Telehealth as a catalyst for smart rural development and sustainable tourism: a feasibility case study from Agrafa, Greece

Introduction: Rural regions often face persistent healthcare access challenges due to geographic isolation, aging populations, limited infrastructure, and seasonal fluctuations in demand. These challenges not only impact resident well-being but also hinder tourism development. While research has addressed rural healthcare or development separately, limited attention has been given to the synergies between telehealth, regional revitalization, and tourism. This study investigates how telehealth can act as a catalyst for both rural development and sustainable tourism in remote settings. Methods: This pilot study introduces a telehealth framework using a portable diagnostic device integrated into a broader smart village strategy. The initiative was led by the Digital Innovation in Public Health Research Lab at the University of West Attica, in partnership with local authorities and private healthcare providers. Key components included: (a) cross-sector collaboration; (b) a custom-built web platform for monitoring effectiveness; (c) training of local personnel to assist with guided remote consultations; (d) use cases such as chronic disease monitoring, acute symptom triage for tourists, and digital nomad services; and (e) policy alignment at national and European levels. Results: Preliminary qualitative findings suggest improved healthcare accessibility for residents with chronic conditions and enhanced medical support for visitors and digital nomads. The system demonstrated feasibility even in low-connectivity environments and received positive feedback from community stakeholders. Discussion: This study contributes both theoretically and practically by advancing literature on the intersection of telehealth and rural tourism development. The framework offers a replicable model for other European rural regions seeking to enhance health equity, promote digital inclusion, and attract long-term visitors. Despite challenges-such as digital literacy, infrastructure limitations, and sustainability-the pilot illustrates the strategic potential of telehealth in underserved areas. Future research will focus on longitudinal outcomes and the policy tools needed for broader scalability.