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Virtual Care and Telehealth for Improving Healthcare Access in Rural Western Canada and the Western United States: A Scoping Review and Narrative Synthesis

Year: 2026

Type: article

Abstract: Background/Objectives: Western Canadian and US communities beyond urban centres are routinely underserved by primary, specialist, and emergency care services, whether based in rural, remote, frontier or Indigenous settings. Access issues in these contexts have traditionally been framed by distance, weather, and clinician availability challenges, but also extend to specialist maldistribution, attachment gaps and uneven broadband availability. This systematic review and narrative evidence synthesis scoped the impact of telehealth and other virtual-care models on rural access to services, broadly construed to include timely access, travel burden, specialist input, emergency support, continuity and clinician support, safety, and equity, or impacts on service fairness and effectiveness. Methods: Searches conducted in May 2026 included PubMed/MEDLINE-indexed records, PubMed Central full-text records, the Cochrane Library search interface, publisher platforms, reference chasing, and official sources from Canadian and US health systems. Eligible evidence from 1 January 2016 through 6 May 2026 addressed rural, remote, frontier, Indigenous, underserved, western or northern health-service settings, with earlier landmark sources retained for historical framing where relevant. Results: The search identified 112 records; after de-duplication and screening, 28 eligible peer-reviewed records were included in the evidence synthesis and 7 official sources informed jurisdictional contextualization. Evidence supported virtual care as an access extender in contexts where it can reduce travel, enable specialist input or support rural clinicians, maintain continuity of chronic disease or mental health follow-up. Virtual care is best when paired with on-site physical assessment and in-person escalation pathways. Evidence was weaker for virtual-only models, and for durable effects on emergency department use. Conclusions: Telehealth should therefore be implemented as a hybrid, locally anchored, culturally safe access model rather than as a stand-alone substitute for rural primary care or specialist capacity.

Source: Journal of Clinical Medicine

DOI: 10.3390/jcm15124749