{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T16:04:24Z","timestamp":1788883464698,"version":"build-2803163510"},"reference-count":42,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Western Canadian and U.S. communities outside urban centres remain underserved by primary, specialist, emergency, mental health, and chronic-disease services. These access problems reflect distance, weather, workforce shortages, specialist maldistribution, primary care attachment gaps, broadband limitations, and the governance realities of Indigenous and Tribal communities. This scoping review with narrative synthesis examined how telehealth and virtual-care models affect rural access in western Canada and the western\/frontier United States. Methods: Searches were completed on 21 May 2026 in PubMed\/MEDLINE, Embase, CINAHL, Scopus, the Cochrane Library, and PubMed Central. Supplementary searches included Google Scholar, publisher platforms, reference-list checking, and official Canadian and U.S. health-system sources. Peer-reviewed evidence published from 1 January 2016 to 21 May 2026 was eligible when it addressed rural, remote, frontier, Indigenous, underserved, western, or northern healthcare settings and reported access, implementation, safety, continuity, equity, or service-use outcomes. Results: The search identified 112 records; 27 duplicates were removed, 85 records were screened, 37 full texts were assessed, and 28 peer-reviewed records were included. Seven official sources were retained separately. Evidence was mainly observational, qualitative, mixed-methods, implementation-focused, or review-level. Moderate confidence supported telehealth for travel reduction and specialist input, especially through eConsultation, provider-to-provider consultation, telementoring, and real-time emergency support. Confidence was low to moderate for hybrid primary care and telemental health, and low for durable reductions in emergency department use. Conclusions: Telehealth may be most appropriately implemented as a hybrid, locally anchored, culturally safe access model, not as a stand-alone substitute for rural primary care, specialist capacity, or emergency services. Implementation should include broadband support, local physical assessment capacity, documentation, continuity, patient education, and clear escalation pathways.<\/jats:p>","DOI":"10.3390\/jcm15124749","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T13:04:04Z","timestamp":1781874244000},"page":"4749","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Virtual Care and Telehealth for Improving Healthcare Access in Rural Western Canada and the Western United States: A Scoping Review and Narrative Synthesis"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-1991-9184","authenticated-orcid":false,"given":"Tomasz","family":"Karczewski","sequence":"first","affiliation":[{"name":"Cranston Ridge Medical Clinic, Calgary, AB T3M 3A9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6358-4619","authenticated-orcid":false,"given":"Jennifer M. L.","family":"Stephens","sequence":"additional","affiliation":[{"name":"Fay W. Whitney School of Nursing, University of Wyoming, Laramie, WY 82071, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4621-5404","authenticated-orcid":false,"given":"Dawid","family":"Karczewski","sequence":"additional","affiliation":[{"name":"Cranston Ridge Medical Clinic, Calgary, AB T3M 3A9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sahar","family":"Feizizadeh","sequence":"additional","affiliation":[{"name":"Cranston Smart Drug Mart, Calgary, AB T3M 3A9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avni K.","family":"Patel","sequence":"additional","affiliation":[{"name":"Cranston Ridge Medical Clinic, Calgary, AB T3M 3A9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merjorie M. A.","family":"Pinero","sequence":"additional","affiliation":[{"name":"Cranston Ridge Medical Clinic, Calgary, AB T3M 3A9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihaela","family":"Olsen","sequence":"additional","affiliation":[{"name":"Cranston Ridge Medical Clinic, Calgary, AB T3M 3A9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie L.","family":"Thompson","sequence":"additional","affiliation":[{"name":"Cranston Ridge Medical Clinic, Calgary, AB T3M 3A9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/1475-9276-12-18","article-title":"Patient-centred access to health care: Conceptualising access at the interface of health systems and populations","volume":"12","author":"Levesque","year":"2013","journal-title":"Int. J. 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