A Holistic Framework of Strategies and Best Practices for Telehealth Service Design and Implementation

Telehealth refers to the use of electronic media to support a broad range of remote services such as patient care, education, and monitoring. Drawing upon the “design thinking” framework, a holistic approach to telehealth service design would be one that takes into consideration the multiple, interdependent dimensions of telehealth services, including processes, user-experience, and sustainability. The information technology infrastructure library (ITIL) is a well-known framework of best practices in IT service management. However, as a stand-alone resource, it is limited in being able to provide a meaningful set of strategies for telehealth service design and implementation for clinicians and healthcare leaders. The ITIL framework emanated from an industry-based approach to developing best practices for IT service management. This paper takes an organizational theory-based approach to identifying strategies for telehealth service design and implementation. These strategies are then integrated with practices put forth by the ITIL framework, to develop a “holistic framework” of strategies and best practices for telehealth service design and implementation, intended to be meaningful to clinicians, healthcare leaders, and IT service managers alike. The primary purpose of this paper is to integrate theory-based “design thinking” and “consolidated framework for implementation research (CFIR)” frameworks, with the existing industry-based ITIL framework, to develop a holistic framework of strategies and best practices for telehealth service design and implementation. A supplemental purpose is to apply the holistic framework to cases of success and failure in telehealth services, to discuss implications for practice and future research.