02270nas a2200181   4500000000100000008004100001100001300042700001600055700001700071700001900088700001700107700001600124245010600140300000900246490000700255520181200262022001402074       2017                            d1 aIvers R.1 aHunter Kate1 aFraser Sarah1 aMackean Tamara1 aGrant Julian1 aTowers Kurt00aUse of telehealth for health care of Indigenous peoples with chronic conditions: a systematic review.  a42050 v173 a<p>
<b>INTRODUCTION: </b>Telehealth may be a cost effective modality in healthcare delivery, but how well used or how appropriate it is for the care of Indigenous peoples is unclear. This review examines the evidence for telehealth in facilitating chronic conditions management with Indigenous peoples.
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<b>METHODS: </b>Databases were systematically searched for qualitative or quantitative primary research studies that investigated telehealth use for chronic conditions management with Indigenous peoples worldwide. Evidence of effectiveness was by consumer health outcomes, evidence of acceptability was through consumer and user perception, and health service feasibility was evident by service impact. Data were assessed for quality and data extracted using pre-defined tools.
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<b>RESULTS: </b>Articles (<i>n</i>=32) examined effectiveness (<i>n</i>=11), critiqued telehealth from the perspectives of the client (<i>n</i>=10) and healthcare professionals (<i>n</i>=8), and examined feasibility (<i>n</i>=12). Studies reported Indigenous people tend to be satisfied with telehealth, but are sceptical about its cultural safety. Evidence for the effectiveness of telehealth from a western biomedical perspective was found.
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<b>CONCLUSIONS: </b>Telehealth is promising; however, a lack of robust studies in this review make tangible conclusions difficult. A better overall understanding of telehealth use with Indigenous peoples, including delivery of culturally competent health care, true consultation and cultural competency of the professionals involved, would be helpful. Telehealth may have the potential to improve health care for Indigenous people, however the modality needs to be culturally competent and the care received must be culturally safe.
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