Implementing home-based digital health in rural Canada: a scoping review

Objective: This scoping review maps the current evidence on implementing home-based digital health technologies in rural Canada. It examines available readiness tools and indicators, stakeholder perspectives, barriers, and outcomes to provide evidence-based insights for successful implementation. Methods: A comprehensive search was conducted in Ovid MEDLINE, IEEE Xplore, and Scopus between February and March 2025. Eligible studies focused on patient-facing, home-based digital health technologies in rural or remote Canadian contexts. Articles addressing pre-implementation, implementation, or adoption of home-based digital health solutions were also included. Data extraction and thematic analysis were performed to synthesize findings. Results: Sixteen studies met the inclusion criteria, spanning diverse rural regions of British Columbia, Ontario, and several Prairie and Atlantic provinces. Findings were categorized under four major themes: (1) readiness tools, frameworks, and indicators; (2) patient and provider perspectives; (3) barriers and corresponding strategies; and (4) outcomes and impacts of home-based digital health implementation in rural Canada. While patients and providers are generally positive towards home-based digital health technologies, several context-dependent factors influence their success. Key barriers include digital divides, infrastructure limitations, and varying digital literacy. Effective implementation necessitates addressing these challenges through tailored strategies, such as culturally sensitive design, infrastructure development, digital literacy training, and community engagement. Conclusion: Home-based digital health technologies have the potential to improve healthcare access and outcomes in rural Canada. Successful implementation requires careful consideration of contextual factors, proactive barrier mitigation, and a focus on co-design with users to ensure equitable access and outcomes.