The impact of telehealth videoconferencing on the healthcare work system: designing for sustained practice

Good health is vital for sustainable social and economic development and improving access to healthcare can help progress this goal. Telehealth is a digital technology that can strengthen health systems. One example is healthcare consultations using videoconferencing (VC) to connect patients and providers. Despite stakeholder benefits, there are challenges in integrating VC into routine practice which has led to failed VC services. This study, guided by the Systems Engineering Initiative for Patient Safety (SEIPS) 2.0 framework, investigated the impact of VC on healthcare work systems in Aotearoa New Zealand. Interviews with experts, healthcare providers and patients (n = 40) and observations at three healthcare sites showed that using VC has cross-level system impacts, including new ways of working, change, human connection and equity. The findings suggest human-centred design and consideration of system interactions could support sustained VC healthcare, with implications for future technology adoption and opportunities for ergonomics and human factors in system analysis and design.