Table 2.
| Barriers | Details |
|---|---|
| Implementation costs | Lack of explicit economic framework, billing and reimbursement clarity; costs of home testing devices |
| Project reliability, sustainability, and applicability in all settings | Workload required to implement programs in our current state without guarantee of long-term sustainability, effectiveness, and acceptance |
| Clarity surrounding legal, ethical, privacy, and security issues | Concern about the medicolegal ramifications of diagnostic error Data security and confidentiality |
| Lack of evidence regarding clinical and economic benefit | Research is needed to evaluate patient-centered outcomes of newly implemented telehealth programs |
| Lack of strategic alignment between stakeholders | Different interests, concerns, and priorities of professionals implementing programs, administrators promoting implementation, patients in need of care, etc Strategic planning should incorporate a patient-centered approach (how patients view telemedicine and what they hope to gain) |
| Resistance to changing comfortable practices and familiar workflows to new uncertain and unstandardized models | Programs must quickly adapt in response to technological changes; information systems and platforms evolving rapidly, requiring rapid training and adoption by clinicians |
| Unintended consequences, such as inequitable access and exacerbation of disparities and barriers to care | Need for specific implementation strategies that consider language barriers, digital literacy, patient and family-centered approach:
|