Recommendations Regarding the Appropriateness of Virtual Care: A Systematic Review

To identify and analyze factors influencing the appropriateness of virtual and in-person care and to synthesize current evidence-based recommendations to assist health care providers in determining when virtual or in-person care is most suitable.

Four databases (MEDLINE, CINAHL, Embase, and APA PsychInfo) and Google Scholar were searched to identify qualitative, quantitative, and mixed methods studies and clinical practice guidelines published between January 2014 and January 2024 focused on appropriateness of virtual care. Articles were extracted and uploaded to Covidence for screening. Two researchers screened the articles independently, and a third researcher resolved any conflicts. Data were extracted from articles, and factors influencing the appropriateness of virtual care were categorized using thematic analysis.

The search retrieved 5,136 articles, of which 75 met inclusion criteria and were included in the review. An additional eight articles were identified following a supplemental search of reference lists, resulting in a total of 83 articles included in the study. Six primary concepts influencing the appropriateness of virtual care were identified from the literature (patient characteristics, clinical presentation and disease, timepoint in the care process, burden of care, provider factors, and technology platform) and 22 subconcepts. A flowchart incorporating these concepts was developed to assist in clinical decision-making regarding the suitability of virtual and in-person care.

Findings from this systematic review provide clinicians with a structured approach to evaluating the suitability of virtual versus in-person care, supporting evidence-based decisions and effective integration of virtual care into the health care system.