Implementation Barriers and Facilitators

Digital health interventions substantially reduced patient travel costs and time, with flow-on reductions in time away from work for patients and carers. Process standardisation, practitioner endorsement, and team-based interprofessional care models were identified as key implementation facilitators. Staff workload was the most commonly cited barrier to digital health implementation in rural settings. Limited internet connectivity, billing challenges, and difficulty sustaining recruitment were pragmatic barriers to implementation. Billing rules, internet connectivity standards, and technical support are the most pressing policy-level barriers to digital health adoption. One smoking cessation programme reported substantially higher provider costs per patient who successfully quit compared with usual care.