Presentation
Examining Perspectives of Virtual Care in Residential Aged Care Homes and Primary Care Settings Using the Seips Framework: A Systematic Literature Review
SessionPoster Session 2
DescriptionBackground
As 2025 marks the halfway point of the UN Decade of Healthy Ageing (2021–2030), the World Health Organization (WHO) continues to call for action to strengthen and transform the way countries provide care and support for older people. A WHO survey of 136 nations found patchy access to quality, affordable, person-centred care, especially in residential care settings. Most countries were facing long wait times, doctor shortages, and unfilled roles, leading to increasing pressure on hospitals and contributing to an emerging, multi-layered primary care crisis. Primary care is a foundational requirement for healthy ageing and high-quality aged care, however, capacity to deliver integrated, person-centred care in residential aged care is critically low, with declining access to general practitioners (GPs) and primary care clinicians. Virtual care models, such as telehealth, have been suggested as a potential solution to improve primary care access for people of all ages. Telehealth use has been associated with improved medication adherence, patient knowledge, satisfaction, and reduced hospital readmissions. Virtual care models involve the use of technologies for telehealth and videoconferencing, remote monitoring (e.g. laryngoscope), and clinical decision support delivered using synchronous (e.g. telephone and video consultations) and asynchronous (e.g. text, email consultations) channels.
Despite rapid telehealth adoption during the COVID-19 pandemic, little is known about the sociotechnical factors influencing use of telehealth and other virtual care technologies in aged care settings, particularly from the perspectives of primary care providers, aged care staff, and residents. This review applied the Systems Engineering Initiative for Patient Safety (SEIPS) framework, a frequently used Human Factors framework, to synthesise evidence on barriers, enablers, processes, and outcomes of virtual care delivery in residential aged care, and primary care.
Methods
We conducted a systematic review in accordance with PRISMA guidelines and registered with PROSPERO (CRD42024562423). Databases searched included MEDLINE, Embase, CINAHL, and Scopus (January 2016-March 2025). Eligible studies reported qualitative, quantitative, or mixed-methods findings on virtual care involving RACHs and primary care. Included studies were quality-assessed using the Mixed Methods Appraisal Tool (MMAT). Data were extracted using a SEIPS-informed template and synthesised deductively across sociotechnical domains.
Results
Thirteen studies met the inclusion criteria and assessed as high quality. Of these studies, five were from Germany, four from the United States, two from the United Kingdom, one from Australia, and one from Austria. Six studies were conducted in urban locations, with three from mixed urban/rural settings, and two in rural settings. Two studies did not specify rurality. The purpose of most studies was to explore perceptions of the value, utility and impact of telehealth, with three studies also examining the social and ethical implications of telehealth. Apart from one study which pre-dated 2019, all studies occurred in the context of the COVID-19 pandemic and its impact on residential aged care and primary care services. Most studies used qualitative designs and interviews. One used a quantitative survey, and one applied a mixed methods approach. One qualitative study also included observations.
Common barriers included those related to the people and tools components of SEIPS, such as limited digital literacy, sensory and cognitive impairments, poor audio-visual quality, lack of staff training, and workflow disruption. Environmental barriers included poor lighting, noise and small workspaces. System-level challenges included poor technology interoperability, inadequate digital infrastructure, and insufficient organisational and policy support. Enablers included strong clinician–resident relationships, access to remote monitoring tools, and peer support. Reported outcomes were mixed: Improved access, communication, and reduced emergency transfers were noted, alongside concerns about increased workload, reduced relational care, and diagnostic limitations that impacted virtual care adoption. Studies reporting resident perspectives are lacking.
Conclusion
Virtual care has the potential to improve aged care access and outcomes, but effective implementation requires more than technology alone. Hybrid models integrating virtual with in-person care require supportive policies, funding models, and organisational workflows. Addressing interoperability gaps, infrastructure needs, and increasing co-design with residents are essential to create virtual care models that are sustainable, person-centred, and scalable in primary care and aged care contexts.
As 2025 marks the halfway point of the UN Decade of Healthy Ageing (2021–2030), the World Health Organization (WHO) continues to call for action to strengthen and transform the way countries provide care and support for older people. A WHO survey of 136 nations found patchy access to quality, affordable, person-centred care, especially in residential care settings. Most countries were facing long wait times, doctor shortages, and unfilled roles, leading to increasing pressure on hospitals and contributing to an emerging, multi-layered primary care crisis. Primary care is a foundational requirement for healthy ageing and high-quality aged care, however, capacity to deliver integrated, person-centred care in residential aged care is critically low, with declining access to general practitioners (GPs) and primary care clinicians. Virtual care models, such as telehealth, have been suggested as a potential solution to improve primary care access for people of all ages. Telehealth use has been associated with improved medication adherence, patient knowledge, satisfaction, and reduced hospital readmissions. Virtual care models involve the use of technologies for telehealth and videoconferencing, remote monitoring (e.g. laryngoscope), and clinical decision support delivered using synchronous (e.g. telephone and video consultations) and asynchronous (e.g. text, email consultations) channels.
Despite rapid telehealth adoption during the COVID-19 pandemic, little is known about the sociotechnical factors influencing use of telehealth and other virtual care technologies in aged care settings, particularly from the perspectives of primary care providers, aged care staff, and residents. This review applied the Systems Engineering Initiative for Patient Safety (SEIPS) framework, a frequently used Human Factors framework, to synthesise evidence on barriers, enablers, processes, and outcomes of virtual care delivery in residential aged care, and primary care.
Methods
We conducted a systematic review in accordance with PRISMA guidelines and registered with PROSPERO (CRD42024562423). Databases searched included MEDLINE, Embase, CINAHL, and Scopus (January 2016-March 2025). Eligible studies reported qualitative, quantitative, or mixed-methods findings on virtual care involving RACHs and primary care. Included studies were quality-assessed using the Mixed Methods Appraisal Tool (MMAT). Data were extracted using a SEIPS-informed template and synthesised deductively across sociotechnical domains.
Results
Thirteen studies met the inclusion criteria and assessed as high quality. Of these studies, five were from Germany, four from the United States, two from the United Kingdom, one from Australia, and one from Austria. Six studies were conducted in urban locations, with three from mixed urban/rural settings, and two in rural settings. Two studies did not specify rurality. The purpose of most studies was to explore perceptions of the value, utility and impact of telehealth, with three studies also examining the social and ethical implications of telehealth. Apart from one study which pre-dated 2019, all studies occurred in the context of the COVID-19 pandemic and its impact on residential aged care and primary care services. Most studies used qualitative designs and interviews. One used a quantitative survey, and one applied a mixed methods approach. One qualitative study also included observations.
Common barriers included those related to the people and tools components of SEIPS, such as limited digital literacy, sensory and cognitive impairments, poor audio-visual quality, lack of staff training, and workflow disruption. Environmental barriers included poor lighting, noise and small workspaces. System-level challenges included poor technology interoperability, inadequate digital infrastructure, and insufficient organisational and policy support. Enablers included strong clinician–resident relationships, access to remote monitoring tools, and peer support. Reported outcomes were mixed: Improved access, communication, and reduced emergency transfers were noted, alongside concerns about increased workload, reduced relational care, and diagnostic limitations that impacted virtual care adoption. Studies reporting resident perspectives are lacking.
Conclusion
Virtual care has the potential to improve aged care access and outcomes, but effective implementation requires more than technology alone. Hybrid models integrating virtual with in-person care require supportive policies, funding models, and organisational workflows. Addressing interoperability gaps, infrastructure needs, and increasing co-design with residents are essential to create virtual care models that are sustainable, person-centred, and scalable in primary care and aged care contexts.
Authors
Event Type
Poster Presentation
TimeTuesday, March 244:45pm - 6:15pm EDT
LocationRhinelander Gallery
Patient Safety Research and Initiatives