title: Barriers for delivering telehealth in rural australia: a review based on Australian trials and studies.
abstract: BACKGROUND
  Australians in rural and remote areas live with far poorer health outcomes than those in urban areas. Telehealth services have emerged as a promising solution to narrow this health gap, as they improve the level and diversity of health services delivery to rural and remote Australian communities. Although the benefits of telehealth services are well studied and understood, the uptake has been very slow.
  
  
  METHODS
  To understand the underpinning issues, we conducted a literature review on barriers to telehealth adoption in rural and remote Australian communities, based on the published works of Australian clinical trials and studies.
  
  
  RESULTS
  This article presents our findings using a comprehensive barrier matrix. This matrix is composed of four stakeholders (governments, technology developers and providers, health professionals, and patients) and five different categorizations of barriers (regulatory, financial, cultural, technological, and workforce). We explain each cell of the matrix (four stakeholders×five categories) and map the reported work into the matrix.
  
  
  CONCLUSIONS
  Several exemplary barrier cases are also described to give more insights into the complexity and dilemma of adopting telehealth services. Finally, we outline recent technological advancements that have a great potential to overcome some of the identified barriers.
authors.affiliation: Computational Informatics, Commonwealth Scientific and Industrial Research Organization , Marsfield, New South Wales, Australia .
authors.forename: Julian
authors.initials: J
authors.lastname: Jang-Jaccard
authors.forename: Surya
authors.initials: S
authors.lastname: Nepal
authors.forename: Leila
authors.initials: L
authors.lastname: Alem
authors.forename: Jane
authors.initials: J
authors.lastname: Li
mesh_terms: D001315:Australia; D002986:Clinical Trials as Topic; D015331:Cohort Studies; D003144:Communication Barriers; D005260:Female; D006801:Humans; D008297:Male; D020380:Needs Assessment; D011787:Quality of Health Care; D019114:Remote Consultation / Q000458:organization & administration; D019035:Rural Health Services / Q000458:organization & administration*; D012424:Rural Population / Q000706:statistics & numerical data; D017216:Telemedicine / Q000458:organization & administration*