Published on in Vol 25 (2023)

Preprints (earlier versions) of this paper are available at https://preprints.jmir.org/preprint/46715, first published .
Barriers to Video Call–Based Telehealth in Allied Health Professions and Nursing: Scoping Review and Mapping Process

Barriers to Video Call–Based Telehealth in Allied Health Professions and Nursing: Scoping Review and Mapping Process

Barriers to Video Call–Based Telehealth in Allied Health Professions and Nursing: Scoping Review and Mapping Process

Authors of this article:

Lena Rettinger1, 2 Author Orcid Image ;   Sebastian Kuhn2 Author Orcid Image

Review

1Health Assisting Engineering, FH Campus Wien, University of Applied Sciences, Vienna, Austria

2Institute of Digital Medicine, University Hospital of Giessen and Marburg, Philipps University Marburg, Marburg, Germany

Corresponding Author:

Lena Rettinger, BSc, MSc

Health Assisting Engineering

FH Campus Wien, University of Applied Sciences

Favoritenstrasse 226

Vienna, 1100

Austria

Phone: 43 1 606 68 77 ext 4382

Email: lena.rettinger@fh-campuswien.ac.at


Background: Telehealth interventions have become increasingly important in health care provision, particularly during the COVID-19 pandemic. Video calls have emerged as a popular and effective method for delivering telehealth services; however, barriers limit the adoption among allied health professionals and nurses.

Objective: This review aimed to identify and map the perceived barriers to the use of video call–based telehealth interventions among allied health professionals and nurses.

Methods: A comprehensive literature search was conducted in the PubMed and CINAHL databases on June 22, 2022, and updated on January 3, 2023, following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Only original studies published in English or German since June 2017 that reported barriers to the use of video call–based telehealth interventions were eligible for inclusion. The studies had to involve interviews, focus groups, or questionnaires with physical therapists, occupational therapists, speech and language therapists, audiologists, orthoptists, dieticians, midwives, or nurses. Each publication was coded for basic characteristics, including country, health profession, and target group. Inductive coding was used to identify the patterns, themes, and categories in the data. Individual codings were analyzed and summarized narratively, with similarities and differences in barriers identified across health professions and target groups.

Results: A total of 56 publications were included in the review, with barriers identified and categorized into 8 main categories and 23 subcategories. The studies were conducted in various countries, predominantly the United States, Australia, the United Kingdom, Canada, Israel, and India. Questionnaires were the most commonly used evaluation method, with 10,245 health professionals involved. Interviews or focus groups were conducted with 288 health professionals. Most of the included publications focused on specific health care professions, with the highest number addressing barriers for physical therapists, speech and language therapists, and audiologists. The barriers were related to technology issues, practice issues, patient issues, environmental issues, attributions, interpersonal issues, policies and regulations, and administration issues. The most reported barriers included the lack of hands-on experience, unreliable network connection, the lack of technology access, diminished fidelity of observations and poor conditions for visual instructions, the lack of technology skills, and diminished client-practitioner interaction and communication.

Conclusions: This review identified key barriers to video call–based telehealth use by allied health professionals and nurses, which can foster the development of stable infrastructure, education, training, guidelines, policies, and support systems to improve telehealth services. Further research is necessary to identify potential solutions to the identified barriers.

J Med Internet Res 2023;25:e46715

doi:10.2196/46715

Keywords



Background

Allied health professionals and nurses are an integral part of our health care system. The allied health professions do not constitute a clearly defined group of professions, as definitions and classifications vary at the international level [Nancarrow S, Borthwick A. The Allied Health Professions: A Sociological Perspective. Bristol, UK. Policy Press; Mar 10, 2021.1]. For the purposes of this review, the allied health professions are occupational therapists (OTs), physical therapists (PTs), speech and language therapists (SLTs), audiologists, dietitians, orthoptists, and midwives. In addition, nurses were identified as a crucial professional group within the context of allied health services. Allied health professionals and nurses have in common that they play an important role in patient care to protect, restore, and maintain physical, sensory, psychological, cognitive, social, and cultural functions [What is allied health? Allied Health Professions Australia. URL: https://ahpa.com.au/what-is-allied-health/ [accessed 2022-11-19] 2].

The COVID-19 pandemic has profoundly challenged the work of health care professionals because of contact restrictions and the risk of infections [Coto J, Restrepo A, Cejas I, Prentiss S. The impact of COVID-19 on allied health professions. PLoS One. Oct 30, 2020;15(10):e0241328. [FREE Full text] [CrossRef] [Medline]3,Hughes MT, Rushton CH. Ethics and well-being: the health professions and the COVID-19 pandemic. Acad Med. Mar 01, 2022;97(3S):S98-103. [FREE Full text] [CrossRef] [Medline]4]. Access to health services was limited worldwide [Tuczyńska M, Matthews-Kozanecka M, Baum E. Accessibility to Non-COVID health services in the world during the COVID-19 pandemic: review. Front Public Health. Dec 16, 2021;9:760795. [FREE Full text] [CrossRef] [Medline]5,Núñez A, Sreeganga SD, Ramaprasad A. Access to Healthcare during COVID-19. Int J Environ Res Public Health. Mar 14, 2021;18(6):2980. [FREE Full text] [CrossRef] [Medline]6] and affected, among others, access to rehabilitation services [De Biase S, Cook L, Skelton DA, Witham M, Ten Hove R. The COVID-19 rehabilitation pandemic. Age Ageing. Aug 24, 2020;49(5):696-700. [FREE Full text] [CrossRef] [Medline]7,D'souza J, Biswas A, Gada P, Mangroliya J, Natarajan M. Barriers leading to increased disability in neurologically challenged populations during COVID-19 pandemic: a scoping review. Disabil Rehabil. Dec 2022;44(24):7693-7706. [CrossRef] [Medline]8] and maternal health services [Pant S, Koirala S, Subedi M. Access to maternal health services during COVID-19. Europasian J Med Sci. Jul 08, 2020;2:46-50. [FREE Full text] [CrossRef]9]. The health care contacts of acute [Mauro V, Lorenzo M, Paolo C, Sergio H. Treat all COVID 19-positive patients, but do not forget those negative with chronic diseases. Intern Emerg Med. Jun 09, 2020;15(5):787-790. [FREE Full text] [CrossRef]10] and chronically ill patients [Mauro V, Lorenzo M, Paolo C, Sergio H. Treat all COVID 19-positive patients, but do not forget those negative with chronic diseases. Intern Emerg Med. Jun 09, 2020;15(5):787-790. [FREE Full text] [CrossRef]10-Chudasama YV, Gillies CL, Zaccardi F, Coles B, Davies MJ, Seidu S, et al. Impact of COVID-19 on routine care for chronic diseases: a global survey of views from healthcare professionals. Diabetes Metab Syndr. Sep 2020;14(5):965-967. [FREE Full text] [CrossRef] [Medline]12] decreased during this period. Therefore, the pandemic has led to fundamental changes in service provision and advanced the integration of telehealth services in various disciplines and health fields [Doraiswamy S, Abraham A, Mamtani R, Cheema S. Use of telehealth during the COVID-19 pandemic: scoping review. J Med Internet Res. Dec 01, 2020;22(12):e24087. [FREE Full text] [CrossRef] [Medline]13]. Telehealth offers advantages for allied health professionals by overcoming barriers related to distance [Sprianu C, Krpalek D, Kugel JD, Bains G, Gharibvand L. COVID-19 and telehealth use among occupational therapy, physical therapy, and speech-language pathology practitioners in the United States. Internet J Allied Health Sci Pract. Mar 31, 2022;20(2) [FREE Full text] [CrossRef]14] and addressing health and services disparities [Grundstein MJ, Fisher C, Titmuss M, Cioppa-Mosca J. The role of virtual physical therapy in a post-pandemic world: pearls, pitfalls, challenges, and adaptations. Phys Ther. Sep 01, 2021;101(9):pzab145. [CrossRef] [Medline]15-Sarsak HI. Telerehabilitation services: a successful paradigm for occupational therapy clinical services? Int J Phys Med Rehabil. Apr 16, 2020;5(2):93-98. [FREE Full text] [CrossRef]17]. This facilitates improved access to services and supports individuals with chronic illnesses in maintaining continuity of care, ultimately optimizing health and well-being [Grundstein MJ, Fisher C, Titmuss M, Cioppa-Mosca J. The role of virtual physical therapy in a post-pandemic world: pearls, pitfalls, challenges, and adaptations. Phys Ther. Sep 01, 2021;101(9):pzab145. [CrossRef] [Medline]15,Kelly JT, Allman-Farinelli M, Chen J, Partridge SR, Collins C, Rollo M, et al. Dietitians Australia position statement on telehealth. Nutr Diet. Sep 2020;77(4):406-415. [FREE Full text] [CrossRef] [Medline]16,Krzyzaniak N, Cardona M, Peiris R, Michaleff ZA, Greenwood H, Clark J, et al. Telerehabilitation versus face-to-face rehabilitation in the management of musculoskeletal conditions: a systematic review and meta-analysis. Phys Ther Rev. Apr 12, 2023:1-17. [FREE Full text] [CrossRef]18]. However, there remains a concern that telehealth may inadvertently exacerbate health care disparities for susceptible populations, particularly those with limited digital literacy or restricted access to digital resources [Eddison N, Leone E, Healy A, Royse C, Chockalingam N. The potential impact of allied health professional telehealth consultations on health inequities and the burden of treatment. Int J Equity Health. Jun 30, 2022;21(1):91. [FREE Full text] [CrossRef] [Medline]19].

Telemedicine or telehealth can be defined as “the use of information and communication technology (ICT) to provide health services where there is physical separation between providers of care and/or recipients over long and short distances” [Gogia S. Fundamentals of Telemedicine and Telehealth. London, UK. Academic Press; 2019.20]. Terminology in this area lacks agreement on the definitions of the telehealth or telemedicine concepts [Fatehi F, Wootton R. Telemedicine, telehealth or e-health? A bibliometric analysis of the trends in the use of these terms. J Telemed Telecare. Dec 2012;18(8):460-464. [CrossRef] [Medline]21]. Telehealth might be related to telemedicine in the same way that health is related to medicine [Bashshur R, Shannon G, Krupinski E, Grigsby J. The taxonomy of telemedicine. Telemed J E Health. Jul 2011;17(6):484-494. [FREE Full text] [CrossRef] [Medline]22]. Consequently, the World Medicine Association describes telehealth and telemedicine to be used for remote clinical services to serve for patient-physician consultation where access is limited and to be used for consultation with ≥2 physicians [WMA statement on digital health. World Medical Association. 2022. URL: https:/​/www.​wma.net/​policies-post/​wma-statement-on-guiding-principles-for-the-use-of-telehealth-for-the-provision-of-health-care/​ [accessed 2023-02-06] 23]. Furthermore, telehealth refers to remote clinical and nonclinical services, such as preventive health support, research, training, and continuing medical education for health professionals [WMA statement on digital health. World Medical Association. 2022. URL: https:/​/www.​wma.net/​policies-post/​wma-statement-on-guiding-principles-for-the-use-of-telehealth-for-the-provision-of-health-care/​ [accessed 2023-02-06] 23]. Similar terms, such as telerehabilitation, telecare, telepractice, or telephysiotherapy, refer to specializations, the context of care, or a specific profession. Telehealth services can be divided into 3 types: synchronous, where health information is delivered in real time; asynchronous, where health information is stored and forwarded; and patient monitoring, where patient clinical status is continuously evaluated over the distance [Mechanic OJ, Persaud Y, Kimball AB. Telehealth Systems. StatPearls Treasure Island. StatPearls Publishing URL: https://www.ncbi.nlm.nih.gov/books/NBK459384/ [accessed 2023-02-06] 24].

Video calls are a common method for providing telehealth services synchronously, as they have become prevalent in personal and professional lives. Everyday technologies, such as computers, tablets, smartphones, webcams, videoconferencing software, and an internet connection, make such services relatively accessible. Especially during the COVID-19 pandemic, there was a demand for readily available solutions without the need for additional infrastructure or equipment. The rapid implementation of video visits with health care professionals prevented infections [Monaghesh E, Hajizadeh A. The role of telehealth during COVID-19 outbreak: a systematic review based on current evidence. BMC Public Health. Aug 01, 2020;20(1):1193. [FREE Full text] [CrossRef] [Medline]25] and kept the health care system running [Kalin ML, Garlow SJ, Thertus K, Peterson MJ. Rapid implementation of telehealth in hospital psychiatry in response to COVID-19. Am J Psychiatry. Jul 01, 2020;177(7):636-637. [CrossRef] [Medline]26-Kwok EY, Chiu J, Rosenbaum P, Cunningham BJ. The process of telepractice implementation during the COVID-19 pandemic: a narrative inquiry of preschool speech-language pathologists and assistants from one center in Canada. BMC Health Serv Res. Jan 16, 2022;22(1):81. [FREE Full text] [CrossRef] [Medline]29]. For instance, telehealth services offered by physiotherapists were used to support patients in isolation [Kalirathinam D, Guruchandran R, Subramani P. Comprehensive physiotherapy management in COVID-19 – a narrative review. Sci Med. May 26, 2020;30(1):38030. [FREE Full text] [CrossRef]30] or to address the ongoing needs of children with neurodevelopmental or musculoskeletal issues [Alonazi A. Effectiveness and acceptability of telerehabilitation in physical therapy during COVID-19 in children: findings of a systematic review. Children (Basel). Nov 29, 2021;8(12):1101. [FREE Full text] [CrossRef] [Medline]31]. This approach enabled the provision of acute care while maintaining continuity in therapeutic interventions.

Telehealth also has potential benefits in addition to the prevention of infections. Such services have been established long before facing a pandemic, especially in rural areas, to increase access to physical or occupational therapy, speech and language therapy, nursing, and other health services [Harkey LC, Jung SM, Newton ER, Patterson A. Patient satisfaction with telehealth in rural settings: a systematic review. Int J Telerehabil. Dec 08, 2020;12(2):53-64. [FREE Full text] [CrossRef] [Medline]32-Shigekawa E, Fix M, Corbett G, Roby DH, Coffman J. The current state of telehealth evidence: a rapid review. Health Aff (Millwood). Dec 2018;37(12):1975-1982. [CrossRef] [Medline]34]. People who are bedridden or have limited mobility can also benefit from easier access [Molini-Avejonas DR, Rondon-Melo S, de La Higuera Amato CA, Samelli AG. A systematic review of the use of telehealth in speech, language and hearing sciences. J Telemed Telecare. Oct 2015;21(7):367-376. [CrossRef] [Medline]35]. Furthermore, increased independence and reassurance have been described through telehealth use [Cox A, Lucas G, Marcu A, Piano M, Grosvenor W, Mold F, et al. Cancer survivors' experience with telehealth: a systematic review and thematic synthesis. J Med Internet Res. Jan 09, 2017;19(1):e11. [FREE Full text] [CrossRef] [Medline]36]. Studies have shown that telehealth can yield equivalent or even superior clinical outcomes for patients [Krzyzaniak N, Cardona M, Peiris R, Michaleff ZA, Greenwood H, Clark J, et al. Telerehabilitation versus face-to-face rehabilitation in the management of musculoskeletal conditions: a systematic review and meta-analysis. Phys Ther Rev. Apr 12, 2023:1-17. [FREE Full text] [CrossRef]18,Coufal K, Parham D, Jakubowitz M, Howell C, Reyes J. Comparing traditional service delivery and telepractice for speech sound production using a functional outcome measure. Am J Speech Lang Pathol. Feb 06, 2018;27(1):82-90. [CrossRef] [Medline]37,Seron P, Oliveros MJ, Gutierrez-Arias R, Fuentes-Aspe R, Torres-Castro RC, Merino-Osorio C, et al. Effectiveness of telerehabilitation in physical therapy: a rapid overview. Phys Ther. Jun 01, 2021;101(6):pzab053. [FREE Full text] [CrossRef] [Medline]38]. However, such services are not a common component of health services.

Objectives

The implementation of telehealth faces organizational, personal, and technological barriers, such as the lack of infrastructure, missing skills, poor strategic alignment, resistance to necessary cultural changes, and cost or reimbursement issues [Framework for the implementation of a telemedicine service. Pan American Health Organization. 2016. URL: https://iris.paho.org/bitstream/handle/10665.2/28414/9789275119037_eng.pdf [accessed 1999-11-30] 39]. However, to date, no review has systematically mapped these barriers. An illustration and analysis of telehealth barriers is important to address them in the future by tailored actions such as training, organizational redesigns, or infrastructure measurements.

To systematically map barriers to video call–based telehealth from nonmedical health professionals, a mapping and scoping review with the following research question was conducted: What barriers are indicated and described by allied health professionals and nurses toward video call–based telehealth?


Overview

First, a scoping review was conducted based on the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines [Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. Oct 02, 2018;169(7):467-473. [FREE Full text] [CrossRef] [Medline]40,Peters MD, Marnie C, Tricco AC, Pollock D, Munn Z, Alexander L, et al. Updated methodological guidance for the conduct of scoping reviews. JBI Evid Synth. Oct 2020;18(10):2119-2126. [CrossRef] [Medline]41]. Before initiating the review, a review protocol was developed, stored in the institutional database, and followed. It was not published publicly. Second, the identified barriers were systematically mapped with respect to the health profession, the context of care, and the research method.

Eligibility Criteria

Only articles that have been published since June 2017 were eligible to ensure that the studies applied technology that is comparable with current standards. Publications that met the inclusion criteria were eligible (Textboxes 1 and What is allied health? Allied Health Professions Australia. URL: https://ahpa.com.au/what-is-allied-health/ [accessed 2022-11-19] 2).

Textbox 1. Inclusion criteria.

Article type

  • Original studies and journal articles

Language

  • English or German

Article scope

  • Article reports barriers or challenges with video call–based telehealth interventions

Health professions

  • Barriers or challenges are based on the perspective of physical therapists, occupational therapists, speech and language therapists or audiologists, orthoptists, dieticians, nurses, or midwives

Methods

  • Survey, interview, or focus group results

Telehealth target

  • Video call–based telehealth targeted patient-to-provider interaction

Time

  • Published since June 2017
Textbox 2. Exclusion criteria.

Article type

  • Review articles, conference papers, abstracts, editorials, newspaper articles, study protocols, and other formats

Language

  • Other languages

Article scope

  • Article reports no barriers or challenges and article reports barriers or challenges with other telehealth interventions than video call based (if other technologies were included in the study, the results must be clearly distinguishable)

Health professions

  • Barriers or challenges are based on the perspective of patients, caregivers, medical doctors, or other health professionals. If they were included in the study, the results must be clearly distinguishable

Methods

  • Results from other resources

Telehealth target

  • Video call–based telehealth targeted academic education or continuing education and video call–based telehealth targeted provider-to-provider interaction

Time

  • Published before June 2017

Search and Selection Strategy

A comprehensive literature search was carried out in the PubMed and CINAHL databases on June 22, 2022, and updated on January 3, 2023. In addition, citation tracking was performed to identify additional relevant literature. Relevant topics for the search were video call–based telehealth; barriers or challenges; health professions of interest; and resources from interviews, focus groups, surveys, or questionnaires. The complete search strings can be found in

Multimedia Appendix 1

Search strings used in PubMed and CINAHL databases.

PDF File (Adobe PDF File), 77 KBMultimedia Appendix 1.

All references were imported to Zotero (Corporation for Digital Scholarship). In a first step, all duplicates were eliminated, and then all titles and abstracts of the sources were screened for inclusion criteria. The full text of the remaining articles was obtained, thoroughly reviewed for eligibility, and searched for further publications that met the inclusion criteria by citation tracking.

Data Charting Process

The full-text articles of the selected publications were imported into MAXQDA (2022; VERBI GmbH), a software for qualitative content analysis. Each publication was coded for country, health profession, and target group of telehealth intervention to compare basic characteristics. The sample sizes were noted. Furthermore, all articles were thoroughly examined for the mentioned barriers, and codes were inductively assigned to text passages. The inductive coding process involved identifying patterns, themes, and categories in the data without the use of preexisting codes to allow for the identification of new and unexpected themes that may not have been anticipated. The codes were continuously refined, structured, and consolidated.

Finally, every publication had a code for country, health profession, target group, and if applicable, the following barrier codes were assigned: interpersonal issues, administration issues, practice issues, patient issues, environmental issues, telehealth attributes, technology issues, policy and regulation issues, and others. Subcodes for topics requiring further refinement were created.

Synthesis of Results

Individual coding (passages with an assigned code) was analyzed and summarized for each code topic narratively. Similarities in the barriers mentioned were identified, and barriers for specific health professions or target groups were determined. Each barrier mentioned was equal in weight. A quantitative outline of barriers was performed only with respect to the number of articles that mentioned each barrier but not in terms of how often it was mentioned within an article.


Overview

The search yielded 786 records (n=609 in June 2022 and n=177 in January 2023). A total of 611 records were screened (n=474 in June 2022 and n=137 in January 2023), and 107 full-text papers were assessed for eligibility (n=77 in June 2022 and n=30 in January 2023). Finally, the review included 56 publications (n=44 in June 2022 and n=12 in January 2023). The selection process is illustrated in the flowchart (Figure 1).

Figure 1. Study selection process.

Study Characteristics

Table 1 presents all included publications with details for authors, publication year, country, included professions, health context, and assessment methods.

The included studies were published in 2017 (n=1) [Barrett D. Rethinking presence: a grounded theory of nurses and teleconsultation. J Clin Nurs. Oct 2017;26(19-20):3088-3098. [CrossRef] [Medline]42], 2018 (n=2) [Lawford BJ, Bennell KL, Kasza J, Hinman RS. Physical therapists' perceptions of telephone- and internet video-mediated service models for exercise management of people with osteoarthritis. Arthritis Care Res (Hoboken). Mar 2018;70(3):398-408. [CrossRef] [Medline]43,Rygg LO, Brataas HV, Nordtug B. Introducing videoconferencing on tablet computers in nurse-patient communication: technical and training challenges. Int J Telemed Appl. Oct 18, 2018;2018:8943960. [FREE Full text] [CrossRef] [Medline]44], 2019 (n=2) [Rortvedt D, Jacobs K. Perspectives on the use of a telehealth service-delivery model as a component of school-based occupational therapy practice: designing a user-experience. Work. 2019;62(1):125-131. [CrossRef] [Medline]45,Spiby H, Faucher MA, Sands G, Roberts J, Kennedy HP. A qualitative study of midwives' perceptions on using video-calling in early labor. Birth. Mar 2019;46(1):105-112. [CrossRef] [Medline]46], 2020 (n=2) [Abbott-Gaffney C, Jacobs K. Telehealth in school-based practice: perceived viability to bridge global OT practitioner shortages prior to COVID-19 global health emergency. Work. 2020;67(1):29-35. [CrossRef] [Medline]47,Wundersitz C, Caelli A, Georgy J, Musovic A, Manning R, Prause M, et al. Conducting community rehabilitation review sessions via videoconference: a feasibility study. Aust J Rural Health. Dec 2020;28(6):603-612. [CrossRef] [Medline]48], 2021 (n=23) [Albahrouh SI, Buabbas AJ. Physiotherapists' perceptions of and willingness to use telerehabilitation in Kuwait during the COVID-19 pandemic. BMC Med Inform Decis Mak. Apr 08, 2021;21(1):122. [FREE Full text] [CrossRef] [Medline]49-Sutherland R, Hodge A, Chan E, Silove N. Barriers and facilitators: clinicians' opinions and experiences of telehealth before and after their use of a telehealth platform for child language assessment. Int J Lang Commun Disord. Nov 2021;56(6):1263-1277. [CrossRef] [Medline]71], and 2022 (n=26) [Kwok EY, Chiu J, Rosenbaum P, Cunningham BJ. The process of telepractice implementation during the COVID-19 pandemic: a narrative inquiry of preschool speech-language pathologists and assistants from one center in Canada. BMC Health Serv Res. Jan 16, 2022;22(1):81. [FREE Full text] [CrossRef] [Medline]29,Abbott-Gaffney CR, Gafni-Lachter L, Cason J, Sheaffer K, Harasink R, Donehower K, et al. Toward successful future use of telehealth in occupational therapy practice: what the COVID-19 rapid shift revealed. Work. 2022;71(2):385-394. [CrossRef] [Medline]72-Beit Yosef A, Maeir T, Khalailh F, Gilboa Y. Perceived feasibility of an occupation-based telerehabilitation intervention for older adults with chronic health conditions in Israel. Hong Kong J Occup Ther. Jun 2022;35(1):62-70. [FREE Full text] [CrossRef] [Medline]96]. Of the 56 papers, 48 (86%) papers focused on COVID-19 [Kwok EY, Chiu J, Rosenbaum P, Cunningham BJ. The process of telepractice implementation during the COVID-19 pandemic: a narrative inquiry of preschool speech-language pathologists and assistants from one center in Canada. BMC Health Serv Res. Jan 16, 2022;22(1):81. [FREE Full text] [CrossRef] [Medline]29,Abbott-Gaffney C, Jacobs K. Telehealth in school-based practice: perceived viability to bridge global OT practitioner shortages prior to COVID-19 global health emergency. Work. 2020;67(1):29-35. [CrossRef] [Medline]47,Albahrouh SI, Buabbas AJ. Physiotherapists' perceptions of and willingness to use telerehabilitation in Kuwait during the COVID-19 pandemic. BMC Med Inform Decis Mak. Apr 08, 2021;21(1):122. [FREE Full text] [CrossRef] [Medline]49,Bennell KL, Lawford BJ, Metcalf B, Mackenzie D, Russell T, van den Berg M, et al. Physiotherapists and patients report positive experiences overall with telehealth during the COVID-19 pandemic: a mixed-methods study. J Physiother. Jul 2021;67(3):201-209. [FREE Full text] [CrossRef] [Medline]51-Harrell RG, Schubert MC, Oxborough S, Whitney SL. Vestibular rehabilitation telehealth during the SAEA-CoV-2 (COVID-19) pandemic. Front Neurol. Jan 20, 2022;12:781482. [FREE Full text] [CrossRef] [Medline]56,Kaufman-Shriqui V, Sherf-Dagan S, Boaz M, Birk R. Virtual nutrition consultation: what can we learn from the COVID-19 pandemic? Public Health Nutr. Apr 2021;24(5):1166-1173. [FREE Full text] [CrossRef] [Medline]58-Beit Yosef A, Maeir T, Khalailh F, Gilboa Y. Perceived feasibility of an occupation-based telerehabilitation intervention for older adults with chronic health conditions in Israel. Hong Kong J Occup Ther. Jun 2022;35(1):62-70. [FREE Full text] [CrossRef] [Medline]96]. In total, 80% (45/56) of publications focused on 1 specific health care profession [Kwok EY, Chiu J, Rosenbaum P, Cunningham BJ. The process of telepractice implementation during the COVID-19 pandemic: a narrative inquiry of preschool speech-language pathologists and assistants from one center in Canada. BMC Health Serv Res. Jan 16, 2022;22(1):81. [FREE Full text] [CrossRef] [Medline]29,Barrett D. Rethinking presence: a grounded theory of nurses and teleconsultation. J Clin Nurs. Oct 2017;26(19-20):3088-3098. [CrossRef] [Medline]42-Abbott-Gaffney C, Jacobs K. Telehealth in school-based practice: perceived viability to bridge global OT practitioner shortages prior to COVID-19 global health emergency. Work. 2020;67(1):29-35. [CrossRef] [Medline]47,Albahrouh SI, Buabbas AJ. Physiotherapists' perceptions of and willingness to use telerehabilitation in Kuwait during the COVID-19 pandemic. BMC Med Inform Decis Mak. Apr 08, 2021;21(1):122. [FREE Full text] [CrossRef] [Medline]49-Bennell KL, Lawford BJ, Metcalf B, Mackenzie D, Russell T, van den Berg M, et al. Physiotherapists and patients report positive experiences overall with telehealth during the COVID-19 pandemic: a mixed-methods study. J Physiother. Jul 2021;67(3):201-209. [FREE Full text] [CrossRef] [Medline]51,D'Souza AF, Rebello SR. Perceptions and willingness of physiotherapists in India to use telerehabilitation during the COVID-19 pandemic. Int J Telerehabil. Dec 16, 2021;13(2):e6425. [FREE Full text] [CrossRef] [Medline]53-Kienle GS, Werthmann P, Grotejohann B, Hundhammer T, Schmoor C, Stumpe C, et al. Addressing COVID-19 challenges in a randomised controlled trial on exercise interventions in a high-risk population. BMC Geriatr. May 01, 2021;21(1):287. [FREE Full text] [CrossRef] [Medline]59,Martin R, Mandrusiak A, Russell T, Forbes R. New-graduate physiotherapists' training needs and readiness for telehealth. Physiother Theory Pract. Nov 2022;38(13):2788-2797. [CrossRef] [Medline]63-Pollard R, Hogan S. Parental and practitioner views of telepractice for pediatric auditory verbal habilitation at a time of global pandemic. Perspective. Dec 2021;6(6):1832-1856. [FREE Full text] [CrossRef]66,Rozga M, Handu D, Kelley K, Jimenez EY, Martin H, Schofield M, et al. Telehealth during the COVID-19 pandemic: a cross-sectional survey of registered dietitian nutritionists. J Acad Nutr Diet. Dec 2021;121(12):2524-2535. [FREE Full text] [CrossRef] [Medline]68-Bhattarai B, Sanghavi T, Abhishek BP. Challenges in delivering tele-practice services for communication disorders among audiologists and speech language pathologists. Indian J Otolaryngol Head Neck Surg. Dec 2022;74(Suppl 3):4360-4365. [FREE Full text] [CrossRef] [Medline]75,Buabbas AJ, Albahrouh SE, Alrowayeh HN, Alshawaf H. Telerehabilitation during the COVID-19 pandemic: patients and physical therapists' experiences. Med Princ Pract. 2022;31(2):156-164. [FREE Full text] [CrossRef] [Medline]77-Ditwiler RE, Swisher LL, Hardwick DD. Doing things you never imagined: professional and ethical issues in the U.S. outpatient physical therapy setting during the COVID-19 pandemic. Musculoskelet Sci Pract. Dec 2022;62:102684. [FREE Full text] [CrossRef] [Medline]81,Eikelboom RH, Bennett RJ, Manchaiah V, Parmar B, Beukes E, Rajasingam SL, et al. International survey of audiologists during the COVID-19 pandemic: use of and attitudes to telehealth. Int J Audiol. Apr 2022;61(4):283-292. [CrossRef] [Medline]83-Hughes L, Petrella A, Phillips N, Taylor RM. Virtual care and the impact of COVID-19 on nursing: a single centre evaluation. J Adv Nurs. Feb 2022;78(2):498-509. [FREE Full text] [CrossRef] [Medline]86,Koppel PD, De Gagne JC, Docherty S, Smith S, Prose NS, Jabaley T. Exploring nurse and patient experiences of developing rapport during oncology ambulatory care videoconferencing visits: qualitative descriptive study. J Med Internet Res. Sep 08, 2022;24(9):e39920. [FREE Full text] [CrossRef] [Medline]88-Peh HP, Yee K, Mantaring EJ. Changes in telepractice use and perspectives among speech and language therapists in Singapore through the COVID-19 pandemic. Int J Lang Commun Disord. May 2023;58(3):802-812. [CrossRef] [Medline]91,Tar-Mahomed Z, Kater KA. The perspectives of speech-language pathologists: providing teletherapy to patients with speech, language and swallowing difficulties during a COVID-19 context. S Afr J Commun Disord. Aug 11, 2022;69(2):e1-e7. [FREE Full text] [CrossRef] [Medline]93,Van Eerdenbrugh S, Schraeyen K, Leysen H, Mostaert C, D'haenens W, Vandenborre D. Delivery of speech-language therapy and audiology services across the world at the start of the COVID-19 pandemic: a survey. Perspect. Apr 14, 2022;7(2):635-646. [FREE Full text] [CrossRef]94,Beit Yosef A, Maeir T, Khalailh F, Gilboa Y. Perceived feasibility of an occupation-based telerehabilitation intervention for older adults with chronic health conditions in Israel. Hong Kong J Occup Ther. Jun 2022;35(1):62-70. [FREE Full text] [CrossRef] [Medline]96], and 20% (11/56) of articles targeted a mix of health care professions [Wundersitz C, Caelli A, Georgy J, Musovic A, Manning R, Prause M, et al. Conducting community rehabilitation review sessions via videoconference: a feasibility study. Aust J Rural Health. Dec 2020;28(6):603-612. [CrossRef] [Medline]48,Bican R, Christensen C, Fallieras K, Sagester G, O'Rourke S, Byars M, et al. Rapid implementation of telerehabilitation for pediatric patients during COVID-19. Int J Telerehabil. Jun 22, 2021;13(1):e6371. [FREE Full text] [CrossRef] [Medline]52,Klamroth-Marganska V, Gemperle M, Ballmer T, Grylka-Baeschlin S, Pehlke-Milde J, Gantschnig BE. Does therapy always need touch? A cross-sectional study among Switzerland-based occupational therapists and midwives regarding their experience with health care at a distance during the COVID-19 pandemic in spring 2020. BMC Health Serv Res. Jun 15, 2021;21(1):578. [FREE Full text] [CrossRef] [Medline]60-Malliaras P, Merolli M, Williams CM, Caneiro JP, Haines T, Barton C. 'It's not hands-on therapy, so it's very limited': telehealth use and views among allied health clinicians during the coronavirus pandemic. Musculoskelet Sci Pract. Apr 2021;52:102340. [FREE Full text] [CrossRef] [Medline]62,Rettinger L, Klupper C, Werner F, Putz P. Changing attitudes towards teletherapy in Austrian therapists during the COVID-19 pandemic. J Telemed Telecare. Jun 2023;29(5):406-414. [FREE Full text] [CrossRef] [Medline]67,Bolden III W. Telehealth across the therapies: examining the impact of the COVID-19 pandemic on clinical staff working with low socioeconomic status populations. Perspective. Aug 2022;7(4):1236-1255. [FREE Full text] [CrossRef]76,Eguia KF, Capio CM. Teletherapy for children with developmental disorders during the COVID-19 pandemic in the Philippines: a mixed-methods evaluation from the perspectives of parents and therapists. Child Care Health Dev. Nov 2022;48(6):963-969. [CrossRef] [Medline]82,Kaur M, Eddy EZ, Tiwari D. Exploring practice patterns of pediatric telerehabilitation during COVID-19: a survey study. Telemed J E Health. Oct 2022;28(10):1505-1516. [FREE Full text] [CrossRef] [Medline]87,Richter B, Wattenberg I, Vollmer AL, Hornberg C, Wrede B, Lätzsch R. The COVID-19 pandemic as an opportunity for teletherapy? - A survey of non-medical therapy professionals in the health sector. Gesundheitswesen. Apr 2022;84(4):319-325. [CrossRef] [Medline]92,Wittmeier KD, Hammond E, Tymko K, Burnham K, Janssen T, Pablo AJ, et al. "Another tool in your toolkit": pediatric occupational and physical therapists' perspectives of initiating telehealth during the COVID-19 pandemic. Phys Occup Ther Pediatr. 2022;42(5):465-481. [CrossRef] [Medline]95]. Most articles covered barriers for PTs (29/56, 52%) [Lawford BJ, Bennell KL, Kasza J, Hinman RS. Physical therapists' perceptions of telephone- and internet video-mediated service models for exercise management of people with osteoarthritis. Arthritis Care Res (Hoboken). Mar 2018;70(3):398-408. [CrossRef] [Medline]43,Wundersitz C, Caelli A, Georgy J, Musovic A, Manning R, Prause M, et al. Conducting community rehabilitation review sessions via videoconference: a feasibility study. Aust J Rural Health. Dec 2020;28(6):603-612. [CrossRef] [Medline]48,Albahrouh SI, Buabbas AJ. Physiotherapists' perceptions of and willingness to use telerehabilitation in Kuwait during the COVID-19 pandemic. BMC Med Inform Decis Mak. Apr 08, 2021;21(1):122. [FREE Full text] [CrossRef] [Medline]49,Bennell KL, Lawford BJ, Metcalf B, Mackenzie D, Russell T, van den Berg M, et al. Physiotherapists and patients report positive experiences overall with telehealth during the COVID-19 pandemic: a mixed-methods study. J Physiother. Jul 2021;67(3):201-209. [FREE Full text] [CrossRef] [Medline]51-D'Souza AF, Rebello SR. Perceptions and willingness of physiotherapists in India to use telerehabilitation during the COVID-19 pandemic. Int J Telerehabil. Dec 16, 2021;13(2):e6425. [FREE Full text] [CrossRef] [Medline]53,Hall JB, Woods ML, Luechtefeld JT. Pediatric physical therapy telehealth and COVID-19: factors, facilitators, and barriers influencing effectiveness-a survey study. Pediatr Phys Ther. Jul 01, 2021;33(3):112-118. [FREE Full text] [CrossRef] [Medline]55-Hasani F, Malliaras P, Haines T, Munteanu SE, White J, Ridgway J, et al. Telehealth sounds a bit challenging, but it has potential: participant and physiotherapist experiences of gym-based exercise intervention for Achilles tendinopathy monitored via telehealth. BMC Musculoskelet Disord. Feb 04, 2021;22(1):138. [FREE Full text] [CrossRef] [Medline]57,Kienle GS, Werthmann P, Grotejohann B, Hundhammer T, Schmoor C, Stumpe C, et al. Addressing COVID-19 challenges in a randomised controlled trial on exercise interventions in a high-risk population. BMC Geriatr. May 01, 2021;21(1):287. [FREE Full text] [CrossRef] [Medline]59,Krasovsky T, Silberg T, Barak S, Eisenstein E, Erez N, Feldman I, et al. Transition to multidisciplinary pediatric telerehabilitation during the COVID-19 pandemic: strategy development and implementation. Int J Environ Res Public Health. Feb 04, 2021;18(4):1484. [FREE Full text] [CrossRef] [Medline]61-Peters S, Botero M, Evers A, Fong B, Jakab B, Petter E, et al. Development and feasibility of a modified Fugl-Meyer lower extremity assessment for telerehabilitation: a pilot study. Pilot Feasibility Stud. Jun 07, 2021;7(1):121. [FREE Full text] [CrossRef] [Medline]65,Rettinger L, Klupper C, Werner F, Putz P. Changing attitudes towards teletherapy in Austrian therapists during the COVID-19 pandemic. J Telemed Telecare. Jun 2023;29(5):406-414. [FREE Full text] [CrossRef] [Medline]67,Alrushud A, Alamam D, Alharthi A, Shaheen A, Alotaibi N, AlSabhan R, et al. Physical therapists' perceptions of and satisfaction with delivering telerehabilitation sessions to patients with knee osteoarthritis during the COVID-19 pandemic: preliminary study. Musculoskeletal Care. Dec 2022;20(4):926-936. [FREE Full text] [CrossRef] [Medline]74,Bolden III W. Telehealth across the therapies: examining the impact of the COVID-19 pandemic on clinical staff working with low socioeconomic status populations. Perspective. Aug 2022;7(4):1236-1255. [FREE Full text] [CrossRef]76-Eguia KF, Capio CM. Teletherapy for children with developmental disorders during the COVID-19 pandemic in the Philippines: a mixed-methods evaluation from the perspectives of parents and therapists. Child Care Health Dev. Nov 2022;48(6):963-969. [CrossRef] [Medline]82,Grant CM, Jones A, Land H. Physiotherapists’ perspectives on the use of telehealth for service delivery to children with developmental delays: a qualitative focus group study. Internet J Allied Health Sci Pract. Mar 31, 2022;20(2):1-10. [FREE Full text] [CrossRef]84,Haines KJ, Sawyer A, McKinnon C, Donovan A, Michael C, Cimoli C, et al. Barriers and enablers to telehealth use by physiotherapists during the COVID-19 pandemic. Physiotherapy. Mar 2023;118:12-19. [FREE Full text] [CrossRef] [Medline]85,Kaur M, Eddy EZ, Tiwari D. Exploring practice patterns of pediatric telerehabilitation during COVID-19: a survey study. Telemed J E Health. Oct 2022;28(10):1505-1516. [FREE Full text] [CrossRef] [Medline]87,Richter B, Wattenberg I, Vollmer AL, Hornberg C, Wrede B, Lätzsch R. The COVID-19 pandemic as an opportunity for teletherapy? - A survey of non-medical therapy professionals in the health sector. Gesundheitswesen. Apr 2022;84(4):319-325. [CrossRef] [Medline]92,Wittmeier KD, Hammond E, Tymko K, Burnham K, Janssen T, Pablo AJ, et al. "Another tool in your toolkit": pediatric occupational and physical therapists' perspectives of initiating telehealth during the COVID-19 pandemic. Phys Occup Ther Pediatr. 2022;42(5):465-481. [CrossRef] [Medline]95], followed by those for SLTs and audiologists (18/56, 32%) [Kwok EY, Chiu J, Rosenbaum P, Cunningham BJ. The process of telepractice implementation during the COVID-19 pandemic: a narrative inquiry of preschool speech-language pathologists and assistants from one center in Canada. BMC Health Serv Res. Jan 16, 2022;22(1):81. [FREE Full text] [CrossRef] [Medline]29,Wundersitz C, Caelli A, Georgy J, Musovic A, Manning R, Prause M, et al. Conducting community rehabilitation review sessions via videoconference: a feasibility study. Aust J Rural Health. Dec 2020;28(6):603-612. [CrossRef] [Medline]48,Bayati B, Ayatollahi H. Speech therapists' perspectives about using tele-speech therapy: a qualitative study. Disabil Rehabil Assist Technol. Jul 2023;18(5):621-626. [CrossRef] [Medline]50,Bican R, Christensen C, Fallieras K, Sagester G, O'Rourke S, Byars M, et al. Rapid implementation of telerehabilitation for pediatric patients during COVID-19. Int J Telerehabil. Jun 22, 2021;13(1):e6371. [FREE Full text] [CrossRef] [Medline]52,Kienle GS, Werthmann P, Grotejohann B, Hundhammer T, Schmoor C, Stumpe C, et al. Addressing COVID-19 challenges in a randomised controlled trial on exercise interventions in a high-risk population. BMC Geriatr. May 01, 2021;21(1):287. [FREE Full text] [CrossRef] [Medline]59-Krasovsky T, Silberg T, Barak S, Eisenstein E, Erez N, Feldman I, et al. Transition to multidisciplinary pediatric telerehabilitation during the COVID-19 pandemic: strategy development and implementation. Int J Environ Res Public Health. Feb 04, 2021;18(4):1484. [FREE Full text] [CrossRef] [Medline]61,Almog T, Gilboa Y. Remote delivery of service: a survey of occupational therapists' perceptions. Rehabil Process Outcome. Sep 06, 2022;11:11795727221117503. [FREE Full text] [CrossRef] [Medline]73,Chaudhari C, Talreja A. Emerging challenges faced by private clinic physiotherapist in new normal times during the COVID-19 pandemic in Pune city. Indian J Occup Ther. Aug 09, 2022;16(3):103-108. [FREE Full text] [CrossRef]79-Ditwiler RE, Swisher LL, Hardwick DD. Doing things you never imagined: professional and ethical issues in the U.S. outpatient physical therapy setting during the COVID-19 pandemic. Musculoskelet Sci Pract. Dec 2022;62:102684. [FREE Full text] [CrossRef] [Medline]81,Eikelboom RH, Bennett RJ, Manchaiah V, Parmar B, Beukes E, Rajasingam SL, et al. International survey of audiologists during the COVID-19 pandemic: use of and attitudes to telehealth. Int J Audiol. Apr 2022;61(4):283-292. [CrossRef] [Medline]83,Haines KJ, Sawyer A, McKinnon C, Donovan A, Michael C, Cimoli C, et al. Barriers and enablers to telehealth use by physiotherapists during the COVID-19 pandemic. Physiotherapy. Mar 2023;118:12-19. [FREE Full text] [CrossRef] [Medline]85,Richter B, Wattenberg I, Vollmer AL, Hornberg C, Wrede B, Lätzsch R. The COVID-19 pandemic as an opportunity for teletherapy? - A survey of non-medical therapy professionals in the health sector. Gesundheitswesen. Apr 2022;84(4):319-325. [CrossRef] [Medline]92-Van Eerdenbrugh S, Schraeyen K, Leysen H, Mostaert C, D'haenens W, Vandenborre D. Delivery of speech-language therapy and audiology services across the world at the start of the COVID-19 pandemic: a survey. Perspect. Apr 14, 2022;7(2):635-646. [FREE Full text] [CrossRef]94,Beit Yosef A, Maeir T, Khalailh F, Gilboa Y. Perceived feasibility of an occupation-based telerehabilitation intervention for older adults with chronic health conditions in Israel. Hong Kong J Occup Ther. Jun 2022;35(1):62-70. [FREE Full text] [CrossRef] [Medline]96]. Furthermore, publications were concentrated on OTs (15/56, 27%) [Rortvedt D, Jacobs K. Perspectives on the use of a telehealth service-delivery model as a component of school-based occupational therapy practice: designing a user-experience. Work. 2019;62(1):125-131. [CrossRef] [Medline]45,Abbott-Gaffney C, Jacobs K. Telehealth in school-based practice: perceived viability to bridge global OT practitioner shortages prior to COVID-19 global health emergency. Work. 2020;67(1):29-35. [CrossRef] [Medline]47,Bican R, Christensen C, Fallieras K, Sagester G, O'Rourke S, Byars M, et al. Rapid implementation of telerehabilitation for pediatric patients during COVID-19. Int J Telerehabil. Jun 22, 2021;13(1):e6371. [FREE Full text] [CrossRef] [Medline]52,Klamroth-Marganska V, Gemperle M, Ballmer T, Grylka-Baeschlin S, Pehlke-Milde J, Gantschnig BE. Does therapy always need touch? A cross-sectional study among Switzerland-based occupational therapists and midwives regarding their experience with health care at a distance during the COVID-19 pandemic in spring 2020. BMC Health Serv Res. Jun 15, 2021;21(1):578. [FREE Full text] [CrossRef] [Medline]60-Malliaras P, Merolli M, Williams CM, Caneiro JP, Haines T, Barton C. 'It's not hands-on therapy, so it's very limited': telehealth use and views among allied health clinicians during the coronavirus pandemic. Musculoskelet Sci Pract. Apr 2021;52:102340. [FREE Full text] [CrossRef] [Medline]62,Rettinger L, Klupper C, Werner F, Putz P. Changing attitudes towards teletherapy in Austrian therapists during the COVID-19 pandemic. J Telemed Telecare. Jun 2023;29(5):406-414. [FREE Full text] [CrossRef] [Medline]67,Abbott-Gaffney CR, Gafni-Lachter L, Cason J, Sheaffer K, Harasink R, Donehower K, et al. Toward successful future use of telehealth in occupational therapy practice: what the COVID-19 rapid shift revealed. Work. 2022;71(2):385-394. [CrossRef] [Medline]72,Almog T, Gilboa Y. Remote delivery of service: a survey of occupational therapists' perceptions. Rehabil Process Outcome. Sep 06, 2022;11:11795727221117503. [FREE Full text] [CrossRef] [Medline]73,Bolden III W. Telehealth across the therapies: examining the impact of the COVID-19 pandemic on clinical staff working with low socioeconomic status populations. Perspective. Aug 2022;7(4):1236-1255. [FREE Full text] [CrossRef]76,Eguia KF, Capio CM. Teletherapy for children with developmental disorders during the COVID-19 pandemic in the Philippines: a mixed-methods evaluation from the perspectives of parents and therapists. Child Care Health Dev. Nov 2022;48(6):963-969. [CrossRef] [Medline]82,Kaur M, Eddy EZ, Tiwari D. Exploring practice patterns of pediatric telerehabilitation during COVID-19: a survey study. Telemed J E Health. Oct 2022;28(10):1505-1516. [FREE Full text] [CrossRef] [Medline]87,Richter B, Wattenberg I, Vollmer AL, Hornberg C, Wrede B, Lätzsch R. The COVID-19 pandemic as an opportunity for teletherapy? - A survey of non-medical therapy professionals in the health sector. Gesundheitswesen. Apr 2022;84(4):319-325. [CrossRef] [Medline]92,Wittmeier KD, Hammond E, Tymko K, Burnham K, Janssen T, Pablo AJ, et al. "Another tool in your toolkit": pediatric occupational and physical therapists' perspectives of initiating telehealth during the COVID-19 pandemic. Phys Occup Ther Pediatr. 2022;42(5):465-481. [CrossRef] [Medline]95,Beit Yosef A, Maeir T, Khalailh F, Gilboa Y. Perceived feasibility of an occupation-based telerehabilitation intervention for older adults with chronic health conditions in Israel. Hong Kong J Occup Ther. Jun 2022;35(1):62-70. [FREE Full text] [CrossRef] [Medline]96], nurses (5/56, 9%) [Barrett D. Rethinking presence: a grounded theory of nurses and teleconsultation. J Clin Nurs. Oct 2017;26(19-20):3088-3098. [CrossRef] [Medline]42,Rygg LO, Brataas HV, Nordtug B. Introducing videoconferencing on tablet computers in nurse-patient communication: technical and training challenges. Int J Telemed Appl. Oct 18, 2018;2018:8943960. [FREE Full text] [CrossRef] [Medline]44,Rygg L, Brataas HV, Nordtug B. Oncology nurses' lived experiences of video communication in follow-up care of home-living patients: a phenomenological study in rural Norway. Eur J Oncol Nurs. Jun 2021;52:101955. [FREE Full text] [CrossRef] [Medline]69,Hughes L, Petrella A, Phillips N, Taylor RM. Virtual care and the impact of COVID-19 on nursing: a single centre evaluation. J Adv Nurs. Feb 2022;78(2):498-509. [FREE Full text] [CrossRef] [Medline]86,Koppel PD, De Gagne JC, Docherty S, Smith S, Prose NS, Jabaley T. Exploring nurse and patient experiences of developing rapport during oncology ambulatory care videoconferencing visits: qualitative descriptive study. J Med Internet Res. Sep 08, 2022;24(9):e39920. [FREE Full text] [CrossRef] [Medline]88], dieticians (4/56, 7%) [Wundersitz C, Caelli A, Georgy J, Musovic A, Manning R, Prause M, et al. Conducting community rehabilitation review sessions via videoconference: a feasibility study. Aust J Rural Health. Dec 2020;28(6):603-612. [CrossRef] [Medline]48,Kaufman-Shriqui V, Sherf-Dagan S, Boaz M, Birk R. Virtual nutrition consultation: what can we learn from the COVID-19 pandemic? Public Health Nutr. Apr 2021;24(5):1166-1173. [FREE Full text] [CrossRef] [Medline]58,Rozga M, Handu D, Kelley K, Jimenez EY, Martin H, Schofield M, et al. Telehealth during the COVID-19 pandemic: a cross-sectional survey of registered dietitian nutritionists. J Acad Nutr Diet. Dec 2021;121(12):2524-2535. [FREE Full text] [CrossRef] [Medline]68,Singh RH, Pringle T, Kenneson A. The use of telemedicine and other strategies by registered dietitians for the medical nutrition therapy of patients with inherited metabolic disorders during the COVID-19 pandemic. Front Nutr. Apr 27, 2021;8:637868. [FREE Full text] [CrossRef] [Medline]70], and midwives (2/56, 4%) [Spiby H, Faucher MA, Sands G, Roberts J, Kennedy HP. A qualitative study of midwives' perceptions on using video-calling in early labor. Birth. Mar 2019;46(1):105-112. [CrossRef] [Medline]46,Klamroth-Marganska V, Gemperle M, Ballmer T, Grylka-Baeschlin S, Pehlke-Milde J, Gantschnig BE. Does therapy always need touch? A cross-sectional study among Switzerland-based occupational therapists and midwives regarding their experience with health care at a distance during the COVID-19 pandemic in spring 2020. BMC Health Serv Res. Jun 15, 2021;21(1):578. [FREE Full text] [CrossRef] [Medline]60]. No studies with orthoptists were included.

The studies focused on various health contexts. Health professionals treated various target groups (27/56, 48%) [Barrett D. Rethinking presence: a grounded theory of nurses and teleconsultation. J Clin Nurs. Oct 2017;26(19-20):3088-3098. [CrossRef] [Medline]42,Rortvedt D, Jacobs K. Perspectives on the use of a telehealth service-delivery model as a component of school-based occupational therapy practice: designing a user-experience. Work. 2019;62(1):125-131. [CrossRef] [Medline]45,Abbott-Gaffney C, Jacobs K. Telehealth in school-based practice: perceived viability to bridge global OT practitioner shortages prior to COVID-19 global health emergency. Work. 2020;67(1):29-35. [CrossRef] [Medline]47-Bennell KL, Lawford BJ, Metcalf B, Mackenzie D, Russell T, van den Berg M, et al. Physiotherapists and patients report positive experiences overall with telehealth during the COVID-19 pandemic: a mixed-methods study. J Physiother. Jul 2021;67(3):201-209. [FREE Full text] [CrossRef] [Medline]51,D'Souza AF, Rebello SR. Perceptions and willingness of physiotherapists in India to use telerehabilitation during the COVID-19 pandemic. Int J Telerehabil. Dec 16, 2021;13(2):e6425. [FREE Full text] [CrossRef] [Medline]53,Fong R, Tsai CF, Yiu OY. The implementation of telepractice in speech language pathology in Hong Kong during the COVID-19 pandemic. Telemed J E Health. Jan 2021;27(1):30-38. [CrossRef] [Medline]54,Kaufman-Shriqui V, Sherf-Dagan S, Boaz M, Birk R. Virtual nutrition consultation: what can we learn from the COVID-19 pandemic? Public Health Nutr. Apr 2021;24(5):1166-1173. [FREE Full text] [CrossRef] [Medline]58,Klamroth-Marganska V, Gemperle M, Ballmer T, Grylka-Baeschlin S, Pehlke-Milde J, Gantschnig BE. Does therapy always need touch? A cross-sectional study among Switzerland-based occupational therapists and midwives regarding their experience with health care at a distance during the COVID-19 pandemic in spring 2020. BMC Health Serv Res. Jun 15, 2021;21(1):578. [FREE Full text] [CrossRef] [Medline]60,Martin R, Mandrusiak A, Russell T, Forbes R. New-graduate physiotherapists' training needs and readiness for telehealth. Physiother Theory Pract. Nov 2022;38(13):2788-2797. [CrossRef] [Medline]63,Rettinger L, Klupper C, Werner F, Putz P. Changing attitudes towards teletherapy in Austrian therapists during the COVID-19 pandemic. J Telemed Telecare. Jun 2023;29(5):406-414. [FREE Full text] [CrossRef] [Medline]67,Almog T, Gilboa Y. Remote delivery of service: a survey of occupational therapists' perceptions. Rehabil Process Outcome. Sep 06, 2022;11:11795727221117503. [FREE Full text] [CrossRef] [Medline]73,Bhattarai B, Sanghavi T, Abhishek BP. Challenges in delivering tele-practice services for communication disorders among audiologists and speech language pathologists. Indian J Otolaryngol Head Neck Surg. Dec 2022;74(Suppl 3):4360-4365. [FREE Full text] [CrossRef] [Medline]75,Ceprnja D, Clark T, Young J, Lee R, Flynn K, Maka K. Evaluating experiences, usability and patient satisfaction with telehealth for tertiary outpatient physiotherapy services during COVID-19: a mixed-methods study. Physiother Theory Pract (Forthcoming). Apr 06, 2022:1-9. [CrossRef] [Medline]78,Chaudhari C, Talreja A. Emerging challenges faced by private clinic physiotherapist in new normal times during the COVID-19 pandemic in Pune city. Indian J Occup Ther. Aug 09, 2022;16(3):103-108. [FREE Full text] [CrossRef]79,Ditwiler RE, Swisher LL, Hardwick DD. Doing things you never imagined: professional and ethical issues in the U.S. outpatient physical therapy setting during the COVID-19 pandemic. Musculoskelet Sci Pract. Dec 2022;62:102684. [FREE Full text] [CrossRef] [Medline]81,Eikelboom RH, Bennett RJ, Manchaiah V, Parmar B, Beukes E, Rajasingam SL, et al. International survey of audiologists during the COVID-19 pandemic: use of and attitudes to telehealth. Int J Audiol. Apr 2022;61(4):283-292. [CrossRef] [Medline]83,Haines KJ, Sawyer A, McKinnon C, Donovan A, Michael C, Cimoli C, et al. Barriers and enablers to telehealth use by physiotherapists during the COVID-19 pandemic. Physiotherapy. Mar 2023;118:12-19. [FREE Full text] [CrossRef] [Medline]85,Hughes L, Petrella A, Phillips N, Taylor RM. Virtual care and the impact of COVID-19 on nursing: a single centre evaluation. J Adv Nurs. Feb 2022;78(2):498-509. [FREE Full text] [CrossRef] [Medline]86,Nazreen Nihara MR, Seethapathy J. Tele-audiology in India: current and future trends in knowledge, attitude, and practice among audiologists. J Audiol Otol. Jul 2022;26(3):130-141. [FREE Full text] [CrossRef] [Medline]89-Van Eerdenbrugh S, Schraeyen K, Leysen H, Mostaert C, D'haenens W, Vandenborre D. Delivery of speech-language therapy and audiology services across the world at the start of the COVID-19 pandemic: a survey. Perspect. Apr 14, 2022;7(2):635-646. [FREE Full text] [CrossRef]94] or focused on specific target groups, such as children (13/56, 23%) [Kwok EY, Chiu J, Rosenbaum P, Cunningham BJ. The process of telepractice implementation during the COVID-19 pandemic: a narrative inquiry of preschool speech-language pathologists and assistants from one center in Canada. BMC Health Serv Res. Jan 16, 2022;22(1):81. [FREE Full text] [CrossRef] [Medline]29,Rortvedt D, Jacobs K. Perspectives on the use of a telehealth service-delivery model as a component of school-based occupational therapy practice: designing a user-experience. Work. 2019;62(1):125-131. [CrossRef] [Medline]45,Bican R, Christensen C, Fallieras K, Sagester G, O'Rourke S, Byars M, et al. Rapid implementation of telerehabilitation for pediatric patients during COVID-19. Int J Telerehabil. Jun 22, 2021;13(1):e6371. [FREE Full text] [CrossRef] [Medline]52,Hall JB, Woods ML, Luechtefeld JT. Pediatric physical therapy telehealth and COVID-19: factors, facilitators, and barriers influencing effectiveness-a survey study. Pediatr Phys Ther. Jul 01, 2021;33(3):112-118. [FREE Full text] [CrossRef] [Medline]55,Krasovsky T, Silberg T, Barak S, Eisenstein E, Erez N, Feldman I, et al. Transition to multidisciplinary pediatric telerehabilitation during the COVID-19 pandemic: strategy development and implementation. Int J Environ Res Public Health. Feb 04, 2021;18(4):1484. [FREE Full text] [CrossRef] [Medline]61,Pollard R, Hogan S. Parental and practitioner views of telepractice for pediatric auditory verbal habilitation at a time of global pandemic. Perspective. Dec 2021;6(6):1832-1856. [FREE Full text] [CrossRef]66,Sutherland R, Hodge A, Chan E, Silove N. Barriers and facilitators: clinicians' opinions and experiences of telehealth before and after their use of a telehealth platform for child language assessment. Int J Lang Commun Disord. Nov 2021;56(6):1263-1277. [CrossRef] [Medline]71,Abbott-Gaffney CR, Gafni-Lachter L, Cason J, Sheaffer K, Harasink R, Donehower K, et al. Toward successful future use of telehealth in occupational therapy practice: what the COVID-19 rapid shift revealed. Work. 2022;71(2):385-394. [CrossRef] [Medline]72,Bolden III W. Telehealth across the therapies: examining the impact of the COVID-19 pandemic on clinical staff working with low socioeconomic status populations. Perspective. Aug 2022;7(4):1236-1255. [FREE Full text] [CrossRef]76,Eguia KF, Capio CM. Teletherapy for children with developmental disorders during the COVID-19 pandemic in the Philippines: a mixed-methods evaluation from the perspectives of parents and therapists. Child Care Health Dev. Nov 2022;48(6):963-969. [CrossRef] [Medline]82,Grant CM, Jones A, Land H. Physiotherapists’ perspectives on the use of telehealth for service delivery to children with developmental delays: a qualitative focus group study. Internet J Allied Health Sci Pract. Mar 31, 2022;20(2):1-10. [FREE Full text] [CrossRef]84,Kaur M, Eddy EZ, Tiwari D. Exploring practice patterns of pediatric telerehabilitation during COVID-19: a survey study. Telemed J E Health. Oct 2022;28(10):1505-1516. [FREE Full text] [CrossRef] [Medline]87,Wittmeier KD, Hammond E, Tymko K, Burnham K, Janssen T, Pablo AJ, et al. "Another tool in your toolkit": pediatric occupational and physical therapists' perspectives of initiating telehealth during the COVID-19 pandemic. Phys Occup Ther Pediatr. 2022;42(5):465-481. [CrossRef] [Medline]95] or older adults (2/56, 4%) [Kienle GS, Werthmann P, Grotejohann B, Hundhammer T, Schmoor C, Stumpe C, et al. Addressing COVID-19 challenges in a randomised controlled trial on exercise interventions in a high-risk population. BMC Geriatr. May 01, 2021;21(1):287. [FREE Full text] [CrossRef] [Medline]59,Beit Yosef A, Maeir T, Khalailh F, Gilboa Y. Perceived feasibility of an occupation-based telerehabilitation intervention for older adults with chronic health conditions in Israel. Hong Kong J Occup Ther. Jun 2022;35(1):62-70. [FREE Full text] [CrossRef] [Medline]96], or patients with specific diseases or issues, such as musculoskeletal disorders (2/56, 4%) [Malliaras P, Merolli M, Williams CM, Caneiro JP, Haines T, Barton C. 'It's not hands-on therapy, so it's very limited': telehealth use and views among allied health clinicians during the coronavirus pandemic. Musculoskelet Sci Pract. Apr 2021;52:102340. [FREE Full text] [CrossRef] [Medline]62,Buabbas AJ, Albahrouh SE, Alrowayeh HN, Alshawaf H. Telerehabilitation during the COVID-19 pandemic: patients and physical therapists' experiences. Med Princ Pract. 2022;31(2):156-164. [FREE Full text] [CrossRef] [Medline]77], cancer (3/56, 5%) [Rygg LO, Brataas HV, Nordtug B. Introducing videoconferencing on tablet computers in nurse-patient communication: technical and training challenges. Int J Telemed Appl. Oct 18, 2018;2018:8943960. [FREE Full text] [CrossRef] [Medline]44,Rygg L, Brataas HV, Nordtug B. Oncology nurses' lived experiences of video communication in follow-up care of home-living patients: a phenomenological study in rural Norway. Eur J Oncol Nurs. Jun 2021;52:101955. [FREE Full text] [CrossRef] [Medline]69,Koppel PD, De Gagne JC, Docherty S, Smith S, Prose NS, Jabaley T. Exploring nurse and patient experiences of developing rapport during oncology ambulatory care videoconferencing visits: qualitative descriptive study. J Med Internet Res. Sep 08, 2022;24(9):e39920. [FREE Full text] [CrossRef] [Medline]88], osteoarthritis (3/56, 5%) [Lawford BJ, Bennell KL, Kasza J, Hinman RS. Physical therapists' perceptions of telephone- and internet video-mediated service models for exercise management of people with osteoarthritis. Arthritis Care Res (Hoboken). Mar 2018;70(3):398-408. [CrossRef] [Medline]43,Alrushud A, Alamam D, Alharthi A, Shaheen A, Alotaibi N, AlSabhan R, et al. Physical therapists' perceptions of and satisfaction with delivering telerehabilitation sessions to patients with knee osteoarthritis during the COVID-19 pandemic: preliminary study. Musculoskeletal Care. Dec 2022;20(4):926-936. [FREE Full text] [CrossRef] [Medline]74,Dissanayaka T, Nakandala P, Sanjeewa C. Physiotherapists' perceptions and barriers to use of telerehabilitation for exercise management of people with knee osteoarthritis in Sri Lanka. Disabil Rehabil Assist Technol (Forthcoming). Sep 13, 2022:1-10. [CrossRef] [Medline]80], vestibular disorders (1/56, 2%) [Harrell RG, Schubert MC, Oxborough S, Whitney SL. Vestibular rehabilitation telehealth during the SAEA-CoV-2 (COVID-19) pandemic. Front Neurol. Jan 20, 2022;12:781482. [FREE Full text] [CrossRef] [Medline]56], early labor (1/56, 2%) [Spiby H, Faucher MA, Sands G, Roberts J, Kennedy HP. A qualitative study of midwives' perceptions on using video-calling in early labor. Birth. Mar 2019;46(1):105-112. [CrossRef] [Medline]46], diabetes (1/56, 2%) [Singh RH, Pringle T, Kenneson A. The use of telemedicine and other strategies by registered dietitians for the medical nutrition therapy of patients with inherited metabolic disorders during the COVID-19 pandemic. Front Nutr. Apr 27, 2021;8:637868. [FREE Full text] [CrossRef] [Medline]70], pelvic health (1/56, 2%) [McPherson K, Nahon I. Telehealth and the provision of pelvic health physiotherapy in regional, rural and remote Australia. Aust N Z Cont J. Aug 2021;27(3):66-70. [CrossRef]64], and Achilles tendinopathy (1/56, 2%) [Hasani F, Malliaras P, Haines T, Munteanu SE, White J, Ridgway J, et al. Telehealth sounds a bit challenging, but it has potential: participant and physiotherapist experiences of gym-based exercise intervention for Achilles tendinopathy monitored via telehealth. BMC Musculoskelet Disord. Feb 04, 2021;22(1):138. [FREE Full text] [CrossRef] [Medline]57]. Overall, 2% (1/56) of studies focused on the execution of assessments via telehealth [Peters S, Botero M, Evers A, Fong B, Jakab B, Petter E, et al. Development and feasibility of a modified Fugl-Meyer lower extremity assessment for telerehabilitation: a pilot study. Pilot Feasibility Stud. Jun 07, 2021;7(1):121. [FREE Full text] [CrossRef] [Medline]65]. Figure 2 shows the study characteristics based on the included professions and health contexts [Kwok EY, Chiu J, Rosenbaum P, Cunningham BJ. The process of telepractice implementation during the COVID-19 pandemic: a narrative inquiry of preschool speech-language pathologists and assistants from one center in Canada. BMC Health Serv Res. Jan 16, 2022;22(1):81. [FREE Full text] [CrossRef] [Medline]29,Barrett D. Rethinking presence: a grounded theory of nurses and teleconsultation. J Clin Nurs. Oct 2017;26(19-20):3088-3098. [CrossRef] [Medline]42-Beit Yosef A, Maeir T, Khalailh F, Gilboa Y. Perceived feasibility of an occupation-based telerehabilitation intervention for older adults with chronic health conditions in Israel. Hong Kong J Occup Ther. Jun 2022;35(1):62-70. [FREE Full text] [CrossRef] [Medline]96].

The publications were from the United States (12/56, 21%) [Rortvedt D, Jacobs K. Perspectives on the use of a telehealth service-delivery model as a component of school-based occupational therapy practice: designing a user-experience. Work. 2019;62(1):125-131. [CrossRef] [Medline]45,Abbott-Gaffney C, Jacobs K. Telehealth in school-based practice: perceived viability to bridge global OT practitioner shortages prior to COVID-19 global health emergency. Work. 2020;67(1):29-35. [CrossRef] [Medline]47,Bican R, Christensen C, Fallieras K, Sagester G, O'Rourke S, Byars M, et al. Rapid implementation of telerehabilitation for pediatric patients during COVID-19. Int J Telerehabil. Jun 22, 2021;13(1):e6371. [FREE Full text] [CrossRef] [Medline]52,Hall JB, Woods ML, Luechtefeld JT. Pediatric physical therapy telehealth and COVID-19: factors, facilitators, and barriers influencing effectiveness-a survey study. Pediatr Phys Ther. Jul 01, 2021;33(3):112-118. [FREE Full text] [CrossRef] [Medline]55,Harrell RG, Schubert MC, Oxborough S, Whitney SL. Vestibular rehabilitation telehealth during the SAEA-CoV-2 (COVID-19) pandemic. Front Neurol. Jan 20, 2022;12:781482. [FREE Full text] [CrossRef] [Medline]56,Rozga M, Handu D, Kelley K, Jimenez EY, Martin H, Schofield M, et al. Telehealth during the COVID-19 pandemic: a cross-sectional survey of registered dietitian nutritionists. J Acad Nutr Diet. Dec 2021;121(12):2524-2535. [FREE Full text] [CrossRef] [Medline]68,Singh RH, Pringle T, Kenneson A. The use of telemedicine and other strategies by registered dietitians for the medical nutrition therapy of patients with inherited metabolic disorders during the COVID-19 pandemic. Front Nutr. Apr 27, 2021;8:637868. [FREE Full text] [CrossRef] [Medline]70,Abbott-Gaffney CR, Gafni-Lachter L, Cason J, Sheaffer K, Harasink R, Donehower K, et al. Toward successful future use of telehealth in occupational therapy practice: what the COVID-19 rapid shift revealed. Work. 2022;71(2):385-394. [CrossRef] [Medline]72,Bolden III W. Telehealth across the therapies: examining the impact of the COVID-19 pandemic on clinical staff working with low socioeconomic status populations. Perspective. Aug 2022;7(4):1236-1255. [FREE Full text] [CrossRef]76,Ditwiler RE, Swisher LL, Hardwick DD. Doing things you never imagined: professional and ethical issues in the U.S. outpatient physical therapy setting during the COVID-19 pandemic. Musculoskelet Sci Pract. Dec 2022;62:102684. [FREE Full text] [CrossRef] [Medline]81,Kaur M, Eddy EZ, Tiwari D. Exploring practice patterns of pediatric telerehabilitation during COVID-19: a survey study. Telemed J E Health. Oct 2022;28(10):1505-1516. [FREE Full text] [CrossRef] [Medline]87,Koppel PD, De Gagne JC, Docherty S, Smith S, Prose NS, Jabaley T. Exploring nurse and patient experiences of developing rapport during oncology ambulatory care videoconferencing visits: qualitative descriptive study. J Med Internet Res. Sep 08, 2022;24(9):e39920. [FREE Full text] [CrossRef] [Medline]88], Australia (12/56, 21%) [Lawford BJ, Bennell KL, Kasza J, Hinman RS. Physical therapists' perceptions of telephone- and internet video-mediated service models for exercise management of people with osteoarthritis. Arthritis Care Res (Hoboken). Mar 2018;70(3):398-408. [CrossRef] [Medline]43,Wundersitz C, Caelli A, Georgy J, Musovic A, Manning R, Prause M, et al. Conducting community rehabilitation review sessions via videoconference: a feasibility study. Aust J Rural Health. Dec 2020;28(6):603-612. [CrossRef] [Medline]48,Bennell KL, Lawford BJ, Metcalf B, Mackenzie D, Russell T, van den Berg M, et al. Physiotherapists and patients report positive experiences overall with telehealth during the COVID-19 pandemic: a mixed-methods study. J Physiother. Jul 2021;67(3):201-209. [FREE Full text] [CrossRef] [Medline]51,Hasani F, Malliaras P, Haines T, Munteanu SE, White J, Ridgway J, et al. Telehealth sounds a bit challenging, but it has potential: participant and physiotherapist experiences of gym-based exercise intervention for Achilles tendinopathy monitored via telehealth. BMC Musculoskelet Disord. Feb 04, 2021;22(1):138. [FREE Full text] [CrossRef] [Medline]57,Malliaras P, Merolli M, Williams CM, Caneiro JP, Haines T, Barton C. 'It's not hands-on therapy, so it's very limited': telehealth use and views among allied health clinicians during the coronavirus pandemic. Musculoskelet Sci Pract. Apr 2021;52:102340. [FREE Full text] [CrossRef] [Medline]62-McPherson K, Nahon I. Telehealth and the provision of pelvic health physiotherapy in regional, rural and remote Australia. Aust N Z Cont J. Aug 2021;27(3):66-70. [CrossRef]64,Sutherland R, Hodge A, Chan E, Silove N. Barriers and facilitators: clinicians' opinions and experiences of telehealth before and after their use of a telehealth platform for child language assessment. Int J Lang Commun Disord. Nov 2021;56(6):1263-1277. [CrossRef] [Medline]71,Ceprnja D, Clark T, Young J, Lee R, Flynn K, Maka K. Evaluating experiences, usability and patient satisfaction with telehealth for tertiary outpatient physiotherapy services during COVID-19: a mixed-methods study. Physiother Theory Pract (Forthcoming). Apr 06, 2022:1-9. [CrossRef] [Medline]78,Eikelboom RH, Bennett RJ, Manchaiah V, Parmar B, Beukes E, Rajasingam SL, et al. International survey of audiologists during the COVID-19 pandemic: use of and attitudes to telehealth. Int J Audiol. Apr 2022;61(4):283-292. [CrossRef] [Medline]83-Haines KJ, Sawyer A, McKinnon C, Donovan A, Michael C, Cimoli C, et al. Barriers and enablers to telehealth use by physiotherapists during the COVID-19 pandemic. Physiotherapy. Mar 2023;118:12-19. [FREE Full text] [CrossRef] [Medline]85], the United Kingdom (5/56, 9%) [Barrett D. Rethinking presence: a grounded theory of nurses and teleconsultation. J Clin Nurs. Oct 2017;26(19-20):3088-3098. [CrossRef] [Medline]42,Spiby H, Faucher MA, Sands G, Roberts J, Kennedy HP. A qualitative study of midwives' perceptions on using video-calling in early labor. Birth. Mar 2019;46(1):105-112. [CrossRef] [Medline]46,Pollard R, Hogan S. Parental and practitioner views of telepractice for pediatric auditory verbal habilitation at a time of global pandemic. Perspective. Dec 2021;6(6):1832-1856. [FREE Full text] [CrossRef]66,Hughes L, Petrella A, Phillips N, Taylor RM. Virtual care and the impact of COVID-19 on nursing: a single centre evaluation. J Adv Nurs. Feb 2022;78(2):498-509. [FREE Full text] [CrossRef] [Medline]86,Parmar B, Beukes E, Rajasingam S. Int J Audiol. Mar 2022;61(3):228-238. [CrossRef] [Medline]90], Israel (4/56, 7%) [Kaufman-Shriqui V, Sherf-Dagan S, Boaz M, Birk R. Virtual nutrition consultation: what can we learn from the COVID-19 pandemic? Public Health Nutr. Apr 2021;24(5):1166-1173. [FREE Full text] [CrossRef] [Medline]58,Krasovsky T, Silberg T, Barak S, Eisenstein E, Erez N, Feldman I, et al. Transition to multidisciplinary pediatric telerehabilitation during the COVID-19 pandemic: strategy development and implementation. Int J Environ Res Public Health. Feb 04, 2021;18(4):1484. [FREE Full text] [CrossRef] [Medline]61,Almog T, Gilboa Y. Remote delivery of service: a survey of occupational therapists' perceptions. Rehabil Process Outcome. Sep 06, 2022;11:11795727221117503. [FREE Full text] [CrossRef] [Medline]73,Beit Yosef A, Maeir T, Khalailh F, Gilboa Y. Perceived feasibility of an occupation-based telerehabilitation intervention for older adults with chronic health conditions in Israel. Hong Kong J Occup Ther. Jun 2022;35(1):62-70. [FREE Full text] [CrossRef] [Medline]96], India (4/56, 7%) [D'Souza AF, Rebello SR. Perceptions and willingness of physiotherapists in India to use telerehabilitation during the COVID-19 pandemic. Int J Telerehabil. Dec 16, 2021;13(2):e6425. [FREE Full text] [CrossRef] [Medline]53,Bhattarai B, Sanghavi T, Abhishek BP. Challenges in delivering tele-practice services for communication disorders among audiologists and speech language pathologists. Indian J Otolaryngol Head Neck Surg. Dec 2022;74(Suppl 3):4360-4365. [FREE Full text] [CrossRef] [Medline]75,Chaudhari C, Talreja A. Emerging challenges faced by private clinic physiotherapist in new normal times during the COVID-19 pandemic in Pune city. Indian J Occup Ther. Aug 09, 2022;16(3):103-108. [FREE Full text] [CrossRef]79,Nazreen Nihara MR, Seethapathy J. Tele-audiology in India: current and future trends in knowledge, attitude, and practice among audiologists. J Audiol Otol. Jul 2022;26(3):130-141. [FREE Full text] [CrossRef] [Medline]89], Canada (3/56, 5%) [Kwok EY, Chiu J, Rosenbaum P, Cunningham BJ. The process of telepractice implementation during the COVID-19 pandemic: a narrative inquiry of preschool speech-language pathologists and assistants from one center in Canada. BMC Health Serv Res. Jan 16, 2022;22(1):81. [FREE Full text] [CrossRef] [Medline]29,Peters S, Botero M, Evers A, Fong B, Jakab B, Petter E, et al. Development and feasibility of a modified Fugl-Meyer lower extremity assessment for telerehabilitation: a pilot study. Pilot Feasibility Stud. Jun 07, 2021;7(1):121. [FREE Full text] [CrossRef] [Medline]65,Wittmeier KD, Hammond E, Tymko K, Burnham K, Janssen T, Pablo AJ, et al. "Another tool in your toolkit": pediatric occupational and physical therapists' perspectives of initiating telehealth during the COVID-19 pandemic. Phys Occup Ther Pediatr. 2022;42(5):465-481. [CrossRef] [Medline]95], Germany (2/56, 4%) [Kienle GS, Werthmann P, Grotejohann B, Hundhammer T, Schmoor C, Stumpe C, et al. Addressing COVID-19 challenges in a randomised controlled trial on exercise interventions in a high-risk population. BMC Geriatr. May 01, 2021;21(1):287. [FREE Full text] [CrossRef] [Medline]59,Richter B, Wattenberg I, Vollmer AL, Hornberg C, Wrede B, Lätzsch R. The COVID-19 pandemic as an opportunity for teletherapy? - A survey of non-medical therapy professionals in the health sector. Gesundheitswesen. Apr 2022;84(4):319-325. [CrossRef] [Medline]92], Kuwait (2/56, 4%) [Albahrouh SI, Buabbas AJ. Physiotherapists' perceptions of and willingness to use telerehabilitation in Kuwait during the COVID-19 pandemic. BMC Med Inform Decis Mak. Apr 08, 2021;21(1):122. [FREE Full text] [CrossRef] [Medline]49,Buabbas AJ, Albahrouh SE, Alrowayeh HN, Alshawaf H. Telerehabilitation during the COVID-19 pandemic: patients and physical therapists' experiences. Med Princ Pract. 2022;31(2):156-164. [FREE Full text] [CrossRef] [Medline]77], Norway (2/56, 4%) [Rygg LO, Brataas HV, Nordtug B. Introducing videoconferencing on tablet computers in nurse-patient communication: technical and training challenges. Int J Telemed Appl. Oct 18, 2018;2018:8943960. [FREE Full text] [CrossRef] [Medline]44,Rygg L, Brataas HV, Nordtug B. Oncology nurses' lived experiences of video communication in follow-up care of home-living patients: a phenomenological study in rural Norway. Eur J Oncol Nurs. Jun 2021;52:101955. [FREE Full text] [CrossRef] [Medline]69], Iran (1/56, 2%) [Bayati B, Ayatollahi H. Speech therapists' perspectives about using tele-speech therapy: a qualitative study. Disabil Rehabil Assist Technol. Jul 2023;18(5):621-626. [CrossRef] [Medline]50], Hong Kong (1/56, 2%) [Fong R, Tsai CF, Yiu OY. The implementation of telepractice in speech language pathology in Hong Kong during the COVID-19 pandemic. Telemed J E Health. Jan 2021;27(1):30-38. [CrossRef] [Medline]54], Switzerland (1/56, 2%) [Klamroth-Marganska V, Gemperle M, Ballmer T, Grylka-Baeschlin S, Pehlke-Milde J, Gantschnig BE. Does therapy always need touch? A cross-sectional study among Switzerland-based occupational therapists and midwives regarding their experience with health care at a distance during the COVID-19 pandemic in spring 2020. BMC Health Serv Res. Jun 15, 2021;21(1):578. [FREE Full text] [CrossRef] [Medline]60], Austria (1/56, 2%) [Rettinger L, Klupper C, Werner F, Putz P. Changing attitudes towards teletherapy in Austrian therapists during the COVID-19 pandemic. J Telemed Telecare. Jun 2023;29(5):406-414. [FREE Full text] [CrossRef] [Medline]67], Belgium (1/56, 2%) [Van Eerdenbrugh S, Schraeyen K, Leysen H, Mostaert C, D'haenens W, Vandenborre D. Delivery of speech-language therapy and audiology services across the world at the start of the COVID-19 pandemic: a survey. Perspect. Apr 14, 2022;7(2):635-646. [FREE Full text] [CrossRef]94], Singapore (1/56, 2%) [Peh HP, Yee K, Mantaring EJ. Changes in telepractice use and perspectives among speech and language therapists in Singapore through the COVID-19 pandemic. Int J Lang Commun Disord. May 2023;58(3):802-812. [CrossRef] [Medline]91], South Africa (1/56, 2%) [Tar-Mahomed Z, Kater KA. The perspectives of speech-language pathologists: providing teletherapy to patients with speech, language and swallowing difficulties during a COVID-19 context. S Afr J Commun Disord. Aug 11, 2022;69(2):e1-e7. [FREE Full text] [CrossRef] [Medline]93], the Philippines (1/56, 2%) [Eguia KF, Capio CM. Teletherapy for children with developmental disorders during the COVID-19 pandemic in the Philippines: a mixed-methods evaluation from the perspectives of parents and therapists. Child Care Health Dev. Nov 2022;48(6):963-969. [CrossRef] [Medline]82], Sri Lanka (1/56, 2%) [Dissanayaka T, Nakandala P, Sanjeewa C. Physiotherapists' perceptions and barriers to use of telerehabilitation for exercise management of people with knee osteoarthritis in Sri Lanka. Disabil Rehabil Assist Technol (Forthcoming). Sep 13, 2022:1-10. [CrossRef] [Medline]80], and Saudi Arabia (1/56, 2%) [Alrushud A, Alamam D, Alharthi A, Shaheen A, Alotaibi N, AlSabhan R, et al. Physical therapists' perceptions of and satisfaction with delivering telerehabilitation sessions to patients with knee osteoarthritis during the COVID-19 pandemic: preliminary study. Musculoskeletal Care. Dec 2022;20(4):926-936. [FREE Full text] [CrossRef] [Medline]74]. Study participants from a variety of continents and countries were included: 27% (15/56) of the participants were from North America, 21% (12/56) were from Europe and Australia each, 14% (8/56) were from the Middle East and South and East Asia each, and 2% (1/56) were from Africa. A visual representation of the worldwide distribution of study participants can be found in Figure 3.

Questionnaires (37/56, 66%) were used with a total of 10,245 health professionals [Lawford BJ, Bennell KL, Kasza J, Hinman RS. Physical therapists' perceptions of telephone- and internet video-mediated service models for exercise management of people with osteoarthritis. Arthritis Care Res (Hoboken). Mar 2018;70(3):398-408. [CrossRef] [Medline]43,Rortvedt D, Jacobs K. Perspectives on the use of a telehealth service-delivery model as a component of school-based occupational therapy practice: designing a user-experience. Work. 2019;62(1):125-131. [CrossRef] [Medline]45,Abbott-Gaffney C, Jacobs K. Telehealth in school-based practice: perceived viability to bridge global OT practitioner shortages prior to COVID-19 global health emergency. Work. 2020;67(1):29-35. [CrossRef] [Medline]47,Bennell KL, Lawford BJ, Metcalf B, Mackenzie D, Russell T, van den Berg M, et al. Physiotherapists and patients report positive experiences overall with telehealth during the COVID-19 pandemic: a mixed-methods study. J Physiother. Jul 2021;67(3):201-209. [FREE Full text] [CrossRef] [Medline]51-Harrell RG, Schubert MC, Oxborough S, Whitney SL. Vestibular rehabilitation telehealth during the SAEA-CoV-2 (COVID-19) pandemic. Front Neurol. Jan 20, 2022;12:781482. [FREE Full text] [CrossRef] [Medline]56,Kaufman-Shriqui V, Sherf-Dagan S, Boaz M, Birk R. Virtual nutrition consultation: what can we learn from the COVID-19 pandemic? Public Health Nutr. Apr 2021;24(5):1166-1173. [FREE Full text] [CrossRef] [Medline]58,Klamroth-Marganska V, Gemperle M, Ballmer T, Grylka-Baeschlin S, Pehlke-Milde J, Gantschnig BE. Does therapy always need touch? A cross-sectional study among Switzerland-based occupational therapists and midwives regarding their experience with health care at a distance during the COVID-19 pandemic in spring 2020. BMC Health Serv Res. Jun 15, 2021;21(1):578. [FREE Full text] [CrossRef] [Medline]60-Malliaras P, Merolli M, Williams CM, Caneiro JP, Haines T, Barton C. 'It's not hands-on therapy, so it's very limited': telehealth use and views among allied health clinicians during the coronavirus pandemic. Musculoskelet Sci Pract. Apr 2021;52:102340. [FREE Full text] [CrossRef] [Medline]62,McPherson K, Nahon I. Telehealth and the provision of pelvic health physiotherapy in regional, rural and remote Australia. Aust N Z Cont J. Aug 2021;27(3):66-70. [CrossRef]64-Rozga M, Handu D, Kelley K, Jimenez EY, Martin H, Schofield M, et al. Telehealth during the COVID-19 pandemic: a cross-sectional survey of registered dietitian nutritionists. J Acad Nutr Diet. Dec 2021;121(12):2524-2535. [FREE Full text] [CrossRef] [Medline]68,Singh RH, Pringle T, Kenneson A. The use of telemedicine and other strategies by registered dietitians for the medical nutrition therapy of patients with inherited metabolic disorders during the COVID-19 pandemic. Front Nutr. Apr 27, 2021;8:637868. [FREE Full text] [CrossRef] [Medline]70-Almog T, Gilboa Y. Remote delivery of service: a survey of occupational therapists' perceptions. Rehabil Process Outcome. Sep 06, 2022;11:11795727221117503. [FREE Full text] [CrossRef] [Medline]73,Bhattarai B, Sanghavi T, Abhishek BP. Challenges in delivering tele-practice services for communication disorders among audiologists and speech language pathologists. Indian J Otolaryngol Head Neck Surg. Dec 2022;74(Suppl 3):4360-4365. [FREE Full text] [CrossRef] [Medline]75,Bolden III W. Telehealth across the therapies: examining the impact of the COVID-19 pandemic on clinical staff working with low socioeconomic status populations. Perspective. Aug 2022;7(4):1236-1255. [FREE Full text] [CrossRef]76,Ceprnja D, Clark T, Young J, Lee R, Flynn K, Maka K. Evaluating experiences, usability and patient satisfaction with telehealth for tertiary outpatient physiotherapy services during COVID-19: a mixed-methods study. Physiother Theory Pract (Forthcoming). Apr 06, 2022:1-9. [CrossRef] [Medline]78-Dissanayaka T, Nakandala P, Sanjeewa C. Physiotherapists' perceptions and barriers to use of telerehabilitation for exercise management of people with knee osteoarthritis in Sri Lanka. Disabil Rehabil Assist Technol (Forthcoming). Sep 13, 2022:1-10. [CrossRef] [Medline]80,Eguia KF, Capio CM. Teletherapy for children with developmental disorders during the COVID-19 pandemic in the Philippines: a mixed-methods evaluation from the perspectives of parents and therapists. Child Care Health Dev. Nov 2022;48(6):963-969. [CrossRef] [Medline]82,Eikelboom RH, Bennett RJ, Manchaiah V, Parmar B, Beukes E, Rajasingam SL, et al. International survey of audiologists during the COVID-19 pandemic: use of and attitudes to telehealth. Int J Audiol. Apr 2022;61(4):283-292. [CrossRef] [Medline]83,Kaur M, Eddy EZ, Tiwari D. Exploring practice patterns of pediatric telerehabilitation during COVID-19: a survey study. Telemed J E Health. Oct 2022;28(10):1505-1516. [FREE Full text] [CrossRef] [Medline]87,Nazreen Nihara MR, Seethapathy J. Tele-audiology in India: current and future trends in knowledge, attitude, and practice among audiologists. J Audiol Otol. Jul 2022;26(3):130-141. [FREE Full text] [CrossRef] [Medline]89-Van Eerdenbrugh S, Schraeyen K, Leysen H, Mostaert C, D'haenens W, Vandenborre D. Delivery of speech-language therapy and audiology services across the world at the start of the COVID-19 pandemic: a survey. Perspect. Apr 14, 2022;7(2):635-646. [FREE Full text] [CrossRef]94,Beit Yosef A, Maeir T, Khalailh F, Gilboa Y. Perceived feasibility of an occupation-based telerehabilitation intervention for older adults with chronic health conditions in Israel. Hong Kong J Occup Ther. Jun 2022;35(1):62-70. [FREE Full text] [CrossRef] [Medline]96], and interviews or focus groups (17/56, 30%) were conducted with 288 health professionals [Kwok EY, Chiu J, Rosenbaum P, Cunningham BJ. The process of telepractice implementation during the COVID-19 pandemic: a narrative inquiry of preschool speech-language pathologists and assistants from one center in Canada. BMC Health Serv Res. Jan 16, 2022;22(1):81. [FREE Full text] [CrossRef] [Medline]29,Barrett D. Rethinking presence: a grounded theory of nurses and teleconsultation. J Clin Nurs. Oct 2017;26(19-20):3088-3098. [CrossRef] [Medline]42,Rygg LO, Brataas HV, Nordtug B. Introducing videoconferencing on tablet computers in nurse-patient communication: technical and training challenges. Int J Telemed Appl. Oct 18, 2018;2018:8943960. [FREE Full text] [CrossRef] [Medline]44,Spiby H, Faucher MA, Sands G, Roberts J, Kennedy HP. A qualitative study of midwives' perceptions on using video-calling in early labor. Birth. Mar 2019;46(1):105-112. [CrossRef] [Medline]46,Wundersitz C, Caelli A, Georgy J, Musovic A, Manning R, Prause M, et al. Conducting community rehabilitation review sessions via videoconference: a feasibility study. Aust J Rural Health. Dec 2020;28(6):603-612. [CrossRef] [Medline]48,Bayati B, Ayatollahi H. Speech therapists' perspectives about using tele-speech therapy: a qualitative study. Disabil Rehabil Assist Technol. Jul 2023;18(5):621-626. [CrossRef] [Medline]50,Hasani F, Malliaras P, Haines T, Munteanu SE, White J, Ridgway J, et al. Telehealth sounds a bit challenging, but it has potential: participant and physiotherapist experiences of gym-based exercise intervention for Achilles tendinopathy monitored via telehealth. BMC Musculoskelet Disord. Feb 04, 2021;22(1):138. [FREE Full text] [CrossRef] [Medline]57,Kienle GS, Werthmann P, Grotejohann B, Hundhammer T, Schmoor C, Stumpe C, et al. Addressing COVID-19 challenges in a randomised controlled trial on exercise interventions in a high-risk population. BMC Geriatr. May 01, 2021;21(1):287. [FREE Full text] [CrossRef] [Medline]59,Martin R, Mandrusiak A, Russell T, Forbes R. New-graduate physiotherapists' training needs and readiness for telehealth. Physiother Theory Pract. Nov 2022;38(13):2788-2797. [CrossRef] [Medline]63,Rygg L, Brataas HV, Nordtug B. Oncology nurses' lived experiences of video communication in follow-up care of home-living patients: a phenomenological study in rural Norway. Eur J Oncol Nurs. Jun 2021;52:101955. [FREE Full text] [CrossRef] [Medline]69,Buabbas AJ, Albahrouh SE, Alrowayeh HN, Alshawaf H. Telerehabilitation during the COVID-19 pandemic: patients and physical therapists' experiences. Med Princ Pract. 2022;31(2):156-164. [FREE Full text] [CrossRef] [Medline]77,Ditwiler RE, Swisher LL, Hardwick DD. Doing things you never imagined: professional and ethical issues in the U.S. outpatient physical therapy setting during the COVID-19 pandemic. Musculoskelet Sci Pract. Dec 2022;62:102684. [FREE Full text] [CrossRef] [Medline]81,Grant CM, Jones A, Land H. Physiotherapists’ perspectives on the use of telehealth for service delivery to children with developmental delays: a qualitative focus group study. Internet J Allied Health Sci Pract. Mar 31, 2022;20(2):1-10. [FREE Full text] [CrossRef]84-Hughes L, Petrella A, Phillips N, Taylor RM. Virtual care and the impact of COVID-19 on nursing: a single centre evaluation. J Adv Nurs. Feb 2022;78(2):498-509. [FREE Full text] [CrossRef] [Medline]86,Koppel PD, De Gagne JC, Docherty S, Smith S, Prose NS, Jabaley T. Exploring nurse and patient experiences of developing rapport during oncology ambulatory care videoconferencing visits: qualitative descriptive study. J Med Internet Res. Sep 08, 2022;24(9):e39920. [FREE Full text] [CrossRef] [Medline]88,Wittmeier KD, Hammond E, Tymko K, Burnham K, Janssen T, Pablo AJ, et al. "Another tool in your toolkit": pediatric occupational and physical therapists' perspectives of initiating telehealth during the COVID-19 pandemic. Phys Occup Ther Pediatr. 2022;42(5):465-481. [CrossRef] [Medline]95]. The methods used were mixed in 2 publications [Albahrouh SI, Buabbas AJ. Physiotherapists' perceptions of and willingness to use telerehabilitation in Kuwait during the COVID-19 pandemic. BMC Med Inform Decis Mak. Apr 08, 2021;21(1):122. [FREE Full text] [CrossRef] [Medline]49,Alrushud A, Alamam D, Alharthi A, Shaheen A, Alotaibi N, AlSabhan R, et al. Physical therapists' perceptions of and satisfaction with delivering telerehabilitation sessions to patients with knee osteoarthritis during the COVID-19 pandemic: preliminary study. Musculoskeletal Care. Dec 2022;20(4):926-936. [FREE Full text] [CrossRef] [Medline]74]. The evaluation methods, according to the included professions and their combined sample sizes, are presented in Table 2.

Table 1. Characteristics of sources.
StudyCountryProfessionsHealth contextaMethodsb
Abbott-Gaffney and Jacobs [Abbott-Gaffney C, Jacobs K. Telehealth in school-based practice: perceived viability to bridge global OT practitioner shortages prior to COVID-19 global health emergency. Work. 2020;67(1):29-35. [CrossRef] [Medline]47], 2020United StatesOTcVariousQuestionnaire
Abbott-Gaffney et al [Abbott-Gaffney CR, Gafni-Lachter L, Cason J, Sheaffer K, Harasink R, Donehower K, et al. Toward successful future use of telehealth in occupational therapy practice: what the COVID-19 rapid shift revealed. Work. 2022;71(2):385-394. [CrossRef] [Medline]72], 2022United StatesOTPediatricsQuestionnaire
Albahrouh and Buabbas [Albahrouh SI, Buabbas AJ. Physiotherapists' perceptions of and willingness to use telerehabilitation in Kuwait during the COVID-19 pandemic. BMC Med Inform Decis Mak. Apr 08, 2021;21(1):122. [FREE Full text] [CrossRef] [Medline]49], 2021KuwaitPTdVariousMixed methods
Almog and Gilboa [Almog T, Gilboa Y. Remote delivery of service: a survey of occupational therapists' perceptions. Rehabil Process Outcome. Sep 06, 2022;11:11795727221117503. [FREE Full text] [CrossRef] [Medline]73], 2022IsraelOTVariousQuestionnaire
Alrushud et al [Alrushud A, Alamam D, Alharthi A, Shaheen A, Alotaibi N, AlSabhan R, et al. Physical therapists' perceptions of and satisfaction with delivering telerehabilitation sessions to patients with knee osteoarthritis during the COVID-19 pandemic: preliminary study. Musculoskeletal Care. Dec 2022;20(4):926-936. [FREE Full text] [CrossRef] [Medline]74], 2022Saudi ArabiaPTOsteoarthritisMixed methods
Barrett [Barrett D. Rethinking presence: a grounded theory of nurses and teleconsultation. J Clin Nurs. Oct 2017;26(19-20):3088-3098. [CrossRef] [Medline]42], 2017United Kingdom NureVariousInterview
Bayati and Ayatollahi [Bayati B, Ayatollahi H. Speech therapists' perspectives about using tele-speech therapy: a qualitative study. Disabil Rehabil Assist Technol. Jul 2023;18(5):621-626. [CrossRef] [Medline]50], 2021IranSLTf and Audg,hVariousInterview
Bennell et al [Bennell KL, Lawford BJ, Metcalf B, Mackenzie D, Russell T, van den Berg M, et al. Physiotherapists and patients report positive experiences overall with telehealth during the COVID-19 pandemic: a mixed-methods study. J Physiother. Jul 2021;67(3):201-209. [FREE Full text] [CrossRef] [Medline]51], 2021AustraliaPTVariousQuestionnaire
Bhattarai et al [Bhattarai B, Sanghavi T, Abhishek BP. Challenges in delivering tele-practice services for communication disorders among audiologists and speech language pathologists. Indian J Otolaryngol Head Neck Surg. Dec 2022;74(Suppl 3):4360-4365. [FREE Full text] [CrossRef] [Medline]75], 2022IndiaSLT and AudVariousQuestionnaire
Bican et al [Bican R, Christensen C, Fallieras K, Sagester G, O'Rourke S, Byars M, et al. Rapid implementation of telerehabilitation for pediatric patients during COVID-19. Int J Telerehabil. Jun 22, 2021;13(1):e6371. [FREE Full text] [CrossRef] [Medline]52], 2021United StatesPT and OTPediatricsQuestionnaire
Bolden [Bolden III W. Telehealth across the therapies: examining the impact of the COVID-19 pandemic on clinical staff working with low socioeconomic status populations. Perspective. Aug 2022;7(4):1236-1255. [FREE Full text] [CrossRef]76], 2022United StatesPT, OT, and SLT and AudPediatricsQuestionnaire
Buabbas et al [Buabbas AJ, Albahrouh SE, Alrowayeh HN, Alshawaf H. Telerehabilitation during the COVID-19 pandemic: patients and physical therapists' experiences. Med Princ Pract. 2022;31(2):156-164. [FREE Full text] [CrossRef] [Medline]77], 2022KuwaitPTMusculoskeletalInterview
Ceprnja et al [Ceprnja D, Clark T, Young J, Lee R, Flynn K, Maka K. Evaluating experiences, usability and patient satisfaction with telehealth for tertiary outpatient physiotherapy services during COVID-19: a mixed-methods study. Physiother Theory Pract (Forthcoming). Apr 06, 2022:1-9. [CrossRef] [Medline]78], 2022AustraliaPTVariousQuestionnaire
Chaudhari and Talreja [Chaudhari C, Talreja A. Emerging challenges faced by private clinic physiotherapist in new normal times during the COVID-19 pandemic in Pune city. Indian J Occup Ther. Aug 09, 2022;16(3):103-108. [FREE Full text] [CrossRef]79], 2022IndiaPTVariousQuestionnaire
Dissanayaka et al [Dissanayaka T, Nakandala P, Sanjeewa C. Physiotherapists' perceptions and barriers to use of telerehabilitation for exercise management of people with knee osteoarthritis in Sri Lanka. Disabil Rehabil Assist Technol (Forthcoming). Sep 13, 2022:1-10. [CrossRef] [Medline]80], 2022Sri LankaPTOsteoarthritisQuestionnaire
Ditwiler et al [Ditwiler RE, Swisher LL, Hardwick DD. Doing things you never imagined: professional and ethical issues in the U.S. outpatient physical therapy setting during the COVID-19 pandemic. Musculoskelet Sci Pract. Dec 2022;62:102684. [FREE Full text] [CrossRef] [Medline]81], 2022United StatesPTVariousInterview
D’Souza and Rebello [D'Souza AF, Rebello SR. Perceptions and willingness of physiotherapists in India to use telerehabilitation during the COVID-19 pandemic. Int J Telerehabil. Dec 16, 2021;13(2):e6425. [FREE Full text] [CrossRef] [Medline]53], 2021IndiaPTVariousQuestionnaire
Eguia and Capio [Eguia KF, Capio CM. Teletherapy for children with developmental disorders during the COVID-19 pandemic in the Philippines: a mixed-methods evaluation from the perspectives of parents and therapists. Child Care Health Dev. Nov 2022;48(6):963-969. [CrossRef] [Medline]82], 2022PhilippinesPT, OT, and SLT and AudPediatricsQuestionnaire
Eikelboom et al [Eikelboom RH, Bennett RJ, Manchaiah V, Parmar B, Beukes E, Rajasingam SL, et al. International survey of audiologists during the COVID-19 pandemic: use of and attitudes to telehealth. Int J Audiol. Apr 2022;61(4):283-292. [CrossRef] [Medline]83], 2022AustraliaSLT and AudVariousQuestionnaire
Fong et al [Fong R, Tsai CF, Yiu OY. The implementation of telepractice in speech language pathology in Hong Kong during the COVID-19 pandemic. Telemed J E Health. Jan 2021;27(1):30-38. [CrossRef] [Medline]54], 2021Hong KongSLT and AudVariousQuestionnaire
Grant et al [Grant CM, Jones A, Land H. Physiotherapists’ perspectives on the use of telehealth for service delivery to children with developmental delays: a qualitative focus group study. Internet J Allied Health Sci Pract. Mar 31, 2022;20(2):1-10. [FREE Full text] [CrossRef]84], 2022AustraliaPTPediatricsInterview
Haines et al [Haines KJ, Sawyer A, McKinnon C, Donovan A, Michael C, Cimoli C, et al. Barriers and enablers to telehealth use by physiotherapists during the COVID-19 pandemic. Physiotherapy. Mar 2023;118:12-19. [FREE Full text] [CrossRef] [Medline]85], 2022AustraliaPTVariousInterview
Hall et al [Hall JB, Woods ML, Luechtefeld JT. Pediatric physical therapy telehealth and COVID-19: factors, facilitators, and barriers influencing effectiveness-a survey study. Pediatr Phys Ther. Jul 01, 2021;33(3):112-118. [FREE Full text] [CrossRef] [Medline]55], 2021United StatesPTPediatricsQuestionnaire
Harrell et al [Harrell RG, Schubert MC, Oxborough S, Whitney SL. Vestibular rehabilitation telehealth during the SAEA-CoV-2 (COVID-19) pandemic. Front Neurol. Jan 20, 2022;12:781482. [FREE Full text] [CrossRef] [Medline]56], 2021United StatesPTVestibularQuestionnaire
Hasani et al [Hasani F, Malliaras P, Haines T, Munteanu SE, White J, Ridgway J, et al. Telehealth sounds a bit challenging, but it has potential: participant and physiotherapist experiences of gym-based exercise intervention for Achilles tendinopathy monitored via telehealth. BMC Musculoskelet Disord. Feb 04, 2021;22(1):138. [FREE Full text] [CrossRef] [Medline]57], 2021AustraliaPTAchilles tendinopathyInterview
Hughes et al [Hughes L, Petrella A, Phillips N, Taylor RM. Virtual care and the impact of COVID-19 on nursing: a single centre evaluation. J Adv Nurs. Feb 2022;78(2):498-509. [FREE Full text] [CrossRef] [Medline]86], 2022United KingdomNurVariousInterview
Kaufman-Shriqui et al [Kaufman-Shriqui V, Sherf-Dagan S, Boaz M, Birk R. Virtual nutrition consultation: what can we learn from the COVID-19 pandemic? Public Health Nutr. Apr 2021;24(5):1166-1173. [FREE Full text] [CrossRef] [Medline]58], 2021IsraelDieiVariousQuestionnaire
Kaur et al [Kaur M, Eddy EZ, Tiwari D. Exploring practice patterns of pediatric telerehabilitation during COVID-19: a survey study. Telemed J E Health. Oct 2022;28(10):1505-1516. [FREE Full text] [CrossRef] [Medline]87], 2022United StatesPT and OTPediatricsQuestionnaire
Kienle et al [Kienle GS, Werthmann P, Grotejohann B, Hundhammer T, Schmoor C, Stumpe C, et al. Addressing COVID-19 challenges in a randomised controlled trial on exercise interventions in a high-risk population. BMC Geriatr. May 01, 2021;21(1):287. [FREE Full text] [CrossRef] [Medline]59], 2021GermanyPTOlder adultsInterview
Klamroth-Marganska et al [Klamroth-Marganska V, Gemperle M, Ballmer T, Grylka-Baeschlin S, Pehlke-Milde J, Gantschnig BE. Does therapy always need touch? A cross-sectional study among Switzerland-based occupational therapists and midwives regarding their experience with health care at a distance during the COVID-19 pandemic in spring 2020. BMC Health Serv Res. Jun 15, 2021;21(1):578. [FREE Full text] [CrossRef] [Medline]60], 2021SwitzerlandOT and MidjVariousQuestionnaire
Koppel et al [Koppel PD, De Gagne JC, Docherty S, Smith S, Prose NS, Jabaley T. Exploring nurse and patient experiences of developing rapport during oncology ambulatory care videoconferencing visits: qualitative descriptive study. J Med Internet Res. Sep 08, 2022;24(9):e39920. [FREE Full text] [CrossRef] [Medline]88], 2022United StatesNurCancerInterview
Krasovsky et al [Krasovsky T, Silberg T, Barak S, Eisenstein E, Erez N, Feldman I, et al. Transition to multidisciplinary pediatric telerehabilitation during the COVID-19 pandemic: strategy development and implementation. Int J Environ Res Public Health. Feb 04, 2021;18(4):1484. [FREE Full text] [CrossRef] [Medline]61], 2021IsraelPT, OT, and SLT and AudPediatricsQuestionnaire
Kwok et al [Kwok EY, Chiu J, Rosenbaum P, Cunningham BJ. The process of telepractice implementation during the COVID-19 pandemic: a narrative inquiry of preschool speech-language pathologists and assistants from one center in Canada. BMC Health Serv Res. Jan 16, 2022;22(1):81. [FREE Full text] [CrossRef] [Medline]29], 2022CanadaSLT and AudPediatricsInterview
Lawford et al [Lawford BJ, Bennell KL, Kasza J, Hinman RS. Physical therapists' perceptions of telephone- and internet video-mediated service models for exercise management of people with osteoarthritis. Arthritis Care Res (Hoboken). Mar 2018;70(3):398-408. [CrossRef] [Medline]43], 2018AustraliaPTOsteoarthritisQuestionnaire
Malliaras et al [Malliaras P, Merolli M, Williams CM, Caneiro JP, Haines T, Barton C. 'It's not hands-on therapy, so it's very limited': telehealth use and views among allied health clinicians during the coronavirus pandemic. Musculoskelet Sci Pract. Apr 2021;52:102340. [FREE Full text] [CrossRef] [Medline]62], 2021AustraliaPT and OTMusculoskeletalQuestionnaire
Martin et al [Martin R, Mandrusiak A, Russell T, Forbes R. New-graduate physiotherapists' training needs and readiness for telehealth. Physiother Theory Pract. Nov 2022;38(13):2788-2797. [CrossRef] [Medline]63], 2021AustraliaPTVariousInterview
McPherson and Nahon [McPherson K, Nahon I. Telehealth and the provision of pelvic health physiotherapy in regional, rural and remote Australia. Aust N Z Cont J. Aug 2021;27(3):66-70. [CrossRef]64], 2021AustraliaPTPelvic healthQuestionnaire
Nazreen and Seethapathy [Nazreen Nihara MR, Seethapathy J. Tele-audiology in India: current and future trends in knowledge, attitude, and practice among audiologists. J Audiol Otol. Jul 2022;26(3):130-141. [FREE Full text] [CrossRef] [Medline]89], 2022IndiaSLT and AudVariousQuestionnaire
Parmar et al [Parmar B, Beukes E, Rajasingam S. Int J Audiol. Mar 2022;61(3):228-238. [CrossRef] [Medline]90], 2022United KingdomSLT and AudVariousQuestionnaire
Peh et al [Peh HP, Yee K, Mantaring EJ. Changes in telepractice use and perspectives among speech and language therapists in Singapore through the COVID-19 pandemic. Int J Lang Commun Disord. May 2023;58(3):802-812. [CrossRef] [Medline]91], 2022SingaporeSLT and AudVariousQuestionnaire
Peters et al [Peters S, Botero M, Evers A, Fong B, Jakab B, Petter E, et al. Development and feasibility of a modified Fugl-Meyer lower extremity assessment for telerehabilitation: a pilot study. Pilot Feasibility Stud. Jun 07, 2021;7(1):121. [FREE Full text] [CrossRef] [Medline]65], 2021CanadaPTAssessmentQuestionnaire
Pollard and Hogan [Pollard R, Hogan S. Parental and practitioner views of telepractice for pediatric auditory verbal habilitation at a time of global pandemic. Perspective. Dec 2021;6(6):1832-1856. [FREE Full text] [CrossRef]66], 2021United KingdomSLT and AudPediatricsQuestionnaire
Rettinger et al [Rettinger L, Klupper C, Werner F, Putz P. Changing attitudes towards teletherapy in Austrian therapists during the COVID-19 pandemic. J Telemed Telecare. Jun 2023;29(5):406-414. [FREE Full text] [CrossRef] [Medline]67], 2021AustriaPT, OT, and SLT and AudVariousQuestionnaire
Richter et al [Richter B, Wattenberg I, Vollmer AL, Hornberg C, Wrede B, Lätzsch R. The COVID-19 pandemic as an opportunity for teletherapy? - A survey of non-medical therapy professionals in the health sector. Gesundheitswesen. Apr 2022;84(4):319-325. [CrossRef] [Medline]92], 2022GermanyPT, OT, and SLT and AudVariousQuestionnaire
Rortvedt and Jacobs [Rortvedt D, Jacobs K. Perspectives on the use of a telehealth service-delivery model as a component of school-based occupational therapy practice: designing a user-experience. Work. 2019;62(1):125-131. [CrossRef] [Medline]45], 2019United StatesOTPediatricsQuestionnaire
Rozga et al [Rozga M, Handu D, Kelley K, Jimenez EY, Martin H, Schofield M, et al. Telehealth during the COVID-19 pandemic: a cross-sectional survey of registered dietitian nutritionists. J Acad Nutr Diet. Dec 2021;121(12):2524-2535. [FREE Full text] [CrossRef] [Medline]68], 2021United StatesDieVariousQuestionnaire
Rygg et al [Rygg LO, Brataas HV, Nordtug B. Introducing videoconferencing on tablet computers in nurse-patient communication: technical and training challenges. Int J Telemed Appl. Oct 18, 2018;2018:8943960. [FREE Full text] [CrossRef] [Medline]44], 2018NorwayNurCancerInterview
Rygg et al [Rygg L, Brataas HV, Nordtug B. Oncology nurses' lived experiences of video communication in follow-up care of home-living patients: a phenomenological study in rural Norway. Eur J Oncol Nurs. Jun 2021;52:101955. [FREE Full text] [CrossRef] [Medline]69], 2021NorwayNurCancerInterview
Singh et al [Singh RH, Pringle T, Kenneson A. The use of telemedicine and other strategies by registered dietitians for the medical nutrition therapy of patients with inherited metabolic disorders during the COVID-19 pandemic. Front Nutr. Apr 27, 2021;8:637868. [FREE Full text] [CrossRef] [Medline]70], 2021United StatesDieDiabetes or metabolic disorderQuestionnaire
Spiby et al [Spiby H, Faucher MA, Sands G, Roberts J, Kennedy HP. A qualitative study of midwives' perceptions on using video-calling in early labor. Birth. Mar 2019;46(1):105-112. [CrossRef] [Medline]46], 2019United KingdomMidEarly laborInterview
Sutherland et al [Sutherland R, Hodge A, Chan E, Silove N. Barriers and facilitators: clinicians' opinions and experiences of telehealth before and after their use of a telehealth platform for child language assessment. Int J Lang Commun Disord. Nov 2021;56(6):1263-1277. [CrossRef] [Medline]71], 2021AustraliaSLT and AudPediatricsQuestionnaire
Tar-Mahomed and Kater [Tar-Mahomed Z, Kater KA. The perspectives of speech-language pathologists: providing teletherapy to patients with speech, language and swallowing difficulties during a COVID-19 context. S Afr J Commun Disord. Aug 11, 2022;69(2):e1-e7. [FREE Full text] [CrossRef] [Medline]93], 2022South AfricaSLT and AudVariousQuestionnaire
Van Eerdenbrugh et al [Van Eerdenbrugh S, Schraeyen K, Leysen H, Mostaert C, D'haenens W, Vandenborre D. Delivery of speech-language therapy and audiology services across the world at the start of the COVID-19 pandemic: a survey. Perspect. Apr 14, 2022;7(2):635-646. [FREE Full text] [CrossRef]94], 2022BelgiumSLT and AudVariousQuestionnaire
Wittmeier et al [Wittmeier KD, Hammond E, Tymko K, Burnham K, Janssen T, Pablo AJ, et al. "Another tool in your toolkit": pediatric occupational and physical therapists' perspectives of initiating telehealth during the COVID-19 pandemic. Phys Occup Ther Pediatr. 2022;42(5):465-481. [CrossRef] [Medline]95], 2022CanadaPT and OTPediatricsInterview
Wundersitz et al [Wundersitz C, Caelli A, Georgy J, Musovic A, Manning R, Prause M, et al. Conducting community rehabilitation review sessions via videoconference: a feasibility study. Aust J Rural Health. Dec 2020;28(6):603-612. [CrossRef] [Medline]48], 2020AustraliaDie, SLT and Aud, and PTVariousInterview
Yosef et al [Beit Yosef A, Maeir T, Khalailh F, Gilboa Y. Perceived feasibility of an occupation-based telerehabilitation intervention for older adults with chronic health conditions in Israel. Hong Kong J Occup Ther. Jun 2022;35(1):62-70. [FREE Full text] [CrossRef] [Medline]96], 2022IsraelOTOlder adultsQuestionnaire

aHealth context refers to specific patient or target groups or matter of interest in the included study.

bMethods were summarized as “Interview” when individual interviews or focus groups were conducted, “Questionnaire” when participants gave written answers, and “Mixed methods” when both methods were applied.

cOT: occupational therapist.

dPT: physical therapist.

eNur: nurse.

fSLT: speech and language therapist.

gAud: audiologist.

hSLT and Aud were combined, as they are a single profession in some countries and 2 professions in others.

iDie: dietitian.

jMid: midwife.

Figure 2. Mapping of study characteristics. Summary of the study characteristics from inner to outer circle: health profession, health context, method, authors, and year. Aud: audiologist; Die: dietitian; Mid: midwife; Nur: nurse; OT: occupational therapist; PT: physical therapist; SLT: speech and language therapist.
Figure 3. Total number of participants in the included studies according to region. The combined participant numbers of the included studies were based on the country, continent, or region.
Table 2. Participants in the included studies according to profession and evaluation methods.

OTa (n=1519), n (%)PTb (n=2857), n (%)SLTc and Audd (n=2852), n (%)Nure (n=68), n (%)Dief (n=2435), n (%)Midg (n=679), n (%)PT or OT (n=16), n (%)PT, OT, or SLT and Aud (n=102), n (%)Total (n=10,533), n (%)
Questionnaire1515 (99.7)2722 (95.3)2822 (98.9)h2433 (99.9)630 (92.8)16 (100)102 (100)10,245 (97.3)
Interview4 (0.3)135 (4.7)30 (1.1)68 (100)2 (0.1)49 (7.2)288 (2.7)

aOT: occupational therapist.

bPT: physical therapist.

cSLT: speech and language therapist.

dAud: audiologist.

eNur: nurse.

fDie: dietitian.

gMid: midwife.

hNot available.

Barriers to Video Call–Based Telehealth

Barriers were assigned to 8 categories: technology issues, practice issues, patient issues, environmental issues, attributions, interpersonal issues, policies and regulations, and administration issues. Technology issues were found to encompass several subcategories, including limited access to technology, concerns about the reliability and usability of technology, network issues, a lack of technology skills among health care providers and patients, and other unspecified technological barriers. The analysis indicated that practice issues covered aspects such as diminished fidelity of observations and poor conditions for visual instructions; a lack of knowledge, skills, or experience; a lack of training, guidelines, or protocols; and the inability to provide hands-on care. Subcategories attributed to patient issues included addressing inappropriate target groups, managing patient behaviors, and addressing safety issues. Furthermore, physical, sensory, and social environmental issues were identified. Barriers to telehealth identified under the attributions category were negative attitudes toward telehealth from providers, patients, and caregivers, along with perceived drawbacks associated with telehealth use. Moreover, policy and regulation issues, which included privacy and security issues, billing and reimbursement topics, and workplace or health policies, were relevant barriers. Interpersonal barriers included reduced client-practitioner interaction and communication as well as the presence of ethical and cultural concerns. Finally, administration issues, such as a lack of support and a perceived increase in workload, were identified. A detailed description of the barriers for each subcategory and their references are provided in Table 3. The percentages of publications mentioning this barrier are depicted in Figure 4.

Publications reporting the barriers of PT, OT, and SLT covered all main categories, whereas nurse publications did not report any policy and regulation barriers. Dietitian and midwife publications had no information about patient issues, and midwife publications did not address category attributions. An overview of the distribution of reported barriers in the health profession is shown in Figure 5.

For further reference,

Multimedia Appendix 2

Barriers addressed by the publications according to category and subcategory for each publication.

XLSX File (Microsoft Excel File), 16 KBMultimedia Appendix 2 provides an overview of the categories and subcategories of the barriers addressed in the individual studies [Kwok EY, Chiu J, Rosenbaum P, Cunningham BJ. The process of telepractice implementation during the COVID-19 pandemic: a narrative inquiry of preschool speech-language pathologists and assistants from one center in Canada. BMC Health Serv Res. Jan 16, 2022;22(1):81. [FREE Full text] [CrossRef] [Medline]29,Barrett D. Rethinking presence: a grounded theory of nurses and teleconsultation. J Clin Nurs. Oct 2017;26(19-20):3088-3098. [CrossRef] [Medline]42-Beit Yosef A, Maeir T, Khalailh F, Gilboa Y. Perceived feasibility of an occupation-based telerehabilitation intervention for older adults with chronic health conditions in Israel. Hong Kong J Occup Ther. Jun 2022;35(1):62-70. [FREE Full text] [CrossRef] [Medline]96].

Table 3. Details of each category and subcategory and the corresponding references.
Categories and subcategoriesReferences
Technology issues

Lack of technology access
  • Availability of adequate equipment [Rortvedt D, Jacobs K. Perspectives on the use of a telehealth service-delivery model as a component of school-based occupational therapy practice: designing a user-experience. Work. 2019;62(1):125-131. [CrossRef] [Medline]45,Spiby H, Faucher MA, Sands G, Roberts J, Kennedy HP. A qualitative study of midwives' perceptions on using video-calling in early labor. Birth. Mar 2019;46(1):105-112. [CrossRef] [Medline]46,Albahrouh SI, Buabbas AJ. Physiotherapists' perceptions of and willingness to use telerehabilitation in Kuwait during the COVID-19 pandemic. BMC Med Inform Decis Mak. Apr 08, 2021;21(1):122. [FREE Full text] [CrossRef] [Medline]49,Fong R, Tsai CF, Yiu OY. The implementation of telepractice in speech language pathology in Hong Kong during the COVID-19 pandemic. Telemed J E Health. Jan 2021;27(1):30-38. [CrossRef] [Medline]54,Hall JB, Woods ML, Luechtefeld JT. Pediatric physical therapy telehealth and COVID-19: factors, facilitators, and barriers influencing effectiveness-a survey study. Pediatr Phys Ther. Jul 01, 2021;33(3):112-118. [FREE Full text] [CrossRef] [Medline]55,Kienle GS, Werthmann P, Grotejohann B, Hundhammer T, Schmoor C, Stumpe C, et al. Addressing COVID-19 challenges in a randomised controlled trial on exercise interventions in a high-risk population. BMC Geriatr. May 01, 2021;21(1):287. [FREE Full text] [CrossRef] [Medline]59,Malliaras P, Merolli M, Williams CM, Caneiro JP, Haines T, Barton C. 'It's not hands-on therapy, so it's very limited': telehealth use and views among allied health clinicians during the coronavirus pandemic. Musculoskelet Sci Pract. Apr 2021;52:102340. [FREE Full text] [CrossRef] [Medline]62,McPherson K, Nahon I. Telehealth and the provision of pelvic health physiotherapy in regional, rural and remote Australia. Aust N Z Cont J. Aug 2021;27(3):66-70. [CrossRef]64,Rozga M, Handu D, Kelley K, Jimenez EY, Martin H, Schofield M, et al. Telehealth during the COVID-19 pandemic: a cross-sectional survey of registered dietitian nutritionists. J Acad Nutr Diet. Dec 2021;121(12):2524-2535. [FREE Full text] [CrossRef] [Medline]68,Singh RH, Pringle T, Kenneson A. The use of telemedicine and other strategies by registered dietitians for the medical nutrition therapy of patients with inherited metabolic disorders during the COVID-19 pandemic. Front Nutr. Apr 27, 2021;8:637868. [FREE Full text] [CrossRef] [Medline]70,Sutherland R, Hodge A, Chan E, Silove N. Barriers and facilitators: clinicians' opinions and experiences of telehealth before and after their use of a telehealth platform for child language assessment. Int J Lang Commun Disord. Nov 2021;56(6):1263-1277. [CrossRef] [Medline]71,Almog T, Gilboa Y. Remote delivery of service: a survey of occupational therapists' perceptions. Rehabil Process Outcome. Sep 06, 2022;11:11795727221117503. [FREE Full text] [CrossRef] [Medline]73,Buabbas AJ, Albahrouh SE, Alrowayeh HN, Alshawaf H. Telerehabilitation during the COVID-19 pandemic: patients and physical therapists' experiences. Med Princ Pract. 2022;31(2):156-164. [FREE Full text] [CrossRef] [Medline]77,Ceprnja D, Clark T, Young J, Lee R, Flynn K, Maka K. Evaluating experiences, usability and patient satisfaction with telehealth for tertiary outpatient physiotherapy services during COVID-19: a mixed-methods study. Physiother Theory Pract (Forthcoming). Apr 06, 2022:1-9. [CrossRef] [Medline]78,Eikelboom RH, Bennett RJ, Manchaiah V, Parmar B, Beukes E, Rajasingam SL, et al. International survey of audiologists during the COVID-19 pandemic: use of and attitudes to telehealth. Int J Audiol. Apr 2022;61(4):283-292. [CrossRef] [Medline]83-Kaur M, Eddy EZ, Tiwari D. Exploring practice patterns of pediatric telerehabilitation during COVID-19: a survey study. Telemed J E Health. Oct 2022;28(10):1505-1516. [FREE Full text] [CrossRef] [Medline]87,Parmar B, Beukes E, Rajasingam S. Int J Audiol. Mar 2022;61(3):228-238. [CrossRef] [Medline]90,Richter B, Wattenberg I, Vollmer AL, Hornberg C, Wrede B, Lätzsch R. The COVID-19 pandemic as an opportunity for teletherapy? - A survey of non-medical therapy professionals in the health sector. Gesundheitswesen. Apr 2022;84(4):319-325. [CrossRef] [Medline]92-Wittmeier KD, Hammond E, Tymko K, Burnham K, Janssen T, Pablo AJ, et al. "Another tool in your toolkit": pediatric occupational and physical therapists' perspectives of initiating telehealth during the COVID-19 pandemic. Phys Occup Ther Pediatr. 2022;42(5):465-481. [CrossRef] [Medline]95]
  • Access of older adults [Kienle GS, Werthmann P, Grotejohann B, Hundhammer T, Schmoor C, Stumpe C, et al. Addressing COVID-19 challenges in a randomised controlled trial on exercise interventions in a high-risk population. BMC Geriatr. May 01, 2021;21(1):287. [FREE Full text] [CrossRef] [Medline]59,Rozga M, Handu D, Kelley K, Jimenez EY, Martin H, Schofield M, et al. Telehealth during the COVID-19 pandemic: a cross-sectional survey of registered dietitian nutritionists. J Acad Nutr Diet. Dec 2021;121(12):2524-2535. [FREE Full text] [CrossRef] [Medline]68]
  • Patient groups in rural areas [Hall JB, Woods ML, Luechtefeld JT. Pediatric physical therapy telehealth and COVID-19: factors, facilitators, and barriers influencing effectiveness-a survey study. Pediatr Phys Ther. Jul 01, 2021;33(3):112-118. [FREE Full text] [CrossRef] [Medline]55,Grant CM, Jones A, Land H. Physiotherapists’ perspectives on the use of telehealth for service delivery to children with developmental delays: a qualitative focus group study. Internet J Allied Health Sci Pract. Mar 31, 2022;20(2):1-10. [FREE Full text] [CrossRef]84]
  • Technology costs [Rortvedt D, Jacobs K. Perspectives on the use of a telehealth service-delivery model as a component of school-based occupational therapy practice: designing a user-experience. Work. 2019;62(1):125-131. [CrossRef] [Medline]45,Albahrouh SI, Buabbas AJ. Physiotherapists' perceptions of and willingness to use telerehabilitation in Kuwait during the COVID-19 pandemic. BMC Med Inform Decis Mak. Apr 08, 2021;21(1):122. [FREE Full text] [CrossRef] [Medline]49,D'Souza AF, Rebello SR. Perceptions and willingness of physiotherapists in India to use telerehabilitation during the COVID-19 pandemic. Int J Telerehabil. Dec 16, 2021;13(2):e6425. [FREE Full text] [CrossRef] [Medline]53,Fong R, Tsai CF, Yiu OY. The implementation of telepractice in speech language pathology in Hong Kong during the COVID-19 pandemic. Telemed J E Health. Jan 2021;27(1):30-38. [CrossRef] [Medline]54,Malliaras P, Merolli M, Williams CM, Caneiro JP, Haines T, Barton C. 'It's not hands-on therapy, so it's very limited': telehealth use and views among allied health clinicians during the coronavirus pandemic. Musculoskelet Sci Pract. Apr 2021;52:102340. [FREE Full text] [CrossRef] [Medline]62,McPherson K, Nahon I. Telehealth and the provision of pelvic health physiotherapy in regional, rural and remote Australia. Aust N Z Cont J. Aug 2021;27(3):66-70. [CrossRef]64,Sutherland R, Hodge A, Chan E, Silove N. Barriers and facilitators: clinicians' opinions and experiences of telehealth before and after their use of a telehealth platform for child language assessment. Int J Lang Commun Disord. Nov 2021;56(6):1263-1277. [CrossRef] [Medline]71,Abbott-Gaffney CR, Gafni-Lachter L, Cason J, Sheaffer K, Harasink R, Donehower K, et al. Toward successful future use of telehealth in occupational therapy practice: what the COVID-19 rapid shift revealed. Work. 2022;71(2):385-394. [CrossRef] [Medline]72,Nazreen Nihara MR, Seethapathy J. Tele-audiology in India: current and future trends in knowledge, attitude, and practice among audiologists. J Audiol Otol. Jul 2022;26(3):130-141. [FREE Full text] [CrossRef] [Medline]89,Tar-Mahomed Z, Kater KA. The perspectives of speech-language pathologists: providing teletherapy to patients with speech, language and swallowing difficulties during a COVID-19 context. S Afr J Commun Disord. Aug 11, 2022;69(2):e1-e7. [FREE Full text] [CrossRef] [Medline]93]

Lack of reliability and usability of technology
  • Insufficient quality of technology [Malliaras P, Merolli M, Williams CM, Caneiro JP, Haines T, Barton C. 'It's not hands-on therapy, so it's very limited': telehealth use and views among allied health clinicians during the coronavirus pandemic. Musculoskelet Sci Pract. Apr 2021;52:102340. [FREE Full text] [CrossRef] [Medline]62,Singh RH, Pringle T, Kenneson A. The use of telemedicine and other strategies by registered dietitians for the medical nutrition therapy of patients with inherited metabolic disorders during the COVID-19 pandemic. Front Nutr. Apr 27, 2021;8:637868. [FREE Full text] [CrossRef] [Medline]70,Van Eerdenbrugh S, Schraeyen K, Leysen H, Mostaert C, D'haenens W, Vandenborre D. Delivery of speech-language therapy and audiology services across the world at the start of the COVID-19 pandemic: a survey. Perspect. Apr 14, 2022;7(2):635-646. [FREE Full text] [CrossRef]94]
  • Unreliability of technology [Barrett D. Rethinking presence: a grounded theory of nurses and teleconsultation. J Clin Nurs. Oct 2017;26(19-20):3088-3098. [CrossRef] [Medline]42,Spiby H, Faucher MA, Sands G, Roberts J, Kennedy HP. A qualitative study of midwives' perceptions on using video-calling in early labor. Birth. Mar 2019;46(1):105-112. [CrossRef] [Medline]46,Wundersitz C, Caelli A, Georgy J, Musovic A, Manning R, Prause M, et al. Conducting community rehabilitation review sessions via videoconference: a feasibility study. Aust J Rural Health. Dec 2020;28(6):603-612. [CrossRef] [Medline]48,Bennell KL, Lawford BJ, Metcalf B, Mackenzie D, Russell T, van den Berg M, et al. Physiotherapists and patients report positive experiences overall with telehealth during the COVID-19 pandemic: a mixed-methods study. J Physiother. Jul 2021;67(3):201-209. [FREE Full text] [CrossRef] [Medline]51,Bican R, Christensen C, Fallieras K, Sagester G, O'Rourke S, Byars M, et al. Rapid implementation of telerehabilitation for pediatric patients during COVID-19. Int J Telerehabil. Jun 22, 2021;13(1):e6371. [FREE Full text] [CrossRef] [Medline]52,Hasani F, Malliaras P, Haines T, Munteanu SE, White J, Ridgway J, et al. Telehealth sounds a bit challenging, but it has potential: participant and physiotherapist experiences of gym-based exercise intervention for Achilles tendinopathy monitored via telehealth. BMC Musculoskelet Disord. Feb 04, 2021;22(1):138. [FREE Full text] [CrossRef] [Medline]57,Malliaras P, Merolli M, Williams CM, Caneiro JP, Haines T, Barton C. 'It's not hands-on therapy, so it's very limited': telehealth use and views among allied health clinicians during the coronavirus pandemic. Musculoskelet Sci Pract. Apr 2021;52:102340. [FREE Full text] [CrossRef] [Medline]62,Peters S, Botero M, Evers A, Fong B, Jakab B, Petter E, et al. Development and feasibility of a modified Fugl-Meyer lower extremity assessment for telerehabilitation: a pilot study. Pilot Feasibility Stud. Jun 07, 2021;7(1):121. [FREE Full text] [CrossRef] [Medline]65-Rettinger L, Klupper C, Werner F, Putz P. Changing attitudes towards teletherapy in Austrian therapists during the COVID-19 pandemic. J Telemed Telecare. Jun 2023;29(5):406-414. [FREE Full text] [CrossRef] [Medline]67,Abbott-Gaffney CR, Gafni-Lachter L, Cason J, Sheaffer K, Harasink R, Donehower K, et al. Toward successful future use of telehealth in occupational therapy practice: what the COVID-19 rapid shift revealed. Work. 2022;71(2):385-394. [CrossRef] [Medline]72,Hughes L, Petrella A, Phillips N, Taylor RM. Virtual care and the impact of COVID-19 on nursing: a single centre evaluation. J Adv Nurs. Feb 2022;78(2):498-509. [FREE Full text] [CrossRef] [Medline]86,Nazreen Nihara MR, Seethapathy J. Tele-audiology in India: current and future trends in knowledge, attitude, and practice among audiologists. J Audiol Otol. Jul 2022;26(3):130-141. [FREE Full text] [CrossRef] [Medline]89,Peh HP, Yee K, Mantaring EJ. Changes in telepractice use and perspectives among speech and language therapists in Singapore through the COVID-19 pandemic. Int J Lang Commun Disord. May 2023;58(3):802-812. [CrossRef] [Medline]91]
  • Lack of user-friendly software [Albahrouh SI, Buabbas AJ. Physiotherapists' perceptions of and willingness to use telerehabilitation in Kuwait during the COVID-19 pandemic. BMC Med Inform Decis Mak. Apr 08, 2021;21(1):122. [FREE Full text] [CrossRef] [Medline]49,D'Souza AF, Rebello SR. Perceptions and willingness of physiotherapists in India to use telerehabilitation during the COVID-19 pandemic. Int J Telerehabil. Dec 16, 2021;13(2):e6425. [FREE Full text] [CrossRef] [Medline]53,Kienle GS, Werthmann P, Grotejohann B, Hundhammer T, Schmoor C, Stumpe C, et al. Addressing COVID-19 challenges in a randomised controlled trial on exercise interventions in a high-risk population. BMC Geriatr. May 01, 2021;21(1):287. [FREE Full text] [CrossRef] [Medline]59,Singh RH, Pringle T, Kenneson A. The use of telemedicine and other strategies by registered dietitians for the medical nutrition therapy of patients with inherited metabolic disorders during the COVID-19 pandemic. Front Nutr. Apr 27, 2021;8:637868. [FREE Full text] [CrossRef] [Medline]70,Wittmeier KD, Hammond E, Tymko K, Burnham K, Janssen T, Pablo AJ, et al. "Another tool in your toolkit": pediatric occupational and physical therapists' perspectives of initiating telehealth during the COVID-19 pandemic. Phys Occup Ther Pediatr. 2022;42(5):465-481. [CrossRef] [Medline]95]

Network issues
  • Connection failure or limited bandwidth [Rygg LO, Brataas HV, Nordtug B. Introducing videoconferencing on tablet computers in nurse-patient communication: technical and training challenges. Int J Telemed Appl. Oct 18, 2018;2018:8943960. [FREE Full text] [CrossRef] [Medline]44,Abbott-Gaffney C, Jacobs K. Telehealth in school-based practice: perceived viability to bridge global OT practitioner shortages prior to COVID-19 global health emergency. Work. 2020;67(1):29-35. [CrossRef] [Medline]47-Albahrouh SI, Buabbas AJ. Physiotherapists' perceptions of and willingness to use telerehabilitation in Kuwait during the COVID-19 pandemic. BMC Med Inform Decis Mak. Apr 08, 2021;21(1):122. [FREE Full text] [CrossRef] [Medline]49,Bennell KL, Lawford BJ, Metcalf B, Mackenzie D, Russell T, van den Berg M, et al. Physiotherapists and patients report positive experiences overall with telehealth during the COVID-19 pandemic: a mixed-methods study. J Physiother. Jul 2021;67(3):201-209. [FREE Full text] [CrossRef] [Medline]51-D'Souza AF, Rebello SR. Perceptions and willingness of physiotherapists in India to use telerehabilitation during the COVID-19 pandemic. Int J Telerehabil. Dec 16, 2021;13(2):e6425. [FREE Full text] [CrossRef] [Medline]53,Hall JB, Woods ML, Luechtefeld JT. Pediatric physical therapy telehealth and COVID-19: factors, facilitators, and barriers influencing effectiveness-a survey study. Pediatr Phys Ther. Jul 01, 2021;33(3):112-118. [FREE Full text] [CrossRef] [Medline]55-Hasani F, Malliaras P, Haines T, Munteanu SE, White J, Ridgway J, et al. Telehealth sounds a bit challenging, but it has potential: participant and physiotherapist experiences of gym-based exercise intervention for Achilles tendinopathy monitored via telehealth. BMC Musculoskelet Disord. Feb 04, 2021;22(1):138. [FREE Full text] [CrossRef] [Medline]57,Kienle GS, Werthmann P, Grotejohann B, Hundhammer T, Schmoor C, Stumpe C, et al. Addressing COVID-19 challenges in a randomised controlled trial on exercise interventions in a high-risk population. BMC Geriatr. May 01, 2021;21(1):287. [FREE Full text] [CrossRef] [Medline]59,Malliaras P, Merolli M, Williams CM, Caneiro JP, Haines T, Barton C. 'It's not hands-on therapy, so it's very limited': telehealth use and views among allied health clinicians during the coronavirus pandemic. Musculoskelet Sci Pract. Apr 2021;52:102340. [FREE Full text] [CrossRef] [Medline]62,McPherson K, Nahon I. Telehealth and the provision of pelvic health physiotherapy in regional, rural and remote Australia. Aust N Z Cont J. Aug 2021;27(3):66-70. [CrossRef]64-Pollard R, Hogan S. Parental and practitioner views of telepractice for pediatric auditory verbal habilitation at a time of global pandemic. Perspective. Dec 2021;6(6):1832-1856. [FREE Full text] [CrossRef]66,Singh RH, Pringle T, Kenneson A. The use of telemedicine and other strategies by registered dietitians for the medical nutrition therapy of patients with inherited metabolic disorders during the COVID-19 pandemic. Front Nutr. Apr 27, 2021;8:637868. [FREE Full text] [CrossRef] [Medline]70,Sutherland R, Hodge A, Chan E, Silove N. Barriers and facilitators: clinicians' opinions and experiences of telehealth before and after their use of a telehealth platform for child language assessment. Int J Lang Commun Disord. Nov 2021;56(6):1263-1277. [CrossRef] [Medline]71,Bolden III W. Telehealth across the therapies: examining the impact of the COVID-19 pandemic on clinical staff working with low socioeconomic status populations. Perspective. Aug 2022;7(4):1236-1255. [FREE Full text] [CrossRef]76-Chaudhari C, Talreja A. Emerging challenges faced by private clinic physiotherapist in new normal times during the COVID-19 pandemic in Pune city. Indian J Occup Ther. Aug 09, 2022;16(3):103-108. [FREE Full text] [CrossRef]79,Grant CM, Jones A, Land H. Physiotherapists’ perspectives on the use of telehealth for service delivery to children with developmental delays: a qualitative focus group study. Internet J Allied Health Sci Pract. Mar 31, 2022;20(2):1-10. [FREE Full text] [CrossRef]84,Haines KJ, Sawyer A, McKinnon C, Donovan A, Michael C, Cimoli C, et al. Barriers and enablers to telehealth use by physiotherapists during the COVID-19 pandemic. Physiotherapy. Mar 2023;118:12-19. [FREE Full text] [CrossRef] [Medline]85,Kaur M, Eddy EZ, Tiwari D. Exploring practice patterns of pediatric telerehabilitation during COVID-19: a survey study. Telemed J E Health. Oct 2022;28(10):1505-1516. [FREE Full text] [CrossRef] [Medline]87-Parmar B, Beukes E, Rajasingam S. Int J Audiol. Mar 2022;61(3):228-238. [CrossRef] [Medline]90,Tar-Mahomed Z, Kater KA. The perspectives of speech-language pathologists: providing teletherapy to patients with speech, language and swallowing difficulties during a COVID-19 context. S Afr J Commun Disord. Aug 11, 2022;69(2):e1-e7. [FREE Full text] [CrossRef] [Medline]93-Wittmeier KD, Hammond E, Tymko K, Burnham K, Janssen T, Pablo AJ, et al. "Another tool in your toolkit": pediatric occupational and physical therapists' perspectives of initiating telehealth during the COVID-19 pandemic. Phys Occup Ther Pediatr. 2022;42(5):465-481. [CrossRef] [Medline]95]

Lack of technology skills
  • Limited technology skills or confidence in use [Bennell KL, Lawford BJ, Metcalf B, Mackenzie D, Russell T, van den Berg M, et al. Physiotherapists and patients report positive experiences overall with telehealth during the COVID-19 pandemic: a mixed-methods study. J Physiother. Jul 2021;67(3):201-209. [FREE Full text] [CrossRef] [Medline]51,Kienle GS, Werthmann P, Grotejohann B, Hundhammer T, Schmoor C, Stumpe C, et al. Addressing COVID-19 challenges in a randomised controlled trial on exercise interventions in a high-risk population. BMC Geriatr. May 01, 2021;21(1):287. [FREE Full text] [CrossRef] [Medline]59] of patients [Rygg LO, Brataas HV, Nordtug B. Introducing videoconferencing on tablet computers in nurse-patient communication: technical and training challenges. Int J Telemed Appl. Oct 18, 2018;2018:8943960. [FREE Full text] [CrossRef] [Medline]44,Albahrouh SI, Buabbas AJ. Physiotherapists' perceptions of and willingness to use telerehabilitation in Kuwait during the COVID-19 pandemic. BMC Med Inform Decis Mak. Apr 08, 2021;21(1):122. [FREE Full text] [CrossRef] [Medline]49,Bennell KL, Lawford BJ, Metcalf B, Mackenzie D, Russell T, van den Berg M, et al. Physiotherapists and patients report positive experiences overall with telehealth during the COVID-19 pandemic: a mixed-methods study. J Physiother. Jul 2021;67(3):201-209. [FREE Full text] [CrossRef] [Medline]51,Harrell RG, Schubert MC, Oxborough S, Whitney SL. Vestibular rehabilitation telehealth during the SAEA-CoV-2 (COVID-19) pandemic. Front Neurol. Jan 20, 2022;12:781482. [FREE Full text] [CrossRef] [Medline]56,Hasani F, Malliaras P, Haines T, Munteanu SE, White J, Ridgway J, et al. Telehealth sounds a bit challenging, but it has potential: participant and physiotherapist experiences of gym-based exercise intervention for Achilles tendinopathy monitored via telehealth. BMC Musculoskelet Disord. Feb 04, 2021;22(1):138. [FREE Full text] [CrossRef] [Medline]57,Kienle GS, Werthmann P, Grotejohann B, Hundhammer T, Schmoor C, Stumpe C, et al. Addressing COVID-19 challenges in a randomised controlled trial on exercise interventions in a high-risk population. BMC Geriatr. May 01, 2021;21(1):287. [FREE Full text] [CrossRef] [Medline]59,Malliaras P, Merolli M, Williams CM, Caneiro JP, Haines T, Barton C. 'It's not hands-on therapy, so it's very limited': telehealth use and views among allied health clinicians during the coronavirus pandemic. Musculoskelet Sci Pract. Apr 2021;52:102340. [FREE Full text] [CrossRef] [Medline]62,McPherson K, Nahon I. Telehealth and the provision of pelvic health physiotherapy in regional, rural and remote Australia. Aust N Z Cont J. Aug 2021;27(3):66-70. [CrossRef]64,Rettinger L, Klupper C, Werner F, Putz P. Changing attitudes towards teletherapy in Austrian therapists during the COVID-19 pandemic. J Telemed Telecare. Jun 2023;29(5):406-414. [FREE Full text] [CrossRef] [Medline]67,Singh RH, Pringle T, Kenneson A. The use of telemedicine and other strategies by registered dietitians for the medical nutrition therapy of patients with inherited metabolic disorders during the COVID-19 pandemic. Front Nutr. Apr 27, 2021;8:637868. [FREE Full text] [CrossRef] [Medline]70-Alrushud A, Alamam D, Alharthi A, Shaheen A, Alotaibi N, AlSabhan R, et al. Physical therapists' perceptions of and satisfaction with delivering telerehabilitation sessions to patients with knee osteoarthritis during the COVID-19 pandemic: preliminary study. Musculoskeletal Care. Dec 2022;20(4):926-936. [FREE Full text] [CrossRef] [Medline]74,Chaudhari C, Talreja A. Emerging challenges faced by private clinic physiotherapist in new normal times during the COVID-19 pandemic in Pune city. Indian J Occup Ther. Aug 09, 2022;16(3):103-108. [FREE Full text] [CrossRef]79,Eikelboom RH, Bennett RJ, Manchaiah V, Parmar B, Beukes E, Rajasingam SL, et al. International survey of audiologists during the COVID-19 pandemic: use of and attitudes to telehealth. Int J Audiol. Apr 2022;61(4):283-292. [CrossRef] [Medline]83,Hughes L, Petrella A, Phillips N, Taylor RM. Virtual care and the impact of COVID-19 on nursing: a single centre evaluation. J Adv Nurs. Feb 2022;78(2):498-509. [FREE Full text] [CrossRef] [Medline]86,Parmar B, Beukes E, Rajasingam S. Int J Audiol. Mar 2022;61(3):228-238. [CrossRef] [Medline]90,Wittmeier KD, Hammond E, Tymko K, Burnham K, Janssen T, Pablo AJ, et al. "Another tool in your toolkit": pediatric occupational and physical therapists' perspectives of initiating telehealth during the COVID-19 pandemic. Phys Occup Ther Pediatr. 2022;42(5):465-481. [CrossRef] [Medline]95,Beit Yosef A, Maeir T, Khalailh F, Gilboa Y. Perceived feasibility of an occupation-based telerehabilitation intervention for older adults with chronic health conditions in Israel. Hong Kong J Occup Ther. Jun 2022;35(1):62-70. [FREE Full text] [CrossRef] [Medline]96] of health professionals [Kwok EY, Chiu J, Rosenbaum P, Cunningham BJ. The process of telepractice implementation during the COVID-19 pandemic: a narrative inquiry of preschool speech-language pathologists and assistants from one center in Canada. BMC Health Serv Res. Jan 16, 2022;22(1):81. [FREE Full text] [CrossRef] [Medline]29,Malliaras P, Merolli M, Williams CM, Caneiro JP, Haines T, Barton C. 'It's not hands-on therapy, so it's very limited': telehealth use and views among allied health clinicians during the coronavirus pandemic. Musculoskelet Sci Pract. Apr 2021;52:102340. [FREE Full text] [CrossRef] [Medline]62,Singh RH, Pringle T, Kenneson A. The use of telemedicine and other strategies by registered dietitians for the medical nutrition therapy of patients with inherited metabolic disorders during the COVID-19 pandemic. Front Nutr. Apr 27, 2021;8:637868. [FREE Full text] [CrossRef] [Medline]70,Abbott-Gaffney CR, Gafni-Lachter L, Cason J, Sheaffer K, Harasink R, Donehower K, et al. Toward successful future use of telehealth in occupational therapy practice: what the COVID-19 rapid shift revealed. Work. 2022;71(2):385-394. [CrossRef] [Medline]72,Ditwiler RE, Swisher LL, Hardwick DD. Doing things you never imagined: professional and ethical issues in the U.S. outpatient physical therapy setting during the COVID-19 pandemic. Musculoskelet Sci Pract. Dec 2022;62:102684. [FREE Full text] [CrossRef] [Medline]81-Grant CM, Jones A, Land H. Physiotherapists’ perspectives on the use of telehealth for service delivery to children with developmental delays: a qualitative focus group study. Internet J Allied Health Sci Pract. Mar 31, 2022;20(2):1-10. [FREE Full text] [CrossRef]84,Parmar B, Beukes E, Rajasingam S. Int J Audiol. Mar 2022;61(3):228-238. [CrossRef] [Medline]90,Wittmeier KD, Hammond E, Tymko K, Burnham K, Janssen T, Pablo AJ, et al. "Another tool in your toolkit": pediatric occupational and physical therapists' perspectives of initiating telehealth during the COVID-19 pandemic. Phys Occup Ther Pediatr. 2022;42(5):465-481. [CrossRef] [Medline]95]

Technological barriers
  • Not specified [D'Souza AF, Rebello SR. Perceptions and willingness of physiotherapists in India to use telerehabilitation during the COVID-19 pandemic. Int J Telerehabil. Dec 16, 2021;13(2):e6425. [FREE Full text] [CrossRef] [Medline]53,Fong R, Tsai CF, Yiu OY. The implementation of telepractice in speech language pathology in Hong Kong during the COVID-19 pandemic. Telemed J E Health. Jan 2021;27(1):30-38. [CrossRef] [Medline]54,Kaufman-Shriqui V, Sherf-Dagan S, Boaz M, Birk R. Virtual nutrition consultation: what can we learn from the COVID-19 pandemic? Public Health Nutr. Apr 2021;24(5):1166-1173. [FREE Full text] [CrossRef] [Medline]58,Abbott-Gaffney CR, Gafni-Lachter L, Cason J, Sheaffer K, Harasink R, Donehower K, et al. Toward successful future use of telehealth in occupational therapy practice: what the COVID-19 rapid shift revealed. Work. 2022;71(2):385-394. [CrossRef] [Medline]72]
Practice issues

Diminished fidelity of observations and poor conditions for visual instructions
  • Observations or assessment options decreased [Lawford BJ, Bennell KL, Kasza J, Hinman RS. Physical therapists' perceptions of telephone- and internet video-mediated service models for exercise management of people with osteoarthritis. Arthritis Care Res (Hoboken). Mar 2018;70(3):398-408. [CrossRef] [Medline]43,Abbott-Gaffney C, Jacobs K. Telehealth in school-based practice: perceived viability to bridge global OT practitioner shortages prior to COVID-19 global health emergency. Work. 2020;67(1):29-35. [CrossRef] [Medline]47,Bayati B, Ayatollahi H. Speech therapists' perspectives about using tele-speech therapy: a qualitative study. Disabil Rehabil Assist Technol. Jul 2023;18(5):621-626. [CrossRef] [Medline]50,Bennell KL, Lawford BJ, Metcalf B, Mackenzie D, Russell T, van den Berg M, et al. Physiotherapists and patients report positive experiences overall with telehealth during the COVID-19 pandemic: a mixed-methods study. J Physiother. Jul 2021;67(3):201-209. [FREE Full text] [CrossRef] [Medline]51,Harrell RG, Schubert MC, Oxborough S, Whitney SL. Vestibular rehabilitation telehealth during the SAEA-CoV-2 (COVID-19) pandemic. Front Neurol. Jan 20, 2022;12:781482. [FREE Full text] [CrossRef] [Medline]56,Hasani F, Malliaras P, Haines T, Munteanu SE, White J, Ridgway J, et al. Telehealth sounds a bit challenging, but it has potential: participant and physiotherapist experiences of gym-based exercise intervention for Achilles tendinopathy monitored via telehealth. BMC Musculoskelet Disord. Feb 04, 2021;22(1):138. [FREE Full text] [CrossRef] [Medline]57,Krasovsky T, Silberg T, Barak S, Eisenstein E, Erez N, Feldman I, et al. Transition to multidisciplinary pediatric telerehabilitation during the COVID-19 pandemic: strategy development and implementation. Int J Environ Res Public Health. Feb 04, 2021;18(4):1484. [FREE Full text] [CrossRef] [Medline]61-Martin R, Mandrusiak A, Russell T, Forbes R. New-graduate physiotherapists' training needs and readiness for telehealth. Physiother Theory Pract. Nov 2022;38(13):2788-2797. [CrossRef] [Medline]63,Peters S, Botero M, Evers A, Fong B, Jakab B, Petter E, et al. Development and feasibility of a modified Fugl-Meyer lower extremity assessment for telerehabilitation: a pilot study. Pilot Feasibility Stud. Jun 07, 2021;7(1):121. [FREE Full text] [CrossRef] [Medline]65,Pollard R, Hogan S. Parental and practitioner views of telepractice for pediatric auditory verbal habilitation at a time of global pandemic. Perspective. Dec 2021;6(6):1832-1856. [FREE Full text] [CrossRef]66,Singh RH, Pringle T, Kenneson A. The use of telemedicine and other strategies by registered dietitians for the medical nutrition therapy of patients with inherited metabolic disorders during the COVID-19 pandemic. Front Nutr. Apr 27, 2021;8:637868. [FREE Full text] [CrossRef] [Medline]70,Sutherland R, Hodge A, Chan E, Silove N. Barriers and facilitators: clinicians' opinions and experiences of telehealth before and after their use of a telehealth platform for child language assessment. Int J Lang Commun Disord. Nov 2021;56(6):1263-1277. [CrossRef] [Medline]71,Ceprnja D, Clark T, Young J, Lee R, Flynn K, Maka K. Evaluating experiences, usability and patient satisfaction with telehealth for tertiary outpatient physiotherapy services during COVID-19: a mixed-methods study. Physiother Theory Pract (Forthcoming). Apr 06, 2022:1-9. [CrossRef] [Medline]78,Ditwiler RE, Swisher LL, Hardwick DD. Doing things you never imagined: professional and ethical issues in the U.S. outpatient physical therapy setting during the COVID-19 pandemic. Musculoskelet Sci Pract. Dec 2022;62:102684. [FREE Full text] [CrossRef] [Medline]81,Eguia KF, Capio CM. Teletherapy for children with developmental disorders during the COVID-19 pandemic in the Philippines: a mixed-methods evaluation from the perspectives of parents and therapists. Child Care Health Dev. Nov 2022;48(6):963-969. [CrossRef] [Medline]82,Grant CM, Jones A, Land H. Physiotherapists’ perspectives on the use of telehealth for service delivery to children with developmental delays: a qualitative focus group study. Internet J Allied Health Sci Pract. Mar 31, 2022;20(2):1-10. [FREE Full text] [CrossRef]84,Haines KJ, Sawyer A, McKinnon C, Donovan A, Michael C, Cimoli C, et al. Barriers and enablers to telehealth use by physiotherapists during the COVID-19 pandemic. Physiotherapy. Mar 2023;118:12-19. [FREE Full text] [CrossRef] [Medline]85,Kaur M, Eddy EZ, Tiwari D. Exploring practice patterns of pediatric telerehabilitation during COVID-19: a survey study. Telemed J E Health. Oct 2022;28(10):1505-1516. [FREE Full text] [CrossRef] [Medline]87,Parmar B, Beukes E, Rajasingam S. Int J Audiol. Mar 2022;61(3):228-238. [CrossRef] [Medline]90,Van Eerdenbrugh S, Schraeyen K, Leysen H, Mostaert C, D'haenens W, Vandenborre D. Delivery of speech-language therapy and audiology services across the world at the start of the COVID-19 pandemic: a survey. Perspect. Apr 14, 2022;7(2):635-646. [FREE Full text] [CrossRef]94,Beit Yosef A, Maeir T, Khalailh F, Gilboa Y. Perceived feasibility of an occupation-based telerehabilitation intervention for older adults with chronic health conditions in Israel. Hong Kong J Occup Ther. Jun 2022;35(1):62-70. [FREE Full text] [CrossRef] [Medline]96]
  • Fear to oversee red flags [Albahrouh SI, Buabbas AJ. Physiotherapists' perceptions of and willingness to use telerehabilitation in Kuwait during the COVID-19 pandemic. BMC Med Inform Decis Mak. Apr 08, 2021;21(1):122. [FREE Full text] [CrossRef] [Medline]49,Kienle GS, Werthmann P, Grotejohann B, Hundhammer T, Schmoor C, Stumpe C, et al. Addressing COVID-19 challenges in a randomised controlled trial on exercise interventions in a high-risk population. BMC Geriatr. May 01, 2021;21(1):287. [FREE Full text] [CrossRef] [Medline]59,Malliaras P, Merolli M, Williams CM, Caneiro JP, Haines T, Barton C. 'It's not hands-on therapy, so it's very limited': telehealth use and views among allied health clinicians during the coronavirus pandemic. Musculoskelet Sci Pract. Apr 2021;52:102340. [FREE Full text] [CrossRef] [Medline]62,Ceprnja D, Clark T, Young J, Lee R, Flynn K, Maka K. Evaluating experiences, usability and patient satisfaction with telehealth for tertiary outpatient physiotherapy services during COVID-19: a mixed-methods study. Physiother Theory Pract (Forthcoming). Apr 06, 2022:1-9. [CrossRef] [Medline]78]
  • Small screen size or pixilation [Ceprnja D, Clark T, Young J, Lee R, Flynn K, Maka K. Evaluating experiences, usability and patient satisfaction with telehealth for tertiary outpatient physiotherapy services during COVID-19: a mixed-methods study. Physiother Theory Pract (Forthcoming). Apr 06, 2022:1-9. [CrossRef] [Medline]78]
  • Video lag [Peters S, Botero M, Evers A, Fong B, Jakab B, Petter E, et al. Development and feasibility of a modified Fugl-Meyer lower extremity assessment for telerehabilitation: a pilot study. Pilot Feasibility Stud. Jun 07, 2021;7(1):121. [FREE Full text] [CrossRef] [Medline]65]
  • Single-camera angle [Harrell RG, Schubert MC, Oxborough S, Whitney SL. Vestibular rehabilitation telehealth during the SAEA-CoV-2 (COVID-19) pandemic. Front Neurol. Jan 20, 2022;12:781482. [FREE Full text] [CrossRef] [Medline]56,Hasani F, Malliaras P, Haines T, Munteanu SE, White J, Ridgway J, et al. Telehealth sounds a bit challenging, but it has potential: participant and physiotherapist experiences of gym-based exercise intervention for Achilles tendinopathy monitored via telehealth. BMC Musculoskelet Disord. Feb 04, 2021;22(1):138. [FREE Full text] [CrossRef] [Medline]57,Malliaras P, Merolli M, Williams CM, Caneiro JP, Haines T, Barton C. 'It's not hands-on therapy, so it's very limited': telehealth use and views among allied health clinicians during the coronavirus pandemic. Musculoskelet Sci Pract. Apr 2021;52:102340. [FREE Full text] [CrossRef] [Medline]62,Pollard R, Hogan S. Parental and practitioner views of telepractice for pediatric auditory verbal habilitation at a time of global pandemic. Perspective. Dec 2021;6(6):1832-1856. [FREE Full text] [CrossRef]66]
  • Assessment that required walking [Harrell RG, Schubert MC, Oxborough S, Whitney SL. Vestibular rehabilitation telehealth during the SAEA-CoV-2 (COVID-19) pandemic. Front Neurol. Jan 20, 2022;12:781482. [FREE Full text] [CrossRef] [Medline]56]
  • Lightning glare in glasses during eye exam [Harrell RG, Schubert MC, Oxborough S, Whitney SL. Vestibular rehabilitation telehealth during the SAEA-CoV-2 (COVID-19) pandemic. Front Neurol. Jan 20, 2022;12:781482. [FREE Full text] [CrossRef] [Medline]56]
  • Sound quality [Pollard R, Hogan S. Parental and practitioner views of telepractice for pediatric auditory verbal habilitation at a time of global pandemic. Perspective. Dec 2021;6(6):1832-1856. [FREE Full text] [CrossRef]66]
  • Loss of perception of smell [Klamroth-Marganska V, Gemperle M, Ballmer T, Grylka-Baeschlin S, Pehlke-Milde J, Gantschnig BE. Does therapy always need touch? A cross-sectional study among Switzerland-based occupational therapists and midwives regarding their experience with health care at a distance during the COVID-19 pandemic in spring 2020. BMC Health Serv Res. Jun 15, 2021;21(1):578. [FREE Full text] [CrossRef] [Medline]60]
  • Lack of experience to “fill the blanks” [Martin R, Mandrusiak A, Russell T, Forbes R. New-graduate physiotherapists' training needs and readiness for telehealth. Physiother Theory Pract. Nov 2022;38(13):2788-2797. [CrossRef] [Medline]63]
  • Lack of perception of the strengths of the patient [Kienle GS, Werthmann P, Grotejohann B, Hundhammer T, Schmoor C, Stumpe C, et al. Addressing COVID-19 challenges in a randomised controlled trial on exercise interventions in a high-risk population. BMC Geriatr. May 01, 2021;21(1):287. [FREE Full text] [CrossRef] [Medline]59,Parmar B, Beukes E, Rajasingam S. Int J Audiol. Mar 2022;61(3):228-238. [CrossRef] [Medline]90]
  • Lack of ability to read body language [Singh RH, Pringle T, Kenneson A. The use of telemedicine and other strategies by registered dietitians for the medical nutrition therapy of patients with inherited metabolic disorders during the COVID-19 pandemic. Front Nutr. Apr 27, 2021;8:637868. [FREE Full text] [CrossRef] [Medline]70,Parmar B, Beukes E, Rajasingam S. Int J Audiol. Mar 2022;61(3):228-238. [CrossRef] [Medline]90]
  • Demonstration of exercises [Kienle GS, Werthmann P, Grotejohann B, Hundhammer T, Schmoor C, Stumpe C, et al. Addressing COVID-19 challenges in a randomised controlled trial on exercise interventions in a high-risk population. BMC Geriatr. May 01, 2021;21(1):287. [FREE Full text] [CrossRef] [Medline]59,Malliaras P, Merolli M, Williams CM, Caneiro JP, Haines T, Barton C. 'It's not hands-on therapy, so it's very limited': telehealth use and views among allied health clinicians during the coronavirus pandemic. Musculoskelet Sci Pract. Apr 2021;52:102340. [FREE Full text] [CrossRef] [Medline]62]

Lack of knowledge, skills, or experience
  • Patients lack knowledge about the role of technology in rehabilitation [Albahrouh SI, Buabbas AJ. Physiotherapists' perceptions of and willingness to use telerehabilitation in Kuwait during the COVID-19 pandemic. BMC Med Inform Decis Mak. Apr 08, 2021;21(1):122. [FREE Full text] [CrossRef] [Medline]49]
  • Therapist skills [Hall JB, Woods ML, Luechtefeld JT. Pediatric physical therapy telehealth and COVID-19: factors, facilitators, and barriers influencing effectiveness-a survey study. Pediatr Phys Ther. Jul 01, 2021;33(3):112-118. [FREE Full text] [CrossRef] [Medline]55]
  • Lack of knowledge and experience [Kwok EY, Chiu J, Rosenbaum P, Cunningham BJ. The process of telepractice implementation during the COVID-19 pandemic: a narrative inquiry of preschool speech-language pathologists and assistants from one center in Canada. BMC Health Serv Res. Jan 16, 2022;22(1):81. [FREE Full text] [CrossRef] [Medline]29,Abbott-Gaffney C, Jacobs K. Telehealth in school-based practice: perceived viability to bridge global OT practitioner shortages prior to COVID-19 global health emergency. Work. 2020;67(1):29-35. [CrossRef] [Medline]47,Hall JB, Woods ML, Luechtefeld JT. Pediatric physical therapy telehealth and COVID-19: factors, facilitators, and barriers influencing effectiveness-a survey study. Pediatr Phys Ther. Jul 01, 2021;33(3):112-118. [FREE Full text] [CrossRef] [Medline]55,Kienle GS, Werthmann P, Grotejohann B, Hundhammer T, Schmoor C, Stumpe C, et al. Addressing COVID-19 challenges in a randomised controlled trial on exercise interventions in a high-risk population. BMC Geriatr. May 01, 2021;21(1):287. [FREE Full text] [CrossRef] [Medline]59,Martin R, Mandrusiak A, Russell T, Forbes R. New-graduate physiotherapists' training needs and readiness for telehealth. Physiother Theory Pract. Nov 2022;38(13):2788-2797. [CrossRef] [Medline]63,McPherson K, Nahon I. Telehealth and the provision of pelvic health physiotherapy in regional, rural and remote Australia. Aust N Z Cont J. Aug 2021;27(3):66-70. [CrossRef]64,Rettinger L, Klupper C, Werner F, Putz P. Changing attitudes towards teletherapy in Austrian therapists during the COVID-19 pandemic. J Telemed Telecare. Jun 2023;29(5):406-414. [FREE Full text] [CrossRef] [Medline]67,Sutherland R, Hodge A, Chan E, Silove N. Barriers and facilitators: clinicians' opinions and experiences of telehealth before and after their use of a telehealth platform for child language assessment. Int J Lang Commun Disord. Nov 2021;56(6):1263-1277. [CrossRef] [Medline]71,Haines KJ, Sawyer A, McKinnon C, Donovan A, Michael C, Cimoli C, et al. Barriers and enablers to telehealth use by physiotherapists during the COVID-19 pandemic. Physiotherapy. Mar 2023;118:12-19. [FREE Full text] [CrossRef] [Medline]85,Parmar B, Beukes E, Rajasingam S. Int J Audiol. Mar 2022;61(3):228-238. [CrossRef] [Medline]90,Richter B, Wattenberg I, Vollmer AL, Hornberg C, Wrede B, Lätzsch R. The COVID-19 pandemic as an opportunity for teletherapy? - A survey of non-medical therapy professionals in the health sector. Gesundheitswesen. Apr 2022;84(4):319-325. [CrossRef] [Medline]92,Van Eerdenbrugh S, Schraeyen K, Leysen H, Mostaert C, D'haenens W, Vandenborre D. Delivery of speech-language therapy and audiology services across the world at the start of the COVID-19 pandemic: a survey. Perspect. Apr 14, 2022;7(2):635-646. [FREE Full text] [CrossRef]94,Wittmeier KD, Hammond E, Tymko K, Burnham K, Janssen T, Pablo AJ, et al. "Another tool in your toolkit": pediatric occupational and physical therapists' perspectives of initiating telehealth during the COVID-19 pandemic. Phys Occup Ther Pediatr. 2022;42(5):465-481. [CrossRef] [Medline]95]
  • Lack of confidence [Lawford BJ, Bennell KL, Kasza J, Hinman RS. Physical therapists' perceptions of telephone- and internet video-mediated service models for exercise management of people with osteoarthritis. Arthritis Care Res (Hoboken). Mar 2018;70(3):398-408. [CrossRef] [Medline]43,Rettinger L, Klupper C, Werner F, Putz P. Changing attitudes towards teletherapy in Austrian therapists during the COVID-19 pandemic. J Telemed Telecare. Jun 2023;29(5):406-414. [FREE Full text] [CrossRef] [Medline]67,Chaudhari C, Talreja A. Emerging challenges faced by private clinic physiotherapist in new normal times during the COVID-19 pandemic in Pune city. Indian J Occup Ther. Aug 09, 2022;16(3):103-108. [FREE Full text] [CrossRef]79,Dissanayaka T, Nakandala P, Sanjeewa C. Physiotherapists' perceptions and barriers to use of telerehabilitation for exercise management of people with knee osteoarthritis in Sri Lanka. Disabil Rehabil Assist Technol (Forthcoming). Sep 13, 2022:1-10. [CrossRef] [Medline]80,Peh HP, Yee K, Mantaring EJ. Changes in telepractice use and perspectives among speech and language therapists in Singapore through the COVID-19 pandemic. Int J Lang Commun Disord. May 2023;58(3):802-812. [CrossRef] [Medline]91]
  • Lack of activity options for telehealth [Abbott-Gaffney C, Jacobs K. Telehealth in school-based practice: perceived viability to bridge global OT practitioner shortages prior to COVID-19 global health emergency. Work. 2020;67(1):29-35. [CrossRef] [Medline]47,McPherson K, Nahon I. Telehealth and the provision of pelvic health physiotherapy in regional, rural and remote Australia. Aust N Z Cont J. Aug 2021;27(3):66-70. [CrossRef]64,Abbott-Gaffney CR, Gafni-Lachter L, Cason J, Sheaffer K, Harasink R, Donehower K, et al. Toward successful future use of telehealth in occupational therapy practice: what the COVID-19 rapid shift revealed. Work. 2022;71(2):385-394. [CrossRef] [Medline]72,Peh HP, Yee K, Mantaring EJ. Changes in telepractice use and perspectives among speech and language therapists in Singapore through the COVID-19 pandemic. Int J Lang Commun Disord. May 2023;58(3):802-812. [CrossRef] [Medline]91]
  • Hard to engage clients [Bolden III W. Telehealth across the therapies: examining the impact of the COVID-19 pandemic on clinical staff working with low socioeconomic status populations. Perspective. Aug 2022;7(4):1236-1255. [FREE Full text] [CrossRef]76]
  • Missing evidence base [Rettinger L, Klupper C, Werner F, Putz P. Changing attitudes towards teletherapy in Austrian therapists during the COVID-19 pandemic. J Telemed Telecare. Jun 2023;29(5):406-414. [FREE Full text] [CrossRef] [Medline]67,Bhattarai B, Sanghavi T, Abhishek BP. Challenges in delivering tele-practice services for communication disorders among audiologists and speech language pathologists. Indian J Otolaryngol Head Neck Surg. Dec 2022;74(Suppl 3):4360-4365. [FREE Full text] [CrossRef] [Medline]75,Parmar B, Beukes E, Rajasingam S. Int J Audiol. Mar 2022;61(3):228-238. [CrossRef] [Medline]90]

Lack of training, guidelines, or protocols
  • Lack of appropriate telehealth training [Albahrouh SI, Buabbas AJ. Physiotherapists' perceptions of and willingness to use telerehabilitation in Kuwait during the COVID-19 pandemic. BMC Med Inform Decis Mak. Apr 08, 2021;21(1):122. [FREE Full text] [CrossRef] [Medline]49,D'Souza AF, Rebello SR. Perceptions and willingness of physiotherapists in India to use telerehabilitation during the COVID-19 pandemic. Int J Telerehabil. Dec 16, 2021;13(2):e6425. [FREE Full text] [CrossRef] [Medline]53,Fong R, Tsai CF, Yiu OY. The implementation of telepractice in speech language pathology in Hong Kong during the COVID-19 pandemic. Telemed J E Health. Jan 2021;27(1):30-38. [CrossRef] [Medline]54,McPherson K, Nahon I. Telehealth and the provision of pelvic health physiotherapy in regional, rural and remote Australia. Aust N Z Cont J. Aug 2021;27(3):66-70. [CrossRef]64,Bolden III W. Telehealth across the therapies: examining the impact of the COVID-19 pandemic on clinical staff working with low socioeconomic status populations. Perspective. Aug 2022;7(4):1236-1255. [FREE Full text] [CrossRef]76,Eikelboom RH, Bennett RJ, Manchaiah V, Parmar B, Beukes E, Rajasingam SL, et al. International survey of audiologists during the COVID-19 pandemic: use of and attitudes to telehealth. Int J Audiol. Apr 2022;61(4):283-292. [CrossRef] [Medline]83-Haines KJ, Sawyer A, McKinnon C, Donovan A, Michael C, Cimoli C, et al. Barriers and enablers to telehealth use by physiotherapists during the COVID-19 pandemic. Physiotherapy. Mar 2023;118:12-19. [FREE Full text] [CrossRef] [Medline]85,Parmar B, Beukes E, Rajasingam S. Int J Audiol. Mar 2022;61(3):228-238. [CrossRef] [Medline]90,Richter B, Wattenberg I, Vollmer AL, Hornberg C, Wrede B, Lätzsch R. The COVID-19 pandemic as an opportunity for teletherapy? - A survey of non-medical therapy professionals in the health sector. Gesundheitswesen. Apr 2022;84(4):319-325. [CrossRef] [Medline]92,Wittmeier KD, Hammond E, Tymko K, Burnham K, Janssen T, Pablo AJ, et al. "Another tool in your toolkit": pediatric occupational and physical therapists' perspectives of initiating telehealth during the COVID-19 pandemic. Phys Occup Ther Pediatr. 2022;42(5):465-481. [CrossRef] [Medline]95]
  • Learning curve required [Bolden III W. Telehealth across the therapies: examining the impact of the COVID-19 pandemic on clinical staff working with low socioeconomic status populations. Perspective. Aug 2022;7(4):1236-1255. [FREE Full text] [CrossRef]76,Wittmeier KD, Hammond E, Tymko K, Burnham K, Janssen T, Pablo AJ, et al. "Another tool in your toolkit": pediatric occupational and physical therapists' perspectives of initiating telehealth during the COVID-19 pandemic. Phys Occup Ther Pediatr. 2022;42(5):465-481. [CrossRef] [Medline]95]
  • Missing guidelines or standard protocols [Buabbas AJ, Albahrouh SE, Alrowayeh HN, Alshawaf H. Telerehabilitation during the COVID-19 pandemic: patients and physical therapists' experiences. Med Princ Pract. 2022;31(2):156-164. [FREE Full text] [CrossRef] [Medline]77,Eikelboom RH, Bennett RJ, Manchaiah V, Parmar B, Beukes E, Rajasingam SL, et al. International survey of audiologists during the COVID-19 pandemic: use of and attitudes to telehealth. Int J Audiol. Apr 2022;61(4):283-292. [CrossRef] [Medline]83,Grant CM, Jones A, Land H. Physiotherapists’ perspectives on the use of telehealth for service delivery to children with developmental delays: a qualitative focus group study. Internet J Allied Health Sci Pract. Mar 31, 2022;20(2):1-10. [FREE Full text] [CrossRef]84,Koppel PD, De Gagne JC, Docherty S, Smith S, Prose NS, Jabaley T. Exploring nurse and patient experiences of developing rapport during oncology ambulatory care videoconferencing visits: qualitative descriptive study. J Med Internet Res. Sep 08, 2022;24(9):e39920. [FREE Full text] [CrossRef] [Medline]88,Parmar B, Beukes E, Rajasingam S. Int J Audiol. Mar 2022;61(3):228-238. [CrossRef] [Medline]90,Peh HP, Yee K, Mantaring EJ. Changes in telepractice use and perspectives among speech and language therapists in Singapore through the COVID-19 pandemic. Int J Lang Commun Disord. May 2023;58(3):802-812. [CrossRef] [Medline]91]

Lack of hands-on methods
  • Lack of direct hands-on methods [Barrett D. Rethinking presence: a grounded theory of nurses and teleconsultation. J Clin Nurs. Oct 2017;26(19-20):3088-3098. [CrossRef] [Medline]42,Lawford BJ, Bennell KL, Kasza J, Hinman RS. Physical therapists' perceptions of telephone- and internet video-mediated service models for exercise management of people with osteoarthritis. Arthritis Care Res (Hoboken). Mar 2018;70(3):398-408. [CrossRef] [Medline]43,Rortvedt D, Jacobs K. Perspectives on the use of a telehealth service-delivery model as a component of school-based occupational therapy practice: designing a user-experience. Work. 2019;62(1):125-131. [CrossRef] [Medline]45,Abbott-Gaffney C, Jacobs K. Telehealth in school-based practice: perceived viability to bridge global OT practitioner shortages prior to COVID-19 global health emergency. Work. 2020;67(1):29-35. [CrossRef] [Medline]47-Bennell KL, Lawford BJ, Metcalf B, Mackenzie D, Russell T, van den Berg M, et al. Physiotherapists and patients report positive experiences overall with telehealth during the COVID-19 pandemic: a mixed-methods study. J Physiother. Jul 2021;67(3):201-209. [FREE Full text] [CrossRef] [Medline]51,D'Souza AF, Rebello SR. Perceptions and willingness of physiotherapists in India to use telerehabilitation during the COVID-19 pandemic. Int J Telerehabil. Dec 16, 2021;13(2):e6425. [FREE Full text] [CrossRef] [Medline]53-Harrell RG, Schubert MC, Oxborough S, Whitney SL. Vestibular rehabilitation telehealth during the SAEA-CoV-2 (COVID-19) pandemic. Front Neurol. Jan 20, 2022;12:781482. [FREE Full text] [CrossRef] [Medline]56,Kaufman-Shriqui V, Sherf-Dagan S, Boaz M, Birk R. Virtual nutrition consultation: what can we learn from the COVID-19 pandemic? Public Health Nutr. Apr 2021;24(5):1166-1173. [FREE Full text] [CrossRef] [Medline]58-Malliaras P, Merolli M, Williams CM, Caneiro JP, Haines T, Barton C. 'It's not hands-on therapy, so it's very limited': telehealth use and views among allied health clinicians during the coronavirus pandemic. Musculoskelet Sci Pract. Apr 2021;52:102340. [FREE Full text] [CrossRef] [Medline]62,McPherson K, Nahon I. Telehealth and the provision of pelvic health physiotherapy in regional, rural and remote Australia. Aust N Z Cont J. Aug 2021;27(3):66-70. [CrossRef]64,Pollard R, Hogan S. Parental and practitioner views of telepractice for pediatric auditory verbal habilitation at a time of global pandemic. Perspective. Dec 2021;6(6):1832-1856. [FREE Full text] [CrossRef]66,Rettinger L, Klupper C, Werner F, Putz P. Changing attitudes towards teletherapy in Austrian therapists during the COVID-19 pandemic. J Telemed Telecare. Jun 2023;29(5):406-414. [FREE Full text] [CrossRef] [Medline]67,Singh RH, Pringle T, Kenneson A. The use of telemedicine and other strategies by registered dietitians for the medical nutrition therapy of patients with inherited metabolic disorders during the COVID-19 pandemic. Front Nutr. Apr 27, 2021;8:637868. [FREE Full text] [CrossRef] [Medline]70,Almog T, Gilboa Y. Remote delivery of service: a survey of occupational therapists' perceptions. Rehabil Process Outcome. Sep 06, 2022;11:11795727221117503. [FREE Full text] [CrossRef] [Medline]73,Bolden III W. Telehealth across the therapies: examining the impact of the COVID-19 pandemic on clinical staff working with low socioeconomic status populations. Perspective. Aug 2022;7(4):1236-1255. [FREE Full text] [CrossRef]76,Buabbas AJ, Albahrouh SE, Alrowayeh HN, Alshawaf H. Telerehabilitation during the COVID-19 pandemic: patients and physical therapists' experiences. Med Princ Pract. 2022;31(2):156-164. [FREE Full text] [CrossRef] [Medline]77,Dissanayaka T, Nakandala P, Sanjeewa C. Physiotherapists' perceptions and barriers to use of telerehabilitation for exercise management of people with knee osteoarthritis in Sri Lanka. Disabil Rehabil Assist Technol (Forthcoming). Sep 13, 2022:1-10. [CrossRef] [Medline]80-Grant CM, Jones A, Land H. Physiotherapists’ perspectives on the use of telehealth for service delivery to children with developmental delays: a qualitative focus group study. Internet J Allied Health Sci Pract. Mar 31, 2022;20(2):1-10. [FREE Full text] [CrossRef]84,Koppel PD, De Gagne JC, Docherty S, Smith S, Prose NS, Jabaley T. Exploring nurse and patient experiences of developing rapport during oncology ambulatory care videoconferencing visits: qualitative descriptive study. J Med Internet Res. Sep 08, 2022;24(9):e39920. [FREE Full text] [CrossRef] [Medline]88,Parmar B, Beukes E, Rajasingam S. Int J Audiol. Mar 2022;61(3):228-238. [CrossRef] [Medline]90,Richter B, Wattenberg I, Vollmer AL, Hornberg C, Wrede B, Lätzsch R. The COVID-19 pandemic as an opportunity for teletherapy? - A survey of non-medical therapy professionals in the health sector. Gesundheitswesen. Apr 2022;84(4):319-325. [CrossRef] [Medline]92,Van Eerdenbrugh S, Schraeyen K, Leysen H, Mostaert C, D'haenens W, Vandenborre D. Delivery of speech-language therapy and audiology services across the world at the start of the COVID-19 pandemic: a survey. Perspect. Apr 14, 2022;7(2):635-646. [FREE Full text] [CrossRef]94-Beit Yosef A, Maeir T, Khalailh F, Gilboa Y. Perceived feasibility of an occupation-based telerehabilitation intervention for older adults with chronic health conditions in Israel. Hong Kong J Occup Ther. Jun 2022;35(1):62-70. [FREE Full text] [CrossRef] [Medline]96]
  • Inability of physical examinations [Bayati B, Ayatollahi H. Speech therapists' perspectives about using tele-speech therapy: a qualitative study. Disabil Rehabil Assist Technol. Jul 2023;18(5):621-626. [CrossRef] [Medline]50,Bennell KL, Lawford BJ, Metcalf B, Mackenzie D, Russell T, van den Berg M, et al. Physiotherapists and patients report positive experiences overall with telehealth during the COVID-19 pandemic: a mixed-methods study. J Physiother. Jul 2021;67(3):201-209. [FREE Full text] [CrossRef] [Medline]51,Kaufman-Shriqui V, Sherf-Dagan S, Boaz M, Birk R. Virtual nutrition consultation: what can we learn from the COVID-19 pandemic? Public Health Nutr. Apr 2021;24(5):1166-1173. [FREE Full text] [CrossRef] [Medline]58,Krasovsky T, Silberg T, Barak S, Eisenstein E, Erez N, Feldman I, et al. Transition to multidisciplinary pediatric telerehabilitation during the COVID-19 pandemic: strategy development and implementation. Int J Environ Res Public Health. Feb 04, 2021;18(4):1484. [FREE Full text] [CrossRef] [Medline]61,Malliaras P, Merolli M, Williams CM, Caneiro JP, Haines T, Barton C. 'It's not hands-on therapy, so it's very limited': telehealth use and views among allied health clinicians during the coronavirus pandemic. Musculoskelet Sci Pract. Apr 2021;52:102340. [FREE Full text] [CrossRef] [Medline]62,McPherson K, Nahon I. Telehealth and the provision of pelvic health physiotherapy in regional, rural and remote Australia. Aust N Z Cont J. Aug 2021;27(3):66-70. [CrossRef]64,Pollard R, Hogan S. Parental and practitioner views of telepractice for pediatric auditory verbal habilitation at a time of global pandemic. Perspective. Dec 2021;6(6):1832-1856. [FREE Full text] [CrossRef]66,Singh RH, Pringle T, Kenneson A. The use of telemedicine and other strategies by registered dietitians for the medical nutrition therapy of patients with inherited metabolic disorders during the COVID-19 pandemic. Front Nutr. Apr 27, 2021;8:637868. [FREE Full text] [CrossRef] [Medline]70,Ditwiler RE, Swisher LL, Hardwick DD. Doing things you never imagined: professional and ethical issues in the U.S. outpatient physical therapy setting during the COVID-19 pandemic. Musculoskelet Sci Pract. Dec 2022;62:102684. [FREE Full text] [CrossRef] [Medline]81,Grant CM, Jones A, Land H. Physiotherapists’ perspectives on the use of telehealth for service delivery to children with developmental delays: a qualitative focus group study. Internet J Allied Health Sci Pract. Mar 31, 2022;20(2):1-10. [FREE Full text] [CrossRef]84,Koppel PD, De Gagne JC, Docherty S, Smith S, Prose NS, Jabaley T. Exploring nurse and patient experiences of developing rapport during oncology ambulatory care videoconferencing visits: qualitative descriptive study. J Med Internet Res. Sep 08, 2022;24(9):e39920. [FREE Full text] [CrossRef] [Medline]88,Van Eerdenbrugh S, Schraeyen K, Leysen H, Mostaert C, D'haenens W, Vandenborre D. Delivery of speech-language therapy and audiology services across the world at the start of the COVID-19 pandemic: a survey. Perspect. Apr 14, 2022;7(2):635-646. [FREE Full text] [CrossRef]94,Wittmeier KD, Hammond E, Tymko K, Burnham K, Janssen T, Pablo AJ, et al. "Another tool in your toolkit": pediatric occupational and physical therapists' perspectives of initiating telehealth during the COVID-19 pandemic. Phys Occup Ther Pediatr. 2022;42(5):465-481. [CrossRef] [Medline]95]
  • Inability to demonstrate, intervene, or provide assistance with hands [Abbott-Gaffney C, Jacobs K. Telehealth in school-based practice: perceived viability to bridge global OT practitioner shortages prior to COVID-19 global health emergency. Work. 2020;67(1):29-35. [CrossRef] [Medline]47,Wundersitz C, Caelli A, Georgy J, Musovic A, Manning R, Prause M, et al. Conducting community rehabilitation review sessions via videoconference: a feasibility study. Aust J Rural Health. Dec 2020;28(6):603-612. [CrossRef] [Medline]48,Bennell KL, Lawford BJ, Metcalf B, Mackenzie D, Russell T, van den Berg M, et al. Physiotherapists and patients report positive experiences overall with telehealth during the COVID-19 pandemic: a mixed-methods study. J Physiother. Jul 2021;67(3):201-209. [FREE Full text] [CrossRef] [Medline]51,Malliaras P, Merolli M, Williams CM, Caneiro JP, Haines T, Barton C. 'It's not hands-on therapy, so it's very limited': telehealth use and views among allied health clinicians during the coronavirus pandemic. Musculoskelet Sci Pract. Apr 2021;52:102340. [FREE Full text] [CrossRef] [Medline]62,Almog T, Gilboa Y. Remote delivery of service: a survey of occupational therapists' perceptions. Rehabil Process Outcome. Sep 06, 2022;11:11795727221117503. [FREE Full text] [CrossRef] [Medline]73,Bolden III W. Telehealth across the therapies: examining the impact of the COVID-19 pandemic on clinical staff working with low socioeconomic status populations. Perspective. Aug 2022;7(4):1236-1255. [FREE Full text] [CrossRef]76,Ditwiler RE, Swisher LL, Hardwick DD. Doing things you never imagined: professional and ethical issues in the U.S. outpatient physical therapy setting during the COVID-19 pandemic. Musculoskelet Sci Pract. Dec 2022;62:102684. [FREE Full text] [CrossRef] [Medline]81,Eguia KF, Capio CM. Teletherapy for children with developmental disorders during the COVID-19 pandemic in the Philippines: a mixed-methods evaluation from the perspectives of parents and therapists. Child Care Health Dev. Nov 2022;48(6):963-969. [CrossRef] [Medline]82,Grant CM, Jones A, Land H. Physiotherapists’ perspectives on the use of telehealth for service delivery to children with developmental delays: a qualitative focus group study. Internet J Allied Health Sci Pract. Mar 31, 2022;20(2):1-10. [FREE Full text] [CrossRef]84,Richter B, Wattenberg I, Vollmer AL, Hornberg C, Wrede B, Lätzsch R. The COVID-19 pandemic as an opportunity for teletherapy? - A survey of non-medical therapy professionals in the health sector. Gesundheitswesen. Apr 2022;84(4):319-325. [CrossRef] [Medline]92,Van Eerdenbrugh S, Schraeyen K, Leysen H, Mostaert C, D'haenens W, Vandenborre D. Delivery of speech-language therapy and audiology services across the world at the start of the COVID-19 pandemic: a survey. Perspect. Apr 14, 2022;7(2):635-646. [FREE Full text] [CrossRef]94,Wittmeier KD, Hammond E, Tymko K, Burnham K, Janssen T, Pablo AJ, et al. "Another tool in your toolkit": pediatric occupational and physical therapists' perspectives of initiating telehealth during the COVID-19 pandemic. Phys Occup Ther Pediatr. 2022;42(5):465-481. [CrossRef] [Medline]95]
  • Inability to program or adjust hearing aids remotely [Eikelboom RH, Bennett RJ, Manchaiah V, Parmar B, Beukes E, Rajasingam SL, et al. International survey of audiologists during the COVID-19 pandemic: use of and attitudes to telehealth. Int J Audiol. Apr 2022;61(4):283-292. [CrossRef] [Medline]83,Parmar B, Beukes E, Rajasingam S. Int J Audiol. Mar 2022;61(3):228-238. [CrossRef] [Medline]90]
  • Inability to perform swallowing assessments [Wundersitz C, Caelli A, Georgy J, Musovic A, Manning R, Prause M, et al. Conducting community rehabilitation review sessions via videoconference: a feasibility study. Aust J Rural Health. Dec 2020;28(6):603-612. [CrossRef] [Medline]48]
  • Inability to take anthropometric measurements [Singh RH, Pringle T, Kenneson A. The use of telemedicine and other strategies by registered dietitians for the medical nutrition therapy of patients with inherited metabolic disorders during the COVID-19 pandemic. Front Nutr. Apr 27, 2021;8:637868. [FREE Full text] [CrossRef] [Medline]70]
  • Hands-on absence in terms of presence in a broader sense [Barrett D. Rethinking presence: a grounded theory of nurses and teleconsultation. J Clin Nurs. Oct 2017;26(19-20):3088-3098. [CrossRef] [Medline]42,Koppel PD, De Gagne JC, Docherty S, Smith S, Prose NS, Jabaley T. Exploring nurse and patient experiences of developing rapport during oncology ambulatory care videoconferencing visits: qualitative descriptive study. J Med Internet Res. Sep 08, 2022;24(9):e39920. [FREE Full text] [CrossRef] [Medline]88]
Patient issues

Inappropriate target group
  • Not appropriate for all groups of patients [Fong R, Tsai CF, Yiu OY. The implementation of telepractice in speech language pathology in Hong Kong during the COVID-19 pandemic. Telemed J E Health. Jan 2021;27(1):30-38. [CrossRef] [Medline]54,Almog T, Gilboa Y. Remote delivery of service: a survey of occupational therapists' perceptions. Rehabil Process Outcome. Sep 06, 2022;11:11795727221117503. [FREE Full text] [CrossRef] [Medline]73,Ditwiler RE, Swisher LL, Hardwick DD. Doing things you never imagined: professional and ethical issues in the U.S. outpatient physical therapy setting during the COVID-19 pandemic. Musculoskelet Sci Pract. Dec 2022;62:102684. [FREE Full text] [CrossRef] [Medline]81,Peh HP, Yee K, Mantaring EJ. Changes in telepractice use and perspectives among speech and language therapists in Singapore through the COVID-19 pandemic. Int J Lang Commun Disord. May 2023;58(3):802-812. [CrossRef] [Medline]91,Richter B, Wattenberg I, Vollmer AL, Hornberg C, Wrede B, Lätzsch R. The COVID-19 pandemic as an opportunity for teletherapy? - A survey of non-medical therapy professionals in the health sector. Gesundheitswesen. Apr 2022;84(4):319-325. [CrossRef] [Medline]92]
    • Age [55,73,74,85,90]
    • Diagnosis [50,55,64,85,90]
    • Vision and hearing abilities [73,74,88]
    • Cognitive abilities [73,96]
    • Language skills [85,88]
    • Personal preference [81]
    • Technology experience [88]
  • Inappropriate referrals [Abbott-Gaffney C, Jacobs K. Telehealth in school-based practice: perceived viability to bridge global OT practitioner shortages prior to COVID-19 global health emergency. Work. 2020;67(1):29-35. [CrossRef] [Medline]47]

Patient behavior
  • Maintenance of patient attention [Peh HP, Yee K, Mantaring EJ. Changes in telepractice use and perspectives among speech and language therapists in Singapore through the COVID-19 pandemic. Int J Lang Commun Disord. May 2023;58(3):802-812. [CrossRef] [Medline]91,Van Eerdenbrugh S, Schraeyen K, Leysen H, Mostaert C, D'haenens W, Vandenborre D. Delivery of speech-language therapy and audiology services across the world at the start of the COVID-19 pandemic: a survey. Perspect. Apr 14, 2022;7(2):635-646. [FREE Full text] [CrossRef]94]
    • Especially with children [45,47,61,72,76,84]
  • Children’s negative behavior increased [Hall JB, Woods ML, Luechtefeld JT. Pediatric physical therapy telehealth and COVID-19: factors, facilitators, and barriers influencing effectiveness-a survey study. Pediatr Phys Ther. Jul 01, 2021;33(3):112-118. [FREE Full text] [CrossRef] [Medline]55] or harder to manage [Pollard R, Hogan S. Parental and practitioner views of telepractice for pediatric auditory verbal habilitation at a time of global pandemic. Perspective. Dec 2021;6(6):1832-1856. [FREE Full text] [CrossRef]66,Peh HP, Yee K, Mantaring EJ. Changes in telepractice use and perspectives among speech and language therapists in Singapore through the COVID-19 pandemic. Int J Lang Commun Disord. May 2023;58(3):802-812. [CrossRef] [Medline]91]
  • Children’s engagement reduced [Pollard R, Hogan S. Parental and practitioner views of telepractice for pediatric auditory verbal habilitation at a time of global pandemic. Perspective. Dec 2021;6(6):1832-1856. [FREE Full text] [CrossRef]66,Kaur M, Eddy EZ, Tiwari D. A survey of physical therapists and occupational therapists to explore practice patterns of pediatric telerehabilitation during COVID-19. Arch Phys Med Rehabil. Oct 2021;102(10):e15-e16. [FREE Full text] [CrossRef]97]
  • Inferior patient compliance [D'Souza AF, Rebello SR. Perceptions and willingness of physiotherapists in India to use telerehabilitation during the COVID-19 pandemic. Int J Telerehabil. Dec 16, 2021;13(2):e6425. [FREE Full text] [CrossRef] [Medline]53,Van Eerdenbrugh S, Schraeyen K, Leysen H, Mostaert C, D'haenens W, Vandenborre D. Delivery of speech-language therapy and audiology services across the world at the start of the COVID-19 pandemic: a survey. Perspect. Apr 14, 2022;7(2):635-646. [FREE Full text] [CrossRef]94]

Safety issues
  • Safety risks [Lawford BJ, Bennell KL, Kasza J, Hinman RS. Physical therapists' perceptions of telephone- and internet video-mediated service models for exercise management of people with osteoarthritis. Arthritis Care Res (Hoboken). Mar 2018;70(3):398-408. [CrossRef] [Medline]43,Malliaras P, Merolli M, Williams CM, Caneiro JP, Haines T, Barton C. 'It's not hands-on therapy, so it's very limited': telehealth use and views among allied health clinicians during the coronavirus pandemic. Musculoskelet Sci Pract. Apr 2021;52:102340. [FREE Full text] [CrossRef] [Medline]62,McPherson K, Nahon I. Telehealth and the provision of pelvic health physiotherapy in regional, rural and remote Australia. Aust N Z Cont J. Aug 2021;27(3):66-70. [CrossRef]64,Rettinger L, Klupper C, Werner F, Putz P. Changing attitudes towards teletherapy in Austrian therapists during the COVID-19 pandemic. J Telemed Telecare. Jun 2023;29(5):406-414. [FREE Full text] [CrossRef] [Medline]67,Almog T, Gilboa Y. Remote delivery of service: a survey of occupational therapists' perceptions. Rehabil Process Outcome. Sep 06, 2022;11:11795727221117503. [FREE Full text] [CrossRef] [Medline]73,Dissanayaka T, Nakandala P, Sanjeewa C. Physiotherapists' perceptions and barriers to use of telerehabilitation for exercise management of people with knee osteoarthritis in Sri Lanka. Disabil Rehabil Assist Technol (Forthcoming). Sep 13, 2022:1-10. [CrossRef] [Medline]80,Ditwiler RE, Swisher LL, Hardwick DD. Doing things you never imagined: professional and ethical issues in the U.S. outpatient physical therapy setting during the COVID-19 pandemic. Musculoskelet Sci Pract. Dec 2022;62:102684. [FREE Full text] [CrossRef] [Medline]81,Van Eerdenbrugh S, Schraeyen K, Leysen H, Mostaert C, D'haenens W, Vandenborre D. Delivery of speech-language therapy and audiology services across the world at the start of the COVID-19 pandemic: a survey. Perspect. Apr 14, 2022;7(2):635-646. [FREE Full text] [CrossRef]94,Beit Yosef A, Maeir T, Khalailh F, Gilboa Y. Perceived feasibility of an occupation-based telerehabilitation intervention for older adults with chronic health conditions in Israel. Hong Kong J Occup Ther. Jun 2022;35(1):62-70. [FREE Full text] [CrossRef] [Medline]96]
  • High fall risk [Bennell KL, Lawford BJ, Metcalf B, Mackenzie D, Russell T, van den Berg M, et al. Physiotherapists and patients report positive experiences overall with telehealth during the COVID-19 pandemic: a mixed-methods study. J Physiother. Jul 2021;67(3):201-209. [FREE Full text] [CrossRef] [Medline]51]
  • Missing safeguard measures [Harrell RG, Schubert MC, Oxborough S, Whitney SL. Vestibular rehabilitation telehealth during the SAEA-CoV-2 (COVID-19) pandemic. Front Neurol. Jan 20, 2022;12:781482. [FREE Full text] [CrossRef] [Medline]56,Malliaras P, Merolli M, Williams CM, Caneiro JP, Haines T, Barton C. 'It's not hands-on therapy, so it's very limited': telehealth use and views among allied health clinicians during the coronavirus pandemic. Musculoskelet Sci Pract. Apr 2021;52:102340. [FREE Full text] [CrossRef] [Medline]62,Almog T, Gilboa Y. Remote delivery of service: a survey of occupational therapists' perceptions. Rehabil Process Outcome. Sep 06, 2022;11:11795727221117503. [FREE Full text] [CrossRef] [Medline]73,Hughes L, Petrella A, Phillips N, Taylor RM. Virtual care and the impact of COVID-19 on nursing: a single centre evaluation. J Adv Nurs. Feb 2022;78(2):498-509. [FREE Full text] [CrossRef] [Medline]86,Beit Yosef A, Maeir T, Khalailh F, Gilboa Y. Perceived feasibility of an occupation-based telerehabilitation intervention for older adults with chronic health conditions in Israel. Hong Kong J Occup Ther. Jun 2022;35(1):62-70. [FREE Full text] [CrossRef] [Medline]96]
  • Increased need for multitasking in telehealth could increase the risk of fall [Kienle GS, Werthmann P, Grotejohann B, Hundhammer T, Schmoor C, Stumpe C, et al. Addressing COVID-19 challenges in a randomised controlled trial on exercise interventions in a high-risk population. BMC Geriatr. May 01, 2021;21(1):287. [FREE Full text] [CrossRef] [Medline]59]
  • Unsupervised exercise execution might lead to incorrect technique [Bennell KL, Lawford BJ, Metcalf B, Mackenzie D, Russell T, van den Berg M, et al. Physiotherapists and patients report positive experiences overall with telehealth during the COVID-19 pandemic: a mixed-methods study. J Physiother. Jul 2021;67(3):201-209. [FREE Full text] [CrossRef] [Medline]51]
  • Perception of safety risks might be harder [Kienle GS, Werthmann P, Grotejohann B, Hundhammer T, Schmoor C, Stumpe C, et al. Addressing COVID-19 challenges in a randomised controlled trial on exercise interventions in a high-risk population. BMC Geriatr. May 01, 2021;21(1):287. [FREE Full text] [CrossRef] [Medline]59,McPherson K, Nahon I. Telehealth and the provision of pelvic health physiotherapy in regional, rural and remote Australia. Aust N Z Cont J. Aug 2021;27(3):66-70. [CrossRef]64]
Environmental issues

Physical and sensory environment
  • Limit telehealth experience for patients and health care professionals [Kaufman-Shriqui V, Sherf-Dagan S, Boaz M, Birk R. Virtual nutrition consultation: what can we learn from the COVID-19 pandemic? Public Health Nutr. Apr 2021;24(5):1166-1173. [FREE Full text] [CrossRef] [Medline]58,Haines KJ, Sawyer A, McKinnon C, Donovan A, Michael C, Cimoli C, et al. Barriers and enablers to telehealth use by physiotherapists during the COVID-19 pandemic. Physiotherapy. Mar 2023;118:12-19. [FREE Full text] [CrossRef] [Medline]85]
  • Noise distractions [Krasovsky T, Silberg T, Barak S, Eisenstein E, Erez N, Feldman I, et al. Transition to multidisciplinary pediatric telerehabilitation during the COVID-19 pandemic: strategy development and implementation. Int J Environ Res Public Health. Feb 04, 2021;18(4):1484. [FREE Full text] [CrossRef] [Medline]61,Malliaras P, Merolli M, Williams CM, Caneiro JP, Haines T, Barton C. 'It's not hands-on therapy, so it's very limited': telehealth use and views among allied health clinicians during the coronavirus pandemic. Musculoskelet Sci Pract. Apr 2021;52:102340. [FREE Full text] [CrossRef] [Medline]62,Singh RH, Pringle T, Kenneson A. The use of telemedicine and other strategies by registered dietitians for the medical nutrition therapy of patients with inherited metabolic disorders during the COVID-19 pandemic. Front Nutr. Apr 27, 2021;8:637868. [FREE Full text] [CrossRef] [Medline]70,Almog T, Gilboa Y. Remote delivery of service: a survey of occupational therapists' perceptions. Rehabil Process Outcome. Sep 06, 2022;11:11795727221117503. [FREE Full text] [CrossRef] [Medline]73,Haines KJ, Sawyer A, McKinnon C, Donovan A, Michael C, Cimoli C, et al. Barriers and enablers to telehealth use by physiotherapists during the COVID-19 pandemic. Physiotherapy. Mar 2023;118:12-19. [FREE Full text] [CrossRef] [Medline]85,Tar-Mahomed Z, Kater KA. The perspectives of speech-language pathologists: providing teletherapy to patients with speech, language and swallowing difficulties during a COVID-19 context. S Afr J Commun Disord. Aug 11, 2022;69(2):e1-e7. [FREE Full text] [CrossRef] [Medline]93]
  • Poor camera angles [Wundersitz C, Caelli A, Georgy J, Musovic A, Manning R, Prause M, et al. Conducting community rehabilitation review sessions via videoconference: a feasibility study. Aust J Rural Health. Dec 2020;28(6):603-612. [CrossRef] [Medline]48]
  • Limited space [Malliaras P, Merolli M, Williams CM, Caneiro JP, Haines T, Barton C. 'It's not hands-on therapy, so it's very limited': telehealth use and views among allied health clinicians during the coronavirus pandemic. Musculoskelet Sci Pract. Apr 2021;52:102340. [FREE Full text] [CrossRef] [Medline]62,Almog T, Gilboa Y. Remote delivery of service: a survey of occupational therapists' perceptions. Rehabil Process Outcome. Sep 06, 2022;11:11795727221117503. [FREE Full text] [CrossRef] [Medline]73,Grant CM, Jones A, Land H. Physiotherapists’ perspectives on the use of telehealth for service delivery to children with developmental delays: a qualitative focus group study. Internet J Allied Health Sci Pract. Mar 31, 2022;20(2):1-10. [FREE Full text] [CrossRef]84,Hughes L, Petrella A, Phillips N, Taylor RM. Virtual care and the impact of COVID-19 on nursing: a single centre evaluation. J Adv Nurs. Feb 2022;78(2):498-509. [FREE Full text] [CrossRef] [Medline]86,Wittmeier KD, Hammond E, Tymko K, Burnham K, Janssen T, Pablo AJ, et al. "Another tool in your toolkit": pediatric occupational and physical therapists' perspectives of initiating telehealth during the COVID-19 pandemic. Phys Occup Ther Pediatr. 2022;42(5):465-481. [CrossRef] [Medline]95]
  • Lack of privacy [Spiby H, Faucher MA, Sands G, Roberts J, Kennedy HP. A qualitative study of midwives' perceptions on using video-calling in early labor. Birth. Mar 2019;46(1):105-112. [CrossRef] [Medline]46,McPherson K, Nahon I. Telehealth and the provision of pelvic health physiotherapy in regional, rural and remote Australia. Aust N Z Cont J. Aug 2021;27(3):66-70. [CrossRef]64,Almog T, Gilboa Y. Remote delivery of service: a survey of occupational therapists' perceptions. Rehabil Process Outcome. Sep 06, 2022;11:11795727221117503. [FREE Full text] [CrossRef] [Medline]73,Haines KJ, Sawyer A, McKinnon C, Donovan A, Michael C, Cimoli C, et al. Barriers and enablers to telehealth use by physiotherapists during the COVID-19 pandemic. Physiotherapy. Mar 2023;118:12-19. [FREE Full text] [CrossRef] [Medline]85,Wittmeier KD, Hammond E, Tymko K, Burnham K, Janssen T, Pablo AJ, et al. "Another tool in your toolkit": pediatric occupational and physical therapists' perspectives of initiating telehealth during the COVID-19 pandemic. Phys Occup Ther Pediatr. 2022;42(5):465-481. [CrossRef] [Medline]95]
  • Lack of material needed [Wundersitz C, Caelli A, Georgy J, Musovic A, Manning R, Prause M, et al. Conducting community rehabilitation review sessions via videoconference: a feasibility study. Aust J Rural Health. Dec 2020;28(6):603-612. [CrossRef] [Medline]48,Bican R, Christensen C, Fallieras K, Sagester G, O'Rourke S, Byars M, et al. Rapid implementation of telerehabilitation for pediatric patients during COVID-19. Int J Telerehabil. Jun 22, 2021;13(1):e6371. [FREE Full text] [CrossRef] [Medline]52,Abbott-Gaffney CR, Gafni-Lachter L, Cason J, Sheaffer K, Harasink R, Donehower K, et al. Toward successful future use of telehealth in occupational therapy practice: what the COVID-19 rapid shift revealed. Work. 2022;71(2):385-394. [CrossRef] [Medline]72,Almog T, Gilboa Y. Remote delivery of service: a survey of occupational therapists' perceptions. Rehabil Process Outcome. Sep 06, 2022;11:11795727221117503. [FREE Full text] [CrossRef] [Medline]73,Ditwiler RE, Swisher LL, Hardwick DD. Doing things you never imagined: professional and ethical issues in the U.S. outpatient physical therapy setting during the COVID-19 pandemic. Musculoskelet Sci Pract. Dec 2022;62:102684. [FREE Full text] [CrossRef] [Medline]81]

Social environment
  • Absence of people to support with technology or other tasks [Rortvedt D, Jacobs K. Perspectives on the use of a telehealth service-delivery model as a component of school-based occupational therapy practice: designing a user-experience. Work. 2019;62(1):125-131. [CrossRef] [Medline]45,Abbott-Gaffney C, Jacobs K. Telehealth in school-based practice: perceived viability to bridge global OT practitioner shortages prior to COVID-19 global health emergency. Work. 2020;67(1):29-35. [CrossRef] [Medline]47,Harrell RG, Schubert MC, Oxborough S, Whitney SL. Vestibular rehabilitation telehealth during the SAEA-CoV-2 (COVID-19) pandemic. Front Neurol. Jan 20, 2022;12:781482. [FREE Full text] [CrossRef] [Medline]56,Singh RH, Pringle T, Kenneson A. The use of telemedicine and other strategies by registered dietitians for the medical nutrition therapy of patients with inherited metabolic disorders during the COVID-19 pandemic. Front Nutr. Apr 27, 2021;8:637868. [FREE Full text] [CrossRef] [Medline]70,Abbott-Gaffney CR, Gafni-Lachter L, Cason J, Sheaffer K, Harasink R, Donehower K, et al. Toward successful future use of telehealth in occupational therapy practice: what the COVID-19 rapid shift revealed. Work. 2022;71(2):385-394. [CrossRef] [Medline]72,Hughes L, Petrella A, Phillips N, Taylor RM. Virtual care and the impact of COVID-19 on nursing: a single centre evaluation. J Adv Nurs. Feb 2022;78(2):498-509. [FREE Full text] [CrossRef] [Medline]86,Kaur M, Eddy EZ, Tiwari D. Exploring practice patterns of pediatric telerehabilitation during COVID-19: a survey study. Telemed J E Health. Oct 2022;28(10):1505-1516. [FREE Full text] [CrossRef] [Medline]87,Wittmeier KD, Hammond E, Tymko K, Burnham K, Janssen T, Pablo AJ, et al. "Another tool in your toolkit": pediatric occupational and physical therapists' perspectives of initiating telehealth during the COVID-19 pandemic. Phys Occup Ther Pediatr. 2022;42(5):465-481. [CrossRef] [Medline]95]
  • Missing language interpreters [Spiby H, Faucher MA, Sands G, Roberts J, Kennedy HP. A qualitative study of midwives' perceptions on using video-calling in early labor. Birth. Mar 2019;46(1):105-112. [CrossRef] [Medline]46,Bican R, Christensen C, Fallieras K, Sagester G, O'Rourke S, Byars M, et al. Rapid implementation of telerehabilitation for pediatric patients during COVID-19. Int J Telerehabil. Jun 22, 2021;13(1):e6371. [FREE Full text] [CrossRef] [Medline]52,Singh RH, Pringle T, Kenneson A. The use of telemedicine and other strategies by registered dietitians for the medical nutrition therapy of patients with inherited metabolic disorders during the COVID-19 pandemic. Front Nutr. Apr 27, 2021;8:637868. [FREE Full text] [CrossRef] [Medline]70]
  • Struggling, overwhelmed, or reluctant relatives [Hall JB, Woods ML, Luechtefeld JT. Pediatric physical therapy telehealth and COVID-19: factors, facilitators, and barriers influencing effectiveness-a survey study. Pediatr Phys Ther. Jul 01, 2021;33(3):112-118. [FREE Full text] [CrossRef] [Medline]55,Almog T, Gilboa Y. Remote delivery of service: a survey of occupational therapists' perceptions. Rehabil Process Outcome. Sep 06, 2022;11:11795727221117503. [FREE Full text] [CrossRef] [Medline]73,Bolden III W. Telehealth across the therapies: examining the impact of the COVID-19 pandemic on clinical staff working with low socioeconomic status populations. Perspective. Aug 2022;7(4):1236-1255. [FREE Full text] [CrossRef]76,Eguia KF, Capio CM. Teletherapy for children with developmental disorders during the COVID-19 pandemic in the Philippines: a mixed-methods evaluation from the perspectives of parents and therapists. Child Care Health Dev. Nov 2022;48(6):963-969. [CrossRef] [Medline]82,Van Eerdenbrugh S, Schraeyen K, Leysen H, Mostaert C, D'haenens W, Vandenborre D. Delivery of speech-language therapy and audiology services across the world at the start of the COVID-19 pandemic: a survey. Perspect. Apr 14, 2022;7(2):635-646. [FREE Full text] [CrossRef]94,Beit Yosef A, Maeir T, Khalailh F, Gilboa Y. Perceived feasibility of an occupation-based telerehabilitation intervention for older adults with chronic health conditions in Israel. Hong Kong J Occup Ther. Jun 2022;35(1):62-70. [FREE Full text] [CrossRef] [Medline]96]
Attributions

Negative attitudes
  • Negative attitudes or reluctance of health care providers [Albahrouh SI, Buabbas AJ. Physiotherapists' perceptions of and willingness to use telerehabilitation in Kuwait during the COVID-19 pandemic. BMC Med Inform Decis Mak. Apr 08, 2021;21(1):122. [FREE Full text] [CrossRef] [Medline]49,Bayati B, Ayatollahi H. Speech therapists' perspectives about using tele-speech therapy: a qualitative study. Disabil Rehabil Assist Technol. Jul 2023;18(5):621-626. [CrossRef] [Medline]50,D'Souza AF, Rebello SR. Perceptions and willingness of physiotherapists in India to use telerehabilitation during the COVID-19 pandemic. Int J Telerehabil. Dec 16, 2021;13(2):e6425. [FREE Full text] [CrossRef] [Medline]53,Hughes L, Petrella A, Phillips N, Taylor RM. Virtual care and the impact of COVID-19 on nursing: a single centre evaluation. J Adv Nurs. Feb 2022;78(2):498-509. [FREE Full text] [CrossRef] [Medline]86]
  • Negative attitudes or reluctance of patients, clients, or caregivers [Rygg LO, Brataas HV, Nordtug B. Introducing videoconferencing on tablet computers in nurse-patient communication: technical and training challenges. Int J Telemed Appl. Oct 18, 2018;2018:8943960. [FREE Full text] [CrossRef] [Medline]44,Rortvedt D, Jacobs K. Perspectives on the use of a telehealth service-delivery model as a component of school-based occupational therapy practice: designing a user-experience. Work. 2019;62(1):125-131. [CrossRef] [Medline]45,Bayati B, Ayatollahi H. Speech therapists' perspectives about using tele-speech therapy: a qualitative study. Disabil Rehabil Assist Technol. Jul 2023;18(5):621-626. [CrossRef] [Medline]50,Fong R, Tsai CF, Yiu OY. The implementation of telepractice in speech language pathology in Hong Kong during the COVID-19 pandemic. Telemed J E Health. Jan 2021;27(1):30-38. [CrossRef] [Medline]54,Kienle GS, Werthmann P, Grotejohann B, Hundhammer T, Schmoor C, Stumpe C, et al. Addressing COVID-19 challenges in a randomised controlled trial on exercise interventions in a high-risk population. BMC Geriatr. May 01, 2021;21(1):287. [FREE Full text] [CrossRef] [Medline]59,Malliaras P, Merolli M, Williams CM, Caneiro JP, Haines T, Barton C. 'It's not hands-on therapy, so it's very limited': telehealth use and views among allied health clinicians during the coronavirus pandemic. Musculoskelet Sci Pract. Apr 2021;52:102340. [FREE Full text] [CrossRef] [Medline]62,Pollard R, Hogan S. Parental and practitioner views of telepractice for pediatric auditory verbal habilitation at a time of global pandemic. Perspective. Dec 2021;6(6):1832-1856. [FREE Full text] [CrossRef]66,Rozga M, Handu D, Kelley K, Jimenez EY, Martin H, Schofield M, et al. Telehealth during the COVID-19 pandemic: a cross-sectional survey of registered dietitian nutritionists. J Acad Nutr Diet. Dec 2021;121(12):2524-2535. [FREE Full text] [CrossRef] [Medline]68,Sutherland R, Hodge A, Chan E, Silove N. Barriers and facilitators: clinicians' opinions and experiences of telehealth before and after their use of a telehealth platform for child language assessment. Int J Lang Commun Disord. Nov 2021;56(6):1263-1277. [CrossRef] [Medline]71,Kaur M, Eddy EZ, Tiwari D. Exploring practice patterns of pediatric telerehabilitation during COVID-19: a survey study. Telemed J E Health. Oct 2022;28(10):1505-1516. [FREE Full text] [CrossRef] [Medline]87,Peh HP, Yee K, Mantaring EJ. Changes in telepractice use and perspectives among speech and language therapists in Singapore through the COVID-19 pandemic. Int J Lang Commun Disord. May 2023;58(3):802-812. [CrossRef] [Medline]91,Richter B, Wattenberg I, Vollmer AL, Hornberg C, Wrede B, Lätzsch R. The COVID-19 pandemic as an opportunity for teletherapy? - A survey of non-medical therapy professionals in the health sector. Gesundheitswesen. Apr 2022;84(4):319-325. [CrossRef] [Medline]92,Van Eerdenbrugh S, Schraeyen K, Leysen H, Mostaert C, D'haenens W, Vandenborre D. Delivery of speech-language therapy and audiology services across the world at the start of the COVID-19 pandemic: a survey. Perspect. Apr 14, 2022;7(2):635-646. [FREE Full text] [CrossRef]94]
    • Causation of nocebo effects [59]
  • Lack of understanding of telehealth [Rortvedt D, Jacobs K. Perspectives on the use of a telehealth service-delivery model as a component of school-based occupational therapy practice: designing a user-experience. Work. 2019;62(1):125-131. [CrossRef] [Medline]45,Sutherland R, Hodge A, Chan E, Silove N. Barriers and facilitators: clinicians' opinions and experiences of telehealth before and after their use of a telehealth platform for child language assessment. Int J Lang Commun Disord. Nov 2021;56(6):1263-1277. [CrossRef] [Medline]71]
  • Fear of scams by especially older clients [Rozga M, Handu D, Kelley K, Jimenez EY, Martin H, Schofield M, et al. Telehealth during the COVID-19 pandemic: a cross-sectional survey of registered dietitian nutritionists. J Acad Nutr Diet. Dec 2021;121(12):2524-2535. [FREE Full text] [CrossRef] [Medline]68]
  • Worsened public perception of the profession [Eikelboom RH, Bennett RJ, Manchaiah V, Parmar B, Beukes E, Rajasingam SL, et al. International survey of audiologists during the COVID-19 pandemic: use of and attitudes to telehealth. Int J Audiol. Apr 2022;61(4):283-292. [CrossRef] [Medline]83]
  • Fear of job automatization [Parmar B, Beukes E, Rajasingam S. Int J Audiol. Mar 2022;61(3):228-238. [CrossRef] [Medline]90]

Perceived drawbacks
  • Quality concerns [Kaur M, Eddy EZ, Tiwari D. Exploring practice patterns of pediatric telerehabilitation during COVID-19: a survey study. Telemed J E Health. Oct 2022;28(10):1505-1516. [FREE Full text] [CrossRef] [Medline]87,Nazreen Nihara MR, Seethapathy J. Tele-audiology in India: current and future trends in knowledge, attitude, and practice among audiologists. J Audiol Otol. Jul 2022;26(3):130-141. [FREE Full text] [CrossRef] [Medline]89]
  • Lack of perceived clinical usefulness [Lawford BJ, Bennell KL, Kasza J, Hinman RS. Physical therapists' perceptions of telephone- and internet video-mediated service models for exercise management of people with osteoarthritis. Arthritis Care Res (Hoboken). Mar 2018;70(3):398-408. [CrossRef] [Medline]43,Albahrouh SI, Buabbas AJ. Physiotherapists' perceptions of and willingness to use telerehabilitation in Kuwait during the COVID-19 pandemic. BMC Med Inform Decis Mak. Apr 08, 2021;21(1):122. [FREE Full text] [CrossRef] [Medline]49,D'Souza AF, Rebello SR. Perceptions and willingness of physiotherapists in India to use telerehabilitation during the COVID-19 pandemic. Int J Telerehabil. Dec 16, 2021;13(2):e6425. [FREE Full text] [CrossRef] [Medline]53]
  • Lack of clinical effectiveness [Lawford BJ, Bennell KL, Kasza J, Hinman RS. Physical therapists' perceptions of telephone- and internet video-mediated service models for exercise management of people with osteoarthritis. Arthritis Care Res (Hoboken). Mar 2018;70(3):398-408. [CrossRef] [Medline]43,Albahrouh SI, Buabbas AJ. Physiotherapists' perceptions of and willingness to use telerehabilitation in Kuwait during the COVID-19 pandemic. BMC Med Inform Decis Mak. Apr 08, 2021;21(1):122. [FREE Full text] [CrossRef] [Medline]49,Bayati B, Ayatollahi H. Speech therapists' perspectives about using tele-speech therapy: a qualitative study. Disabil Rehabil Assist Technol. Jul 2023;18(5):621-626. [CrossRef] [Medline]50,Fong R, Tsai CF, Yiu OY. The implementation of telepractice in speech language pathology in Hong Kong during the COVID-19 pandemic. Telemed J E Health. Jan 2021;27(1):30-38. [CrossRef] [Medline]54,Malliaras P, Merolli M, Williams CM, Caneiro JP, Haines T, Barton C. 'It's not hands-on therapy, so it's very limited': telehealth use and views among allied health clinicians during the coronavirus pandemic. Musculoskelet Sci Pract. Apr 2021;52:102340. [FREE Full text] [CrossRef] [Medline]62,McPherson K, Nahon I. Telehealth and the provision of pelvic health physiotherapy in regional, rural and remote Australia. Aust N Z Cont J. Aug 2021;27(3):66-70. [CrossRef]64,Pollard R, Hogan S. Parental and practitioner views of telepractice for pediatric auditory verbal habilitation at a time of global pandemic. Perspective. Dec 2021;6(6):1832-1856. [FREE Full text] [CrossRef]66,Rettinger L, Klupper C, Werner F, Putz P. Changing attitudes towards teletherapy in Austrian therapists during the COVID-19 pandemic. J Telemed Telecare. Jun 2023;29(5):406-414. [FREE Full text] [CrossRef] [Medline]67,Buabbas AJ, Albahrouh SE, Alrowayeh HN, Alshawaf H. Telerehabilitation during the COVID-19 pandemic: patients and physical therapists' experiences. Med Princ Pract. 2022;31(2):156-164. [FREE Full text] [CrossRef] [Medline]77,Ceprnja D, Clark T, Young J, Lee R, Flynn K, Maka K. Evaluating experiences, usability and patient satisfaction with telehealth for tertiary outpatient physiotherapy services during COVID-19: a mixed-methods study. Physiother Theory Pract (Forthcoming). Apr 06, 2022:1-9. [CrossRef] [Medline]78,Dissanayaka T, Nakandala P, Sanjeewa C. Physiotherapists' perceptions and barriers to use of telerehabilitation for exercise management of people with knee osteoarthritis in Sri Lanka. Disabil Rehabil Assist Technol (Forthcoming). Sep 13, 2022:1-10. [CrossRef] [Medline]80,Grant CM, Jones A, Land H. Physiotherapists’ perspectives on the use of telehealth for service delivery to children with developmental delays: a qualitative focus group study. Internet J Allied Health Sci Pract. Mar 31, 2022;20(2):1-10. [FREE Full text] [CrossRef]84,Peh HP, Yee K, Mantaring EJ. Changes in telepractice use and perspectives among speech and language therapists in Singapore through the COVID-19 pandemic. Int J Lang Commun Disord. May 2023;58(3):802-812. [CrossRef] [Medline]91,Richter B, Wattenberg I, Vollmer AL, Hornberg C, Wrede B, Lätzsch R. The COVID-19 pandemic as an opportunity for teletherapy? - A survey of non-medical therapy professionals in the health sector. Gesundheitswesen. Apr 2022;84(4):319-325. [CrossRef] [Medline]92,Van Eerdenbrugh S, Schraeyen K, Leysen H, Mostaert C, D'haenens W, Vandenborre D. Delivery of speech-language therapy and audiology services across the world at the start of the COVID-19 pandemic: a survey. Perspect. Apr 14, 2022;7(2):635-646. [FREE Full text] [CrossRef]94]
  • Slower progress of treatment [Ceprnja D, Clark T, Young J, Lee R, Flynn K, Maka K. Evaluating experiences, usability and patient satisfaction with telehealth for tertiary outpatient physiotherapy services during COVID-19: a mixed-methods study. Physiother Theory Pract (Forthcoming). Apr 06, 2022:1-9. [CrossRef] [Medline]78]
  • Reduced patient satisfaction [Rettinger L, Klupper C, Werner F, Putz P. Changing attitudes towards teletherapy in Austrian therapists during the COVID-19 pandemic. J Telemed Telecare. Jun 2023;29(5):406-414. [FREE Full text] [CrossRef] [Medline]67]
  • Diminished capability to meet urgent cases [Eikelboom RH, Bennett RJ, Manchaiah V, Parmar B, Beukes E, Rajasingam SL, et al. International survey of audiologists during the COVID-19 pandemic: use of and attitudes to telehealth. Int J Audiol. Apr 2022;61(4):283-292. [CrossRef] [Medline]83]
Policy and regulation issues

Privacy and security issues
  • Patient privacy at risk [Lawford BJ, Bennell KL, Kasza J, Hinman RS. Physical therapists' perceptions of telephone- and internet video-mediated service models for exercise management of people with osteoarthritis. Arthritis Care Res (Hoboken). Mar 2018;70(3):398-408. [CrossRef] [Medline]43,Rortvedt D, Jacobs K. Perspectives on the use of a telehealth service-delivery model as a component of school-based occupational therapy practice: designing a user-experience. Work. 2019;62(1):125-131. [CrossRef] [Medline]45,Spiby H, Faucher MA, Sands G, Roberts J, Kennedy HP. A qualitative study of midwives' perceptions on using video-calling in early labor. Birth. Mar 2019;46(1):105-112. [CrossRef] [Medline]46,Albahrouh SI, Buabbas AJ. Physiotherapists' perceptions of and willingness to use telerehabilitation in Kuwait during the COVID-19 pandemic. BMC Med Inform Decis Mak. Apr 08, 2021;21(1):122. [FREE Full text] [CrossRef] [Medline]49,Bayati B, Ayatollahi H. Speech therapists' perspectives about using tele-speech therapy: a qualitative study. Disabil Rehabil Assist Technol. Jul 2023;18(5):621-626. [CrossRef] [Medline]50,Kienle GS, Werthmann P, Grotejohann B, Hundhammer T, Schmoor C, Stumpe C, et al. Addressing COVID-19 challenges in a randomised controlled trial on exercise interventions in a high-risk population. BMC Geriatr. May 01, 2021;21(1):287. [FREE Full text] [CrossRef] [Medline]59,Abbott-Gaffney CR, Gafni-Lachter L, Cason J, Sheaffer K, Harasink R, Donehower K, et al. Toward successful future use of telehealth in occupational therapy practice: what the COVID-19 rapid shift revealed. Work. 2022;71(2):385-394. [CrossRef] [Medline]72,Dissanayaka T, Nakandala P, Sanjeewa C. Physiotherapists' perceptions and barriers to use of telerehabilitation for exercise management of people with knee osteoarthritis in Sri Lanka. Disabil Rehabil Assist Technol (Forthcoming). Sep 13, 2022:1-10. [CrossRef] [Medline]80,Grant CM, Jones A, Land H. Physiotherapists’ perspectives on the use of telehealth for service delivery to children with developmental delays: a qualitative focus group study. Internet J Allied Health Sci Pract. Mar 31, 2022;20(2):1-10. [FREE Full text] [CrossRef]84,Wittmeier KD, Hammond E, Tymko K, Burnham K, Janssen T, Pablo AJ, et al. "Another tool in your toolkit": pediatric occupational and physical therapists' perspectives of initiating telehealth during the COVID-19 pandemic. Phys Occup Ther Pediatr. 2022;42(5):465-481. [CrossRef] [Medline]95]
  • Security, confidentiality, and data protection concerns [Lawford BJ, Bennell KL, Kasza J, Hinman RS. Physical therapists' perceptions of telephone- and internet video-mediated service models for exercise management of people with osteoarthritis. Arthritis Care Res (Hoboken). Mar 2018;70(3):398-408. [CrossRef] [Medline]43,Rortvedt D, Jacobs K. Perspectives on the use of a telehealth service-delivery model as a component of school-based occupational therapy practice: designing a user-experience. Work. 2019;62(1):125-131. [CrossRef] [Medline]45,Spiby H, Faucher MA, Sands G, Roberts J, Kennedy HP. A qualitative study of midwives' perceptions on using video-calling in early labor. Birth. Mar 2019;46(1):105-112. [CrossRef] [Medline]46,Albahrouh SI, Buabbas AJ. Physiotherapists' perceptions of and willingness to use telerehabilitation in Kuwait during the COVID-19 pandemic. BMC Med Inform Decis Mak. Apr 08, 2021;21(1):122. [FREE Full text] [CrossRef] [Medline]49,Bayati B, Ayatollahi H. Speech therapists' perspectives about using tele-speech therapy: a qualitative study. Disabil Rehabil Assist Technol. Jul 2023;18(5):621-626. [CrossRef] [Medline]50,D'Souza AF, Rebello SR. Perceptions and willingness of physiotherapists in India to use telerehabilitation during the COVID-19 pandemic. Int J Telerehabil. Dec 16, 2021;13(2):e6425. [FREE Full text] [CrossRef] [Medline]53,Kienle GS, Werthmann P, Grotejohann B, Hundhammer T, Schmoor C, Stumpe C, et al. Addressing COVID-19 challenges in a randomised controlled trial on exercise interventions in a high-risk population. BMC Geriatr. May 01, 2021;21(1):287. [FREE Full text] [CrossRef] [Medline]59,Pollard R, Hogan S. Parental and practitioner views of telepractice for pediatric auditory verbal habilitation at a time of global pandemic. Perspective. Dec 2021;6(6):1832-1856. [FREE Full text] [CrossRef]66,Rettinger L, Klupper C, Werner F, Putz P. Changing attitudes towards teletherapy in Austrian therapists during the COVID-19 pandemic. J Telemed Telecare. Jun 2023;29(5):406-414. [FREE Full text] [CrossRef] [Medline]67,Sutherland R, Hodge A, Chan E, Silove N. Barriers and facilitators: clinicians' opinions and experiences of telehealth before and after their use of a telehealth platform for child language assessment. Int J Lang Commun Disord. Nov 2021;56(6):1263-1277. [CrossRef] [Medline]71,Abbott-Gaffney CR, Gafni-Lachter L, Cason J, Sheaffer K, Harasink R, Donehower K, et al. Toward successful future use of telehealth in occupational therapy practice: what the COVID-19 rapid shift revealed. Work. 2022;71(2):385-394. [CrossRef] [Medline]72,Eikelboom RH, Bennett RJ, Manchaiah V, Parmar B, Beukes E, Rajasingam SL, et al. International survey of audiologists during the COVID-19 pandemic: use of and attitudes to telehealth. Int J Audiol. Apr 2022;61(4):283-292. [CrossRef] [Medline]83,Grant CM, Jones A, Land H. Physiotherapists’ perspectives on the use of telehealth for service delivery to children with developmental delays: a qualitative focus group study. Internet J Allied Health Sci Pract. Mar 31, 2022;20(2):1-10. [FREE Full text] [CrossRef]84,Nazreen Nihara MR, Seethapathy J. Tele-audiology in India: current and future trends in knowledge, attitude, and practice among audiologists. J Audiol Otol. Jul 2022;26(3):130-141. [FREE Full text] [CrossRef] [Medline]89-Richter B, Wattenberg I, Vollmer AL, Hornberg C, Wrede B, Lätzsch R. The COVID-19 pandemic as an opportunity for teletherapy? - A survey of non-medical therapy professionals in the health sector. Gesundheitswesen. Apr 2022;84(4):319-325. [CrossRef] [Medline]92,Wittmeier KD, Hammond E, Tymko K, Burnham K, Janssen T, Pablo AJ, et al. "Another tool in your toolkit": pediatric occupational and physical therapists' perspectives of initiating telehealth during the COVID-19 pandemic. Phys Occup Ther Pediatr. 2022;42(5):465-481. [CrossRef] [Medline]95]

Billing and reimbursement issues
  • Funding, reimbursement, and payment for telehealth services [Spiby H, Faucher MA, Sands G, Roberts J, Kennedy HP. A qualitative study of midwives' perceptions on using video-calling in early labor. Birth. Mar 2019;46(1):105-112. [CrossRef] [Medline]46,Malliaras P, Merolli M, Williams CM, Caneiro JP, Haines T, Barton C. 'It's not hands-on therapy, so it's very limited': telehealth use and views among allied health clinicians during the coronavirus pandemic. Musculoskelet Sci Pract. Apr 2021;52:102340. [FREE Full text] [CrossRef] [Medline]62,McPherson K, Nahon I. Telehealth and the provision of pelvic health physiotherapy in regional, rural and remote Australia. Aust N Z Cont J. Aug 2021;27(3):66-70. [CrossRef]64,Rettinger L, Klupper C, Werner F, Putz P. Changing attitudes towards teletherapy in Austrian therapists during the COVID-19 pandemic. J Telemed Telecare. Jun 2023;29(5):406-414. [FREE Full text] [CrossRef] [Medline]67,Singh RH, Pringle T, Kenneson A. The use of telemedicine and other strategies by registered dietitians for the medical nutrition therapy of patients with inherited metabolic disorders during the COVID-19 pandemic. Front Nutr. Apr 27, 2021;8:637868. [FREE Full text] [CrossRef] [Medline]70,Abbott-Gaffney CR, Gafni-Lachter L, Cason J, Sheaffer K, Harasink R, Donehower K, et al. Toward successful future use of telehealth in occupational therapy practice: what the COVID-19 rapid shift revealed. Work. 2022;71(2):385-394. [CrossRef] [Medline]72,Chaudhari C, Talreja A. Emerging challenges faced by private clinic physiotherapist in new normal times during the COVID-19 pandemic in Pune city. Indian J Occup Ther. Aug 09, 2022;16(3):103-108. [FREE Full text] [CrossRef]79,Peh HP, Yee K, Mantaring EJ. Changes in telepractice use and perspectives among speech and language therapists in Singapore through the COVID-19 pandemic. Int J Lang Commun Disord. May 2023;58(3):802-812. [CrossRef] [Medline]91]

Policies
  • Workplace policies or missing workplace policies [Singh RH, Pringle T, Kenneson A. The use of telemedicine and other strategies by registered dietitians for the medical nutrition therapy of patients with inherited metabolic disorders during the COVID-19 pandemic. Front Nutr. Apr 27, 2021;8:637868. [FREE Full text] [CrossRef] [Medline]70,Abbott-Gaffney CR, Gafni-Lachter L, Cason J, Sheaffer K, Harasink R, Donehower K, et al. Toward successful future use of telehealth in occupational therapy practice: what the COVID-19 rapid shift revealed. Work. 2022;71(2):385-394. [CrossRef] [Medline]72,Buabbas AJ, Albahrouh SE, Alrowayeh HN, Alshawaf H. Telerehabilitation during the COVID-19 pandemic: patients and physical therapists' experiences. Med Princ Pract. 2022;31(2):156-164. [FREE Full text] [CrossRef] [Medline]77,Wittmeier KD, Hammond E, Tymko K, Burnham K, Janssen T, Pablo AJ, et al. "Another tool in your toolkit": pediatric occupational and physical therapists' perspectives of initiating telehealth during the COVID-19 pandemic. Phys Occup Ther Pediatr. 2022;42(5):465-481. [CrossRef] [Medline]95]
  • Licensure issues when providing telehealth across state borders [Abbott-Gaffney C, Jacobs K. Telehealth in school-based practice: perceived viability to bridge global OT practitioner shortages prior to COVID-19 global health emergency. Work. 2020;67(1):29-35. [CrossRef] [Medline]47,Abbott-Gaffney CR, Gafni-Lachter L, Cason J, Sheaffer K, Harasink R, Donehower K, et al. Toward successful future use of telehealth in occupational therapy practice: what the COVID-19 rapid shift revealed. Work. 2022;71(2):385-394. [CrossRef] [Medline]72]
  • Health policies [Rettinger L, Klupper C, Werner F, Putz P. Changing attitudes towards teletherapy in Austrian therapists during the COVID-19 pandemic. J Telemed Telecare. Jun 2023;29(5):406-414. [FREE Full text] [CrossRef] [Medline]67]
Interpersonal issues

Diminished client-practitioner interaction and communication
  • Limited interaction between the client and the practitioner [Eikelboom RH, Bennett RJ, Manchaiah V, Parmar B, Beukes E, Rajasingam SL, et al. International survey of audiologists during the COVID-19 pandemic: use of and attitudes to telehealth. Int J Audiol. Apr 2022;61(4):283-292. [CrossRef] [Medline]83,Van Eerdenbrugh S, Schraeyen K, Leysen H, Mostaert C, D'haenens W, Vandenborre D. Delivery of speech-language therapy and audiology services across the world at the start of the COVID-19 pandemic: a survey. Perspect. Apr 14, 2022;7(2):635-646. [FREE Full text] [CrossRef]94]
  • Harder to establish relationship or rapport [Abbott-Gaffney C, Jacobs K. Telehealth in school-based practice: perceived viability to bridge global OT practitioner shortages prior to COVID-19 global health emergency. Work. 2020;67(1):29-35. [CrossRef] [Medline]47,Hasani F, Malliaras P, Haines T, Munteanu SE, White J, Ridgway J, et al. Telehealth sounds a bit challenging, but it has potential: participant and physiotherapist experiences of gym-based exercise intervention for Achilles tendinopathy monitored via telehealth. BMC Musculoskelet Disord. Feb 04, 2021;22(1):138. [FREE Full text] [CrossRef] [Medline]57,Malliaras P, Merolli M, Williams CM, Caneiro JP, Haines T, Barton C. 'It's not hands-on therapy, so it's very limited': telehealth use and views among allied health clinicians during the coronavirus pandemic. Musculoskelet Sci Pract. Apr 2021;52:102340. [FREE Full text] [CrossRef] [Medline]62,Martin R, Mandrusiak A, Russell T, Forbes R. New-graduate physiotherapists' training needs and readiness for telehealth. Physiother Theory Pract. Nov 2022;38(13):2788-2797. [CrossRef] [Medline]63,Rygg L, Brataas HV, Nordtug B. Oncology nurses' lived experiences of video communication in follow-up care of home-living patients: a phenomenological study in rural Norway. Eur J Oncol Nurs. Jun 2021;52:101955. [FREE Full text] [CrossRef] [Medline]69,Singh RH, Pringle T, Kenneson A. The use of telemedicine and other strategies by registered dietitians for the medical nutrition therapy of patients with inherited metabolic disorders during the COVID-19 pandemic. Front Nutr. Apr 27, 2021;8:637868. [FREE Full text] [CrossRef] [Medline]70,Almog T, Gilboa Y. Remote delivery of service: a survey of occupational therapists' perceptions. Rehabil Process Outcome. Sep 06, 2022;11:11795727221117503. [FREE Full text] [CrossRef] [Medline]73,Eikelboom RH, Bennett RJ, Manchaiah V, Parmar B, Beukes E, Rajasingam SL, et al. International survey of audiologists during the COVID-19 pandemic: use of and attitudes to telehealth. Int J Audiol. Apr 2022;61(4):283-292. [CrossRef] [Medline]83-Haines KJ, Sawyer A, McKinnon C, Donovan A, Michael C, Cimoli C, et al. Barriers and enablers to telehealth use by physiotherapists during the COVID-19 pandemic. Physiotherapy. Mar 2023;118:12-19. [FREE Full text] [CrossRef] [Medline]85,Koppel PD, De Gagne JC, Docherty S, Smith S, Prose NS, Jabaley T. Exploring nurse and patient experiences of developing rapport during oncology ambulatory care videoconferencing visits: qualitative descriptive study. J Med Internet Res. Sep 08, 2022;24(9):e39920. [FREE Full text] [CrossRef] [Medline]88,Parmar B, Beukes E, Rajasingam S. Int J Audiol. Mar 2022;61(3):228-238. [CrossRef] [Medline]90,Peh HP, Yee K, Mantaring EJ. Changes in telepractice use and perspectives among speech and language therapists in Singapore through the COVID-19 pandemic. Int J Lang Commun Disord. May 2023;58(3):802-812. [CrossRef] [Medline]91,Tar-Mahomed Z, Kater KA. The perspectives of speech-language pathologists: providing teletherapy to patients with speech, language and swallowing difficulties during a COVID-19 context. S Afr J Commun Disord. Aug 11, 2022;69(2):e1-e7. [FREE Full text] [CrossRef] [Medline]93]
  • Harder to establish trust [Bayati B, Ayatollahi H. Speech therapists' perspectives about using tele-speech therapy: a qualitative study. Disabil Rehabil Assist Technol. Jul 2023;18(5):621-626. [CrossRef] [Medline]50,Almog T, Gilboa Y. Remote delivery of service: a survey of occupational therapists' perceptions. Rehabil Process Outcome. Sep 06, 2022;11:11795727221117503. [FREE Full text] [CrossRef] [Medline]73]
  • Risk of impersonal care [Fong R, Tsai CF, Yiu OY. The implementation of telepractice in speech language pathology in Hong Kong during the COVID-19 pandemic. Telemed J E Health. Jan 2021;27(1):30-38. [CrossRef] [Medline]54,Rettinger L, Klupper C, Werner F, Putz P. Changing attitudes towards teletherapy in Austrian therapists during the COVID-19 pandemic. J Telemed Telecare. Jun 2023;29(5):406-414. [FREE Full text] [CrossRef] [Medline]67,Eikelboom RH, Bennett RJ, Manchaiah V, Parmar B, Beukes E, Rajasingam SL, et al. International survey of audiologists during the COVID-19 pandemic: use of and attitudes to telehealth. Int J Audiol. Apr 2022;61(4):283-292. [CrossRef] [Medline]83,Parmar B, Beukes E, Rajasingam S. Int J Audiol. Mar 2022;61(3):228-238. [CrossRef] [Medline]90,Tar-Mahomed Z, Kater KA. The perspectives of speech-language pathologists: providing teletherapy to patients with speech, language and swallowing difficulties during a COVID-19 context. S Afr J Commun Disord. Aug 11, 2022;69(2):e1-e7. [FREE Full text] [CrossRef] [Medline]93]
  • Lack of human warmth [Almog T, Gilboa Y. Remote delivery of service: a survey of occupational therapists' perceptions. Rehabil Process Outcome. Sep 06, 2022;11:11795727221117503. [FREE Full text] [CrossRef] [Medline]73]
  • Impaired perception of client personality traits [Kienle GS, Werthmann P, Grotejohann B, Hundhammer T, Schmoor C, Stumpe C, et al. Addressing COVID-19 challenges in a randomised controlled trial on exercise interventions in a high-risk population. BMC Geriatr. May 01, 2021;21(1):287. [FREE Full text] [CrossRef] [Medline]59]
  • Nuances get lost over the screen [Almog T, Gilboa Y. Remote delivery of service: a survey of occupational therapists' perceptions. Rehabil Process Outcome. Sep 06, 2022;11:11795727221117503. [FREE Full text] [CrossRef] [Medline]73]
  • Diminished communication quality in general [Bayati B, Ayatollahi H. Speech therapists' perspectives about using tele-speech therapy: a qualitative study. Disabil Rehabil Assist Technol. Jul 2023;18(5):621-626. [CrossRef] [Medline]50,Kaufman-Shriqui V, Sherf-Dagan S, Boaz M, Birk R. Virtual nutrition consultation: what can we learn from the COVID-19 pandemic? Public Health Nutr. Apr 2021;24(5):1166-1173. [FREE Full text] [CrossRef] [Medline]58,Malliaras P, Merolli M, Williams CM, Caneiro JP, Haines T, Barton C. 'It's not hands-on therapy, so it's very limited': telehealth use and views among allied health clinicians during the coronavirus pandemic. Musculoskelet Sci Pract. Apr 2021;52:102340. [FREE Full text] [CrossRef] [Medline]62,Grant CM, Jones A, Land H. Physiotherapists’ perspectives on the use of telehealth for service delivery to children with developmental delays: a qualitative focus group study. Internet J Allied Health Sci Pract. Mar 31, 2022;20(2):1-10. [FREE Full text] [CrossRef]84,Parmar B, Beukes E, Rajasingam S. Int J Audiol. Mar 2022;61(3):228-238. [CrossRef] [Medline]90,Van Eerdenbrugh S, Schraeyen K, Leysen H, Mostaert C, D'haenens W, Vandenborre D. Delivery of speech-language therapy and audiology services across the world at the start of the COVID-19 pandemic: a survey. Perspect. Apr 14, 2022;7(2):635-646. [FREE Full text] [CrossRef]94]
  • Language barriers [Malliaras P, Merolli M, Williams CM, Caneiro JP, Haines T, Barton C. 'It's not hands-on therapy, so it's very limited': telehealth use and views among allied health clinicians during the coronavirus pandemic. Musculoskelet Sci Pract. Apr 2021;52:102340. [FREE Full text] [CrossRef] [Medline]62,Pollard R, Hogan S. Parental and practitioner views of telepractice for pediatric auditory verbal habilitation at a time of global pandemic. Perspective. Dec 2021;6(6):1832-1856. [FREE Full text] [CrossRef]66,Singh RH, Pringle T, Kenneson A. The use of telemedicine and other strategies by registered dietitians for the medical nutrition therapy of patients with inherited metabolic disorders during the COVID-19 pandemic. Front Nutr. Apr 27, 2021;8:637868. [FREE Full text] [CrossRef] [Medline]70,Van Eerdenbrugh S, Schraeyen K, Leysen H, Mostaert C, D'haenens W, Vandenborre D. Delivery of speech-language therapy and audiology services across the world at the start of the COVID-19 pandemic: a survey. Perspect. Apr 14, 2022;7(2):635-646. [FREE Full text] [CrossRef]94]
  • Increased possibility of misunderstandings [Ditwiler RE, Swisher LL, Hardwick DD. Doing things you never imagined: professional and ethical issues in the U.S. outpatient physical therapy setting during the COVID-19 pandemic. Musculoskelet Sci Pract. Dec 2022;62:102684. [FREE Full text] [CrossRef] [Medline]81,Koppel PD, De Gagne JC, Docherty S, Smith S, Prose NS, Jabaley T. Exploring nurse and patient experiences of developing rapport during oncology ambulatory care videoconferencing visits: qualitative descriptive study. J Med Internet Res. Sep 08, 2022;24(9):e39920. [FREE Full text] [CrossRef] [Medline]88,Van Eerdenbrugh S, Schraeyen K, Leysen H, Mostaert C, D'haenens W, Vandenborre D. Delivery of speech-language therapy and audiology services across the world at the start of the COVID-19 pandemic: a survey. Perspect. Apr 14, 2022;7(2):635-646. [FREE Full text] [CrossRef]94]
  • Risk of social isolation for patients [Hughes L, Petrella A, Phillips N, Taylor RM. Virtual care and the impact of COVID-19 on nursing: a single centre evaluation. J Adv Nurs. Feb 2022;78(2):498-509. [FREE Full text] [CrossRef] [Medline]86]
  • Risk of social isolation for providers [Malliaras P, Merolli M, Williams CM, Caneiro JP, Haines T, Barton C. 'It's not hands-on therapy, so it's very limited': telehealth use and views among allied health clinicians during the coronavirus pandemic. Musculoskelet Sci Pract. Apr 2021;52:102340. [FREE Full text] [CrossRef] [Medline]62,Hughes L, Petrella A, Phillips N, Taylor RM. Virtual care and the impact of COVID-19 on nursing: a single centre evaluation. J Adv Nurs. Feb 2022;78(2):498-509. [FREE Full text] [CrossRef] [Medline]86]

Ethical and cultural issues
  • Web-based sessions of female providers in the presence of male caregivers [Albahrouh SI, Buabbas AJ. Physiotherapists' perceptions of and willingness to use telerehabilitation in Kuwait during the COVID-19 pandemic. BMC Med Inform Decis Mak. Apr 08, 2021;21(1):122. [FREE Full text] [CrossRef] [Medline]49]
  • Cultural reasons for not accepting video calls [Alrushud A, Alamam D, Alharthi A, Shaheen A, Alotaibi N, AlSabhan R, et al. Physical therapists' perceptions of and satisfaction with delivering telerehabilitation sessions to patients with knee osteoarthritis during the COVID-19 pandemic: preliminary study. Musculoskeletal Care. Dec 2022;20(4):926-936. [FREE Full text] [CrossRef] [Medline]74]
  • Discussion of private or embarrassing topics [Eikelboom RH, Bennett RJ, Manchaiah V, Parmar B, Beukes E, Rajasingam SL, et al. International survey of audiologists during the COVID-19 pandemic: use of and attitudes to telehealth. Int J Audiol. Apr 2022;61(4):283-292. [CrossRef] [Medline]83]
  • Reacting to worrisome activities, seen in the home of patients [Spiby H, Faucher MA, Sands G, Roberts J, Kennedy HP. A qualitative study of midwives' perceptions on using video-calling in early labor. Birth. Mar 2019;46(1):105-112. [CrossRef] [Medline]46]
  • Examinations involving disrobing [McPherson K, Nahon I. Telehealth and the provision of pelvic health physiotherapy in regional, rural and remote Australia. Aust N Z Cont J. Aug 2021;27(3):66-70. [CrossRef]64]
  • Lack of comfort and support for difficult or emotional conversations [Koppel PD, De Gagne JC, Docherty S, Smith S, Prose NS, Jabaley T. Exploring nurse and patient experiences of developing rapport during oncology ambulatory care videoconferencing visits: qualitative descriptive study. J Med Internet Res. Sep 08, 2022;24(9):e39920. [FREE Full text] [CrossRef] [Medline]88]
  • Ethical concerns, not specified [Fong R, Tsai CF, Yiu OY. The implementation of telepractice in speech language pathology in Hong Kong during the COVID-19 pandemic. Telemed J E Health. Jan 2021;27(1):30-38. [CrossRef] [Medline]54]
  • Spiritual or religious barriers, not specified [Kienle GS, Werthmann P, Grotejohann B, Hundhammer T, Schmoor C, Stumpe C, et al. Addressing COVID-19 challenges in a randomised controlled trial on exercise interventions in a high-risk population. BMC Geriatr. May 01, 2021;21(1):287. [FREE Full text] [CrossRef] [Medline]59,Singh RH, Pringle T, Kenneson A. The use of telemedicine and other strategies by registered dietitians for the medical nutrition therapy of patients with inherited metabolic disorders during the COVID-19 pandemic. Front Nutr. Apr 27, 2021;8:637868. [FREE Full text] [CrossRef] [Medline]70]
Administration issues

Lack of support
  • Lack of administrative and technical support [Kwok EY, Chiu J, Rosenbaum P, Cunningham BJ. The process of telepractice implementation during the COVID-19 pandemic: a narrative inquiry of preschool speech-language pathologists and assistants from one center in Canada. BMC Health Serv Res. Jan 16, 2022;22(1):81. [FREE Full text] [CrossRef] [Medline]29,Albahrouh SI, Buabbas AJ. Physiotherapists' perceptions of and willingness to use telerehabilitation in Kuwait during the COVID-19 pandemic. BMC Med Inform Decis Mak. Apr 08, 2021;21(1):122. [FREE Full text] [CrossRef] [Medline]49,D'Souza AF, Rebello SR. Perceptions and willingness of physiotherapists in India to use telerehabilitation during the COVID-19 pandemic. Int J Telerehabil. Dec 16, 2021;13(2):e6425. [FREE Full text] [CrossRef] [Medline]53,Fong R, Tsai CF, Yiu OY. The implementation of telepractice in speech language pathology in Hong Kong during the COVID-19 pandemic. Telemed J E Health. Jan 2021;27(1):30-38. [CrossRef] [Medline]54,Singh RH, Pringle T, Kenneson A. The use of telemedicine and other strategies by registered dietitians for the medical nutrition therapy of patients with inherited metabolic disorders during the COVID-19 pandemic. Front Nutr. Apr 27, 2021;8:637868. [FREE Full text] [CrossRef] [Medline]70,Buabbas AJ, Albahrouh SE, Alrowayeh HN, Alshawaf H. Telerehabilitation during the COVID-19 pandemic: patients and physical therapists' experiences. Med Princ Pract. 2022;31(2):156-164. [FREE Full text] [CrossRef] [Medline]77,Ceprnja D, Clark T, Young J, Lee R, Flynn K, Maka K. Evaluating experiences, usability and patient satisfaction with telehealth for tertiary outpatient physiotherapy services during COVID-19: a mixed-methods study. Physiother Theory Pract (Forthcoming). Apr 06, 2022:1-9. [CrossRef] [Medline]78,Eikelboom RH, Bennett RJ, Manchaiah V, Parmar B, Beukes E, Rajasingam SL, et al. International survey of audiologists during the COVID-19 pandemic: use of and attitudes to telehealth. Int J Audiol. Apr 2022;61(4):283-292. [CrossRef] [Medline]83,Grant CM, Jones A, Land H. Physiotherapists’ perspectives on the use of telehealth for service delivery to children with developmental delays: a qualitative focus group study. Internet J Allied Health Sci Pract. Mar 31, 2022;20(2):1-10. [FREE Full text] [CrossRef]84,Parmar B, Beukes E, Rajasingam S. Int J Audiol. Mar 2022;61(3):228-238. [CrossRef] [Medline]90]
  • Inefficiencies in organization, scheduling, or visit preparation [Singh RH, Pringle T, Kenneson A. The use of telemedicine and other strategies by registered dietitians for the medical nutrition therapy of patients with inherited metabolic disorders during the COVID-19 pandemic. Front Nutr. Apr 27, 2021;8:637868. [FREE Full text] [CrossRef] [Medline]70,Ceprnja D, Clark T, Young J, Lee R, Flynn K, Maka K. Evaluating experiences, usability and patient satisfaction with telehealth for tertiary outpatient physiotherapy services during COVID-19: a mixed-methods study. Physiother Theory Pract (Forthcoming). Apr 06, 2022:1-9. [CrossRef] [Medline]78,Parmar B, Beukes E, Rajasingam S. Int J Audiol. Mar 2022;61(3):228-238. [CrossRef] [Medline]90]
  • Lack of knowledge of using the system or troubleshooting [Kwok EY, Chiu J, Rosenbaum P, Cunningham BJ. The process of telepractice implementation during the COVID-19 pandemic: a narrative inquiry of preschool speech-language pathologists and assistants from one center in Canada. BMC Health Serv Res. Jan 16, 2022;22(1):81. [FREE Full text] [CrossRef] [Medline]29]
  • Not enough referrals and promotions for telehealth [McPherson K, Nahon I. Telehealth and the provision of pelvic health physiotherapy in regional, rural and remote Australia. Aust N Z Cont J. Aug 2021;27(3):66-70. [CrossRef]64]

Workload increase
  • Increased workload, pressure, or stress [Albahrouh SI, Buabbas AJ. Physiotherapists' perceptions of and willingness to use telerehabilitation in Kuwait during the COVID-19 pandemic. BMC Med Inform Decis Mak. Apr 08, 2021;21(1):122. [FREE Full text] [CrossRef] [Medline]49,D'Souza AF, Rebello SR. Perceptions and willingness of physiotherapists in India to use telerehabilitation during the COVID-19 pandemic. Int J Telerehabil. Dec 16, 2021;13(2):e6425. [FREE Full text] [CrossRef] [Medline]53,Hall JB, Woods ML, Luechtefeld JT. Pediatric physical therapy telehealth and COVID-19: factors, facilitators, and barriers influencing effectiveness-a survey study. Pediatr Phys Ther. Jul 01, 2021;33(3):112-118. [FREE Full text] [CrossRef] [Medline]55,Pollard R, Hogan S. Parental and practitioner views of telepractice for pediatric auditory verbal habilitation at a time of global pandemic. Perspective. Dec 2021;6(6):1832-1856. [FREE Full text] [CrossRef]66,Eguia KF, Capio CM. Teletherapy for children with developmental disorders during the COVID-19 pandemic in the Philippines: a mixed-methods evaluation from the perspectives of parents and therapists. Child Care Health Dev. Nov 2022;48(6):963-969. [CrossRef] [Medline]82,Hughes L, Petrella A, Phillips N, Taylor RM. Virtual care and the impact of COVID-19 on nursing: a single centre evaluation. J Adv Nurs. Feb 2022;78(2):498-509. [FREE Full text] [CrossRef] [Medline]86]
  • Increased time need to organize and use telehealth [Kwok EY, Chiu J, Rosenbaum P, Cunningham BJ. The process of telepractice implementation during the COVID-19 pandemic: a narrative inquiry of preschool speech-language pathologists and assistants from one center in Canada. BMC Health Serv Res. Jan 16, 2022;22(1):81. [FREE Full text] [CrossRef] [Medline]29,Rygg LO, Brataas HV, Nordtug B. Introducing videoconferencing on tablet computers in nurse-patient communication: technical and training challenges. Int J Telemed Appl. Oct 18, 2018;2018:8943960. [FREE Full text] [CrossRef] [Medline]44,Spiby H, Faucher MA, Sands G, Roberts J, Kennedy HP. A qualitative study of midwives' perceptions on using video-calling in early labor. Birth. Mar 2019;46(1):105-112. [CrossRef] [Medline]46,Malliaras P, Merolli M, Williams CM, Caneiro JP, Haines T, Barton C. 'It's not hands-on therapy, so it's very limited': telehealth use and views among allied health clinicians during the coronavirus pandemic. Musculoskelet Sci Pract. Apr 2021;52:102340. [FREE Full text] [CrossRef] [Medline]62,Singh RH, Pringle T, Kenneson A. The use of telemedicine and other strategies by registered dietitians for the medical nutrition therapy of patients with inherited metabolic disorders during the COVID-19 pandemic. Front Nutr. Apr 27, 2021;8:637868. [FREE Full text] [CrossRef] [Medline]70,Ceprnja D, Clark T, Young J, Lee R, Flynn K, Maka K. Evaluating experiences, usability and patient satisfaction with telehealth for tertiary outpatient physiotherapy services during COVID-19: a mixed-methods study. Physiother Theory Pract (Forthcoming). Apr 06, 2022:1-9. [CrossRef] [Medline]78,Eguia KF, Capio CM. Teletherapy for children with developmental disorders during the COVID-19 pandemic in the Philippines: a mixed-methods evaluation from the perspectives of parents and therapists. Child Care Health Dev. Nov 2022;48(6):963-969. [CrossRef] [Medline]82,Grant CM, Jones A, Land H. Physiotherapists’ perspectives on the use of telehealth for service delivery to children with developmental delays: a qualitative focus group study. Internet J Allied Health Sci Pract. Mar 31, 2022;20(2):1-10. [FREE Full text] [CrossRef]84,Nazreen Nihara MR, Seethapathy J. Tele-audiology in India: current and future trends in knowledge, attitude, and practice among audiologists. J Audiol Otol. Jul 2022;26(3):130-141. [FREE Full text] [CrossRef] [Medline]89-Peh HP, Yee K, Mantaring EJ. Changes in telepractice use and perspectives among speech and language therapists in Singapore through the COVID-19 pandemic. Int J Lang Commun Disord. May 2023;58(3):802-812. [CrossRef] [Medline]91,Van Eerdenbrugh S, Schraeyen K, Leysen H, Mostaert C, D'haenens W, Vandenborre D. Delivery of speech-language therapy and audiology services across the world at the start of the COVID-19 pandemic: a survey. Perspect. Apr 14, 2022;7(2):635-646. [FREE Full text] [CrossRef]94,Wittmeier KD, Hammond E, Tymko K, Burnham K, Janssen T, Pablo AJ, et al. "Another tool in your toolkit": pediatric occupational and physical therapists' perspectives of initiating telehealth during the COVID-19 pandemic. Phys Occup Ther Pediatr. 2022;42(5):465-481. [CrossRef] [Medline]95]
  • Increased level of fatigue [Pollard R, Hogan S. Parental and practitioner views of telepractice for pediatric auditory verbal habilitation at a time of global pandemic. Perspective. Dec 2021;6(6):1832-1856. [FREE Full text] [CrossRef]66,Grant CM, Jones A, Land H. Physiotherapists’ perspectives on the use of telehealth for service delivery to children with developmental delays: a qualitative focus group study. Internet J Allied Health Sci Pract. Mar 31, 2022;20(2):1-10. [FREE Full text] [CrossRef]84-Hughes L, Petrella A, Phillips N, Taylor RM. Virtual care and the impact of COVID-19 on nursing: a single centre evaluation. J Adv Nurs. Feb 2022;78(2):498-509. [FREE Full text] [CrossRef] [Medline]86,Peh HP, Yee K, Mantaring EJ. Changes in telepractice use and perspectives among speech and language therapists in Singapore through the COVID-19 pandemic. Int J Lang Commun Disord. May 2023;58(3):802-812. [CrossRef] [Medline]91,Wittmeier KD, Hammond E, Tymko K, Burnham K, Janssen T, Pablo AJ, et al. "Another tool in your toolkit": pediatric occupational and physical therapists' perspectives of initiating telehealth during the COVID-19 pandemic. Phys Occup Ther Pediatr. 2022;42(5):465-481. [CrossRef] [Medline]95]
  • Worsening of appointment-related travel [Eikelboom RH, Bennett RJ, Manchaiah V, Parmar B, Beukes E, Rajasingam SL, et al. International survey of audiologists during the COVID-19 pandemic: use of and attitudes to telehealth. Int J Audiol. Apr 2022;61(4):283-292. [CrossRef] [Medline]83]
  • Change in working hours [Parmar B, Beukes E, Rajasingam S. Int J Audiol. Mar 2022;61(3):228-238. [CrossRef] [Medline]90]
Figure 4. Barriers addressed by the publications according to category and subcategory in total. The bars on the left side represent the percentage of publications reporting barriers in the respective category. The bars on the right side represent the percentages of publications reporting barriers in the respective subcategory.
Figure 5. Barriers addressed by the publications according to the explored health profession. The size of the dots represents the relative number of documents addressing this barrier (row) based on this health profession (column). Die: dietitian; Mid: midwife; Nur: nurse; OT: occupational therapist; PT: physical therapist; SLT: speech and language therapist.

Principal Findings

This review aimed to map and condense the perceived barriers of allied health professionals concerning the use of video call–based telehealth, as understanding these barriers is crucial for improving telehealth adoption, efficiency, and effectiveness. By providing information to health care professionals and health services on barrier identification, this study serves as the first step toward addressing and overcoming these obstacles. We included 56 publications that reported barriers for OTs, PTs, SLTs and audiologists, dieticians, midwives, and nurses. Barriers were assigned to 8 topics: technology issues, practice issues, patient issues, environmental issues, attributions, policy and regulation issues, interpersonal issues, and administration issues. Previous publications on telemedicine barriers also used similar, but also different, classification schemes. The Pan American Health Organization refers to barriers by technological, organizational, human, and economic environments [Framework for the implementation of a telemedicine service. Pan American Health Organization. 2016. URL: https://iris.paho.org/bitstream/handle/10665.2/28414/9789275119037_eng.pdf [accessed 1999-11-30] 39]. Almathami et al [Almathami HK, Win KT, Vlahu-Gjorgievska E. Barriers and facilitators that influence telemedicine-based, real-time, online consultation at patients' homes: systematic literature review. J Med Internet Res. Feb 20, 2020;22(2):e16407. [FREE Full text] [CrossRef] [Medline]98] described internal and external barriers, and Scott Kruse et al [Scott Kruse C, Karem P, Shifflett K, Vegi L, Ravi K, Brooks M. Evaluating barriers to adopting telemedicine worldwide: a systematic review. J Telemed Telecare. Jan 2018;24(1):4-12. [FREE Full text] [CrossRef] [Medline]99] differentiated between organizational barriers and patient barriers. However, similar barriers underpin these different classifications.

The barriers mentioned most frequently pertain to technological issues. Although video call technologies are widespread in a large part of the population, certain groups or individuals lack suitable hardware or network access. This could be the case not only for some older adults but also for patient groups living in rural areas or those who are socioeconomically disadvantaged. The limited access of patient groups should be considered when telehealth services are offered to avoid possible disadvantages. Furthermore, the risk of a digital divide extends beyond mere access to technology. It also encompasses a lack of knowledge of digital health or technology skills [Ramsetty A, Adams C. Impact of the digital divide in the age of COVID-19. J Am Med Inform Assoc. Jul 01, 2020;27(7):1147-1148. [FREE Full text] [CrossRef] [Medline]100,Cortelyou-Ward K, Atkins DN, Noblin A, Rotarius T, White P, Carey C. Navigating the digital divide: barriers to telehealth in rural areas. J Health Care Poor Underserved. 2020;31(4):1546-1556. [CrossRef] [Medline]101], as they were reported in numerous included studies of this and previous reviews [Scott Kruse C, Karem P, Shifflett K, Vegi L, Ravi K, Brooks M. Evaluating barriers to adopting telemedicine worldwide: a systematic review. J Telemed Telecare. Jan 2018;24(1):4-12. [FREE Full text] [CrossRef] [Medline]99]. To facilitate the acceptance and effective use of telehealth tools, hardware and software must be designed to accommodate users’ needs [Almathami HK, Win KT, Vlahu-Gjorgievska E. Barriers and facilitators that influence telemedicine-based, real-time, online consultation at patients' homes: systematic literature review. J Med Internet Res. Feb 20, 2020;22(2):e16407. [FREE Full text] [CrossRef] [Medline]98]. According to common frameworks, perceived usefulness and perceived ease of use affect the acceptance of a technology and are further influenced by experience [Venkatesh V, Thong YL, Xu TX. Consumer acceptance and use of information technology: extending the unified theory of acceptance and use of technology. MIS Q. Mar 2012;36(1):157-178. [FREE Full text] [CrossRef]102]. To overcome these barriers, it is important to develop and use video call software that meets the specific needs of providers and patients and adheres to usability principles. In addition, health professionals, as well as patients, need to have the knowledge and skills to use technology. Thorough preparation of video visits or calling on e-helpers can facilitate successful implementation [Bennell KL, Lawford BJ, Metcalf B, Mackenzie D, Russell T, van den Berg M, et al. Physiotherapists and patients report positive experiences overall with telehealth during the COVID-19 pandemic: a mixed-methods study. J Physiother. Jul 2021;67(3):201-209. [FREE Full text] [CrossRef] [Medline]51,Hughes L, Petrella A, Phillips N, Taylor RM. Virtual care and the impact of COVID-19 on nursing: a single centre evaluation. J Adv Nurs. Feb 2022;78(2):498-509. [FREE Full text] [CrossRef] [Medline]86,Wittmeier KD, Hammond E, Tymko K, Burnham K, Janssen T, Pablo AJ, et al. "Another tool in your toolkit": pediatric occupational and physical therapists' perspectives of initiating telehealth during the COVID-19 pandemic. Phys Occup Ther Pediatr. 2022;42(5):465-481. [CrossRef] [Medline]95]. However, it is essential to recognize that network issues may still occur, potentially causing interruptions during video calls and affecting the overall telehealth experience. These were the second most cited barriers in this review, showing similarity to the review by Almathami et al [Almathami HK, Win KT, Vlahu-Gjorgievska E. Barriers and facilitators that influence telemedicine-based, real-time, online consultation at patients' homes: systematic literature review. J Med Internet Res. Feb 20, 2020;22(2):e16407. [FREE Full text] [CrossRef] [Medline]98], where this barrier held the top rank. To reduce network problems, it would be necessary to invest in and prioritize the development and maintenance of robust and reliable telecommunication infrastructure. This includes improving broadband connectivity in rural and underserved areas, which are often specifically addressed by telehealth services. In addition, providing telehealth users with guidelines for troubleshooting network-related problems could further enhance the overall experience and success of telehealth initiatives.

Second, most publications have reported barriers related to practice issues. Health care provision involves various physical, verbal, and observational measures. Providing care on the web on the screen involves a variety of challenges concerning this matter. Although physical therapy often involves whole body movements and hands-on techniques, dietitians are more based on conversation. Occupational therapy is often oriented toward daily activities, incorporating many different objects, and speech and language therapy is dependent on good sound quality. However, most practice-related barriers are applicable to all involved health care professions. First, hands-on methods cannot be applied to examinations, demonstrations, interventions, and assistance. This barrier was mentioned in 59% (33/56) of the publications and therefore seems to represent a core barrier for the explored health professions. Notably, it was not represented as a key barrier in earlier reviews that included a wider range of health professions [Almathami HK, Win KT, Vlahu-Gjorgievska E. Barriers and facilitators that influence telemedicine-based, real-time, online consultation at patients' homes: systematic literature review. J Med Internet Res. Feb 20, 2020;22(2):e16407. [FREE Full text] [CrossRef] [Medline]98,Scott Kruse C, Karem P, Shifflett K, Vegi L, Ravi K, Brooks M. Evaluating barriers to adopting telemedicine worldwide: a systematic review. J Telemed Telecare. Jan 2018;24(1):4-12. [FREE Full text] [CrossRef] [Medline]99] and might be more specific for the professions examined in this study. To address the lack of hands-on methods, they must be replaced by other actions that target the same outcome of comparable quality. For this, health professionals need specific training, guidelines, or protocols that expand their skill sets. However, if there are no adequate replacements for hands-on techniques, telehealth services may solely not be appropriate. Practitioners could combine telehealth and in-person services or work closely with local health care professionals to coordinate in-person care when needed. This collaborative approach ensures that patients receive comprehensive care that combines the convenience of telehealth with the benefits of in-person care. Second, limitations are also prevalent with respect to the diminished conditions for observations. Issues that negatively contribute to this are poor video and audio quality, difficulties with camera placement, and a lack of perception of body language, as described previously [Almathami HK, Win KT, Vlahu-Gjorgievska E. Barriers and facilitators that influence telemedicine-based, real-time, online consultation at patients' homes: systematic literature review. J Med Internet Res. Feb 20, 2020;22(2):e16407. [FREE Full text] [CrossRef] [Medline]98]. Establishing a professional setting on both sides can help minimize this barrier. However, these might be associated with additional costs, which were also found to hinder telehealth adoption [Scott Kruse C, Karem P, Shifflett K, Vegi L, Ravi K, Brooks M. Evaluating barriers to adopting telemedicine worldwide: a systematic review. J Telemed Telecare. Jan 2018;24(1):4-12. [FREE Full text] [CrossRef] [Medline]99]. Furthermore, encouraging the development and implementation of digital assessment tools tailored for telehealth sessions could aid health care professionals in making more accurate observations despite the limitations of the web-based setting [Ben-David BM, Mentzel M, Icht M, Gilad M, Dor YI, Ben-David S, et al. Challenges and opportunities for telehealth assessment during COVID-19: iT-RES, adapting a remote version of the test for rating emotions in speech. Int J Audiol. May 2021;60(5):319-321. [CrossRef] [Medline]103,Sprowls GR, Brown JC, Robin BN. The shoulder telehealth assessment tool in transition to distance orthopedics. Arthrosc Tech. Oct 24, 2020;9(11):e1673-e1681. [FREE Full text] [CrossRef] [Medline]104]. Training, guidelines, or protocols are needed to guide health professionals in creating optimal conditions for valid observations and high-quality therapy.

Telehealth provision, in addition to visual observations, is highly dependent on communication. Therefore, a limited interaction between the client and the practitioner was described as a barrier. There exists the fear that information might be lost along the way, and misunderstandings can occur. Moreover, it was mentioned that it is more difficult to establish relationships or trust. Such communication issues and perceptions of impersonal care have been reported previously [Almathami HK, Win KT, Vlahu-Gjorgievska E. Barriers and facilitators that influence telemedicine-based, real-time, online consultation at patients' homes: systematic literature review. J Med Internet Res. Feb 20, 2020;22(2):e16407. [FREE Full text] [CrossRef] [Medline]98,Scott Kruse C, Karem P, Shifflett K, Vegi L, Ravi K, Brooks M. Evaluating barriers to adopting telemedicine worldwide: a systematic review. J Telemed Telecare. Jan 2018;24(1):4-12. [FREE Full text] [CrossRef] [Medline]99]. Therefore, special emphasis should be placed on expanding the communication skills of health care providers to overcome those barriers [van Galen LS, Wang CJ, Nanayakkara PW, Paranjape K, Kramer MH, Car J. Telehealth requires expansion of physicians' communication competencies training. Med Teach. Jun 2019;41(6):714-715. [CrossRef] [Medline]105-Adams JE, Ecker DJ. Telehealth: from the abstract to necessity to competency. FASEB Bioadv. Apr 03, 2021;3(7):475-481. [FREE Full text] [CrossRef] [Medline]107]. Health care professionals should be trained to be more aware of and skilled in nonverbal communication cues, such as facial expressions, gestures, and body language. This can help to better understand patients’ needs, emotions, and reactions during telehealth sessions, thereby improving overall communication and rapport building. Moreover, health care professionals reported a decrease in communication quality, especially when language barriers were present. By implementing appropriate strategies, telehealth on the other hand could also help overcome language barriers when providers on the web collaborate with professional interpreters [Shin TM, Ortega P, Hardin K. Educating clinicians to improve telemedicine access for patients with limited English proficiency. Challenges. Dec 15, 2021;12(2):34. [FREE Full text] [CrossRef]108] or integrate language support features, such as real-time translation [Wołk K, Marasek K, Glinkowski W. Telemedicine as a special case of machine translation. Comput Med Imaging Graph. Dec 2015;46 Pt 2:249-256. [CrossRef] [Medline]109]. Comprehensive training modules that familiarize health care providers with the available language support services and their use in telehealth settings would be needed.

When discussing patient selection for telehealth services, it is crucial to consider several factors, including the demographic, physiological, and personal characteristics of patients. Some health professionals expressed the need for algorithms to establish clear inclusion and exclusion criteria. Certain diagnoses or health restrictions may limit a patient’s ability to interact effectively through telehealth or pose risks that cannot be adequately managed within this service model. Ensuring patient safety and addressing potential risks should be integral to the planning and management of telehealth services [Shulver W, Killington M, Crotty M. 'Massive potential' or 'safety risk'? Health worker views on telehealth in the care of older people and implications for successful normalization. BMC Med Inform Decis Mak. Oct 12, 2016;16(1):131. [FREE Full text] [CrossRef] [Medline]110]. In the context of telehealth for children, some publications highlighted challenges related to maintaining attention, engagement, and managing challenging behaviors. To address these issues, health professionals may need to use innovative approaches in adapting methods and materials to suit web-based settings [Crutchley S, Campbell M, Christiana D. Implementing a school-based telepractice program. Perspect Telepract. Sep 2012;2(1):31-41. [FREE Full text] [CrossRef]111-Caplan-Colon L. Coaching parents on feeding techniques via telepractice. American Speech-Language-Hearing Association. Feb 2021. URL: https://leader.pubs.asha.org/do/10.1044/leader.IPP.26012021.42/full/ [accessed 2023-02-06] 113]. In addition, prioritizing coaching and support for relatives can help overcome barriers associated with telehealth in children [Ramsetty A, Adams C. Impact of the digital divide in the age of COVID-19. J Am Med Inform Assoc. Jul 01, 2020;27(7):1147-1148. [FREE Full text] [CrossRef] [Medline]100,Cortelyou-Ward K, Atkins DN, Noblin A, Rotarius T, White P, Carey C. Navigating the digital divide: barriers to telehealth in rural areas. J Health Care Poor Underserved. 2020;31(4):1546-1556. [CrossRef] [Medline]101].

Caregivers can play an important role in supporting the patient with technology or other tasks. Furthermore, they are directly addressed by health professions for training or support [Chi N, Demiris G. The roles of telehealth tools in supporting family caregivers: current evidence, opportunities, and limitations. J Gerontol Nurs. Feb 01, 2017;43(2):3-5. [CrossRef] [Medline]114]. If they are not available or struggle with the responsibilities assigned, telehealth provision can be challenging, especially if patients depend on them [Almathami HK, Win KT, Vlahu-Gjorgievska E. Barriers and facilitators that influence telemedicine-based, real-time, online consultation at patients' homes: systematic literature review. J Med Internet Res. Feb 20, 2020;22(2):e16407. [FREE Full text] [CrossRef] [Medline]98]. Therefore, the social system of patients should be considered to determine whether telehealth services are appropriate. Furthermore, it is important to evaluate the physical and sensory environments of patients, as described by Almathami et al [Almathami HK, Win KT, Vlahu-Gjorgievska E. Barriers and facilitators that influence telemedicine-based, real-time, online consultation at patients' homes: systematic literature review. J Med Internet Res. Feb 20, 2020;22(2):e16407. [FREE Full text] [CrossRef] [Medline]98]. Depending on the goals and types of health care provision, space and material needs should be considered and evaluated. If possible, providers could conduct home assessments to evaluate the physical and sensory environment of patients and make recommendations for modifications or improvements to the space. In addition, a lack of privacy at home can be an issue. To address this barrier, health care providers can offer guidance on how to create a private space for telehealth visits, such as using a separate room or wearing headphones to ensure confidentiality. Finally, health care providers should consider alternative methods of care for patients who do not have access to a private space for telehealth visits.

Privacy issues also refer to the transmission of sensible health data over the internet and have been widely discussed [Almathami HK, Win KT, Vlahu-Gjorgievska E. Barriers and facilitators that influence telemedicine-based, real-time, online consultation at patients' homes: systematic literature review. J Med Internet Res. Feb 20, 2020;22(2):e16407. [FREE Full text] [CrossRef] [Medline]98,Scott Kruse C, Karem P, Shifflett K, Vegi L, Ravi K, Brooks M. Evaluating barriers to adopting telemedicine worldwide: a systematic review. J Telemed Telecare. Jan 2018;24(1):4-12. [FREE Full text] [CrossRef] [Medline]99]. Many health professionals mentioned that they feared that their patient’s privacy was at risk and that they had concerns about data protection. Telehealth requires secure platforms where data are encrypted to protect patient privacy and confidentiality [CPME policy on telemedicine. Standing Committee of European Doctors. 2021. URL: https:/​/www.​cpme.eu/​api/​documents/​adopted/​2021/​3/​CPME_AD_Board_20032021_012.​FINAL_.​CPME_.​Policy.​on_.​Telemedicine.​pdf [accessed 2023-02-21] 115]. Therefore, it is important to educate health care professionals about suitable platforms and provide guidelines so that they can make informed decisions about IT security measures [Watzlaf VJ, Zhou L, Dealmeida DR, Hartman LM. A systematic review of research studies examining telehealth privacy and security practices used by healthcare providers. Int J Telerehabil. Nov 20, 2017;9(2):39-59. [FREE Full text] [CrossRef] [Medline]116]. Commercial platforms are not always in compliance with the General Data Protection Regulations [CPME policy on telemedicine. Standing Committee of European Doctors. 2021. URL: https:/​/www.​cpme.eu/​api/​documents/​adopted/​2021/​3/​CPME_AD_Board_20032021_012.​FINAL_.​CPME_.​Policy.​on_.​Telemedicine.​pdf [accessed 2023-02-21] 115] or the Health Insurance Portability and Accountability Act [Almathami HK, Win KT, Vlahu-Gjorgievska E. Barriers and facilitators that influence telemedicine-based, real-time, online consultation at patients' homes: systematic literature review. J Med Internet Res. Feb 20, 2020;22(2):e16407. [FREE Full text] [CrossRef] [Medline]98] and should be transparent about how they store, transmit, encrypt, and use data so that health providers can compare those measures with current guidelines [Zhou L, Thieret R, Watzlaf V, Dealmeida D, Parmanto B. A telehealth privacy and security self-assessment questionnaire for telehealth providers: development and validation. Int J Telerehabil. Jun 12, 2019;11(1):3-14. [FREE Full text] [CrossRef] [Medline]117].

In addition to fear of a lack of data privacy, other negative attitudes toward telehealth influence the acceptance of telehealth. This applies to the reluctance to telehealth of health care providers, patients, and caregivers, also described as resistance to change [Scott Kruse C, Karem P, Shifflett K, Vegi L, Ravi K, Brooks M. Evaluating barriers to adopting telemedicine worldwide: a systematic review. J Telemed Telecare. Jan 2018;24(1):4-12. [FREE Full text] [CrossRef] [Medline]99]. Most often, statements about clinical effectiveness or clinical usefulness were reported as reasons. The body of evidence for telehealth effectiveness varies depending on the health context and the involved health care professions. To give some examples, 2 meta-analyses found positive clinical results, even comparable with conventional face-to-face rehabilitation approaches, for PT and OT telerehabilitation services [Suso-Martí L, La Touche R, Herranz-Gómez A, Angulo-Díaz-Parreño S, Paris-Alemany A, Cuenca-Martínez F. Effectiveness of telerehabilitation in physical therapist practice: an umbrella and mapping review with meta-meta-analysis. Phys Ther. May 04, 2021;101(5):pzab075. [FREE Full text] [CrossRef] [Medline]118,Alageel SM. Effects of telerehabilitation on occupational therapy services in the coronavirus disease 2019 era: an umbrella and mapping review with meta– meta-analysis. Ann Physiother Occup Ther. May 24, 2021;4(2):1-8. [FREE Full text] [CrossRef]119]. A systematic review of telepractice for adult speech language therapy supports the use of telepractice as an appropriate service delivery model [Weidner K, Lowman J. Telepractice for adult speech-language pathology services: a systematic review. Perspect. Feb 21, 2020;5(1):326-338. [FREE Full text] [CrossRef]120]. Moreover, the benefits of using telepractice to provide parent-implemented interventions to children with autism spectrum disorders have been described [Akemoglu Y, Muharib R, Meadan H. A systematic and quality review of parent-implemented language and communication interventions conducted via telepractice. J Behav Educ. Nov 11, 2019;29(2):282-316. [FREE Full text] [CrossRef]121]. Telehealth services from dieticians or nutritionists can improve protein intake and quality of life in malnourished older adults [Marx W, Kelly JT, Crichton M, Craven D, Collins J, Mackay H, et al. Is telehealth effective in managing malnutrition in community-dwelling older adults? A systematic review and meta-analysis. Maturitas. May 2018;111:31-46. [CrossRef] [Medline]122]. Yet, there is a lack of high-quality evidence and training courses to inform health care providers about current evidence.

Finally, all the mentioned barriers can lead to an increase in the workload and stress of health care professionals, especially when experience with telehealth has not been established. In such cases, providers may face challenges such as technological difficulties, ineffective communication with patients, and patient selection issues, which can lead to increased stress and a decrease in work efficiency. They need administrative and technological support, protocols, and guidelines to help them establish a well-functioning telehealth practice. To achieve sustainable telehealth services, it is important to ensure that health care professionals are willing and able to use these tools effectively. This means that health organizations must provide adequate resources and training to support the adoption and use of telehealth technology, as their acceptance is crucial to the success of sustainable telehealth services [Wade VA, Eliott JA, Hiller JE. Clinician acceptance is the key factor for sustainable telehealth services. Qual Health Res. May 2014;24(5):682-694. [CrossRef] [Medline]123].

Limitations

This review only covered original studies, which were found in the PubMed and CINAHL databases, in German or English language and were published since June 2017. Although these are widely recognized and commonly used databases in the field of health care research, this may have resulted in the exclusion of relevant studies published in other databases. However, efforts have been made to minimize this limitation using comprehensive search strings and citation tracking to identify additional relevant literature. Future studies could expand the search to include a wider range of databases to increase the comprehensiveness of the search strategy. Furthermore, only 1 researcher conducted the search, selection, and mapping process. A broader search process, with more languages and researchers included, might have increased the number of publications and reliability of the results.

Publications were selected based on included health care professions. In case, professions out of scope were involved, the author selected only information from health care professionals that were within the scope of all conscience but with the risk of interference. Furthermore, there were big differences between the number of publications and included participants in the health care profession of interest. Although more than half of the publications addressed barriers of PTs and another third addressed those of SLTs and audiologists, other professions were less represented. Furthermore, SLTs and audiologists were combined, as they are 1 profession in some countries, whereas in others, they are 2 separate professions. Owing to these quantitative differences, it is difficult to compare the mentioned barriers between these professions and discuss whether there are significant differences. Furthermore, the number of publications that mentioned a barrier might not reflect its relevance. Therefore, all numbers and corresponding figures should be interpreted with caution.

Another limitation is that this review focused on health contexts rather than health settings. The included studies covered a range of health professions and contexts of care but did not distinguish between different settings, such as acute, tertiary, or community settings. There may be differences in the barriers and challenges faced by telehealth interventions across different health settings; therefore, the findings of this study may not be generalizable to all health settings.

This review has a slightly more balanced distribution of publication sites when compared with other reviews that focused on telehealth barriers. It incorporates approximately half of the publications from North America (15/56, 27%) and Europe (12/56, 21%) and the other half from Australia (12/56, 21%), the Middle East (8/56, 14%), South and East Asia (8/56, 14%), and Africa (1/56, 2%). Earlier reviews that focused on telemedicine barriers reported nearly 73% [Scott Kruse C, Karem P, Shifflett K, Vegi L, Ravi K, Brooks M. Evaluating barriers to adopting telemedicine worldwide: a systematic review. J Telemed Telecare. Jan 2018;24(1):4-12. [FREE Full text] [CrossRef] [Medline]99] or even 84% [Almathami HK, Win KT, Vlahu-Gjorgievska E. Barriers and facilitators that influence telemedicine-based, real-time, online consultation at patients' homes: systematic literature review. J Med Internet Res. Feb 20, 2020;22(2):e16407. [FREE Full text] [CrossRef] [Medline]98] of references from North America or Europe. However, there is a huge underrepresentation of African countries especially.

This review covered most studies that were conducted during the COVID-19 pandemic. As this period was highly influenced by contact restrictions, many publications have included participants who used telehealth services as a matter of imperative necessity. This could have influenced their attitudes and may have led to increased confrontation with barriers that could have been prevented with more time for preparation. In addition, the review included only a limited number of prepandemic studies, which may limit the generalizability of our findings beyond the pandemic period. Nonetheless, no differences were observed in the reported barrier categories between studies with and without a COVID-19 context. However, further research is needed to examine the challenges and barriers to telehealth interventions in different settings and contexts.

Finally, qualitative and quantitative results from these studies were synthesized in this review. It should be considered that participants give different answers when they reply to open-ended or closed-ended questions.

Conclusions

This study systematically reports the barriers of allied health professionals toward video call–based telehealth within 59 original studies with OTs, PTs, SLTs and audiologists, dieticians, midwives, and nurses. Through the review, a range of barriers were identified, including technology, practice, patient, environmental, attributions, policy and regulation, interpersonal, and administration issues. The results emphasize the need for stable infrastructure, education, training, guidelines, policies, and support systems to establish high-quality allied telehealth services. The identification of these barriers is crucial, as it highlights the areas where improvements are needed in telehealth services to better meet the needs of allied health professionals, nurses, and their patients. The information gathered in this review can be used to improve telehealth services in health care organizations.

Acknowledgments

The authors thank RAWgraphs [A free and open source tool for data visualization. RAWGraphs. URL: https://www.rawgraphs.io/ [accessed 2023-07-07] 124] for their open-source data visualization framework and INKSCAPE draw freely [Home page. InkSpace. URL: https://inkscape.org/ [accessed 2023-07-07] 125] for their open-source vector graphics editor.

Data Availability

The data set analyzed during this study is available in

Multimedia Appendix 3

Full data excel sheet.

XLSX File (Microsoft Excel File), 16 KBMultimedia Appendix 3.

Conflicts of Interest

None declared.

Multimedia Appendix 1

Search strings used in PubMed and CINAHL databases.

PDF File (Adobe PDF File), 77 KB

Multimedia Appendix 2

Barriers addressed by the publications according to category and subcategory for each publication.

XLSX File (Microsoft Excel File), 16 KB

Multimedia Appendix 3

Full data excel sheet.

XLSX File (Microsoft Excel File), 16 KB

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OT: occupational therapist
PRISMA-ScR: Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews
PT: physical therapist
SLT: speech and language therapist


Edited by A Mavragani; submitted 24.02.23; peer-reviewed by K Drude, H Ayatollahi, D Ceprnja; comments to author 10.04.23; revised version received 01.05.23; accepted 17.05.23; published 01.08.23.

Copyright

©Lena Rettinger, Sebastian Kuhn. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 01.08.2023.

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