural and regional Victoria, Australia. An open-ended interview guide based on the Consolidated Framework for Implementation Research (CFIR) was used to identify key themes and strategies for effective RPM implementation. The analysis considered barriers and facilitators at micro, meso, and macro levels. RESULTS: Several barriers to RPM implementation were identified across different levels: (1) Micro-Level Factors, such as perceived low digital literacy and language barriers among individuals; (2) Meso-Level Factors, including disparities in IT infrastructure and device availability, limited training opportunities, and the need for enhanced governance within healthcare settings; and (3) Macro-Level Factors, encompassing evolving funding models and the reliability of service providers. Despite these challenges, participants acknowledged potential benefits such as improved technological interoperability, enhanced community engagement, and a data-driven approach to quality improvement. Importantly, a flexible, tailored RPM approach to accommodate specific rural and regional needs was deemed valuable. CONCLUSION: Effective RPM deployment in rural and regional areas is viewed by health professionals as crucial for bridging healthcare divides. However, if strategies developed for urban settings are not recalibrated to address rural challenges, the risk of RPM failure may escalate. Future initiatives must prioritize region-specific strategies and policy reforms aimed at ensuring equitable digital infrastructure and financial resource allocation to enhance healthcare access in rural and regional settings. This approach may ensure that RPM solutions are both adaptable and effective, tailored to the unique needs of each community.