{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T22:50:53Z","timestamp":1780613453357,"version":"3.54.1"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2022,12,5]],"date-time":"2022-12-05T00:00:00Z","timestamp":1670198400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001030","name":"National Heart Foundation of Australia","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001030","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>As we move into a new phase of the COVID-19 pandemic, cardiac and pulmonary services are considering how to sustain telehealth modalities long-term. It is important to learn from services that had greater telehealth adoption and determine factors that support sustained use. We aimed to describe how telehealth has been used to deliver cardiac and pulmonary rehabilitation services across Queensland, Australia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Semi-structured interviews (n = 8) and focus groups (n = 7) were conducted with 27 cardiac and pulmonary clinicians and managers from health services across Queensland between June and August 2021. Interview questions were guided by Greenhalgh\u2019s Non-adoption, Abandonment, Scale-up, Spread, and Sustainability framework. Hybrid inductive\/deductive framework analysis elicited six main themes: (i) Variable levels of readiness; (ii) Greater telehealth uptake in pulmonary vs. cardiac rehabilitation; (iii) Safety and risk management; (iv) Client willingness\u2014targeted support required; (v) Equity and access; and (vi) New models of care. We found that sustained integration of telehealth in cardiac and pulmonary rehabilitation will require contributions from all stakeholders: consumers (e.g. co-design), clinicians (e.g. shared learning), health services (e.g. increasing platform functionality), and the profession (e.g. sharing resources).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>There are opportunities for telehealth programmes servicing large geographic areas and opportunities to increase programme participation rates more broadly. Centralized models of care serving large geographic areas could maximize sustainability with current resource limitations; however, realizing the full potential of telehealth will require additional funding for supporting infrastructure and workforce. Individuals and organizations both have roles to play in sustaining telehealth in cardiac and pulmonary services.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurjcn\/zvac111","type":"journal-article","created":{"date-parts":[[2022,12,5]],"date-time":"2022-12-05T09:13:34Z","timestamp":1670231614000},"page":"795-803","source":"Crossref","is-referenced-by-count":20,"title":["Sustaining telehealth among cardiac and pulmonary rehabilitation services: a qualitative framework study"],"prefix":"10.1093","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8415-0521","authenticated-orcid":false,"given":"Emma E","family":"Thomas","sequence":"first","affiliation":[{"name":"Centre for Online Health, Centre for Health Services Research, The University of Queensland , Ground Floor, Building 33, Princess Alexandra Hospital, Woolloongabba, Brisbane, Queensland 4102 , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Chambers","sequence":"additional","affiliation":[{"name":"Healthcare Excellence and Innovation, Metro North Health , Cartwright St, Windsor, QLD 4030 , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9997-6286","authenticated-orcid":false,"given":"Samara","family":"Phillips","sequence":"additional","affiliation":[{"name":"Clinical Improvement Unit, Metro South Health, Princess Alexandra Hospital , 199 Ipswich Road, Woolloongabba, Queensland 4102 , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9755-7993","authenticated-orcid":false,"given":"Jonathan C","family":"Rawstorn","sequence":"additional","affiliation":[{"name":"Institute for Physical Activity and Nutrition, Deakin University , 221 Burwood Highway, Burwood, Victoria 3125 , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6837-2244","authenticated-orcid":false,"given":"Susie","family":"Cartledge","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventive Medicine, Monash University , 553 St Kilda Road, Melbourne, Victoria 3004 , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,12,5]]},"reference":[{"key":"2023121405275144500_zvac111-B1","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.1016\/j.hlc.2017.08.024","article-title":"Cardiac rehabilitation in Australia: a brief survey of program characteristics","volume":"27","author":"Jackson","year":"2018","journal-title":"Heart Lung Circ"},{"key":"2023121405275144500_zvac111-B2","first-page":":CD001800","article-title":"Exercise-based cardiac rehabilitation for coronary heart disease","volume":"1","author":"Anderson","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"2023121405275144500_zvac111-B3","first-page":"CD003793","article-title":"Pulmonary rehabilitation for chronic obstructive pulmonary disease","volume":"2","author":"McCarthy","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"2023121405275144500_zvac111-B4","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1111\/resp.13025","article-title":"Australian and New Zealand pulmonary rehabilitation guidelines","volume":"22","author":"Alison","year":"2017","journal-title":"Respirology"},{"key":"2023121405275144500_zvac111-B5","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1016\/j.hlc.2019.03.015","article-title":"The impact of cardiac rehabilitation and secondary prevention programs on 12-month clinical outcomes: a linked data analysis","volume":"29","author":"Astley","year":"2020","journal-title":"Heart Lung Circ"},{"key":"2023121405275144500_zvac111-B6","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1177\/1741826711409326","article-title":"Participating in cardiac rehabilitation: a systematic review and meta-synthesis of qualitative data","volume":"19","author":"Neubeck","year":"2012","journal-title":"Eur J Prev Cardiol"},{"key":"2023121405275144500_zvac111-B7","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1177\/1479972310393756","article-title":"What prevents people with chronic obstructive pulmonary disease from attending pulmonary rehabilitation? 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