Stakeholder-driven multi-stage adaptive real-world theme-oriented (SMART) telehealth evaluation framework: a scoping review.

Zhang, Yunxi; Lin, Yueh-Yun; Lal, Lincy S; Reneker, Jennifer C; Hinton, Elizabeth G; Chandra, Saurabh; Swint, J Michael · Lancet Reg Health Am · 2025

review · Level V

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Abstract

Telehealth has revolutionized healthcare delivery by integrating cutting-edge technologies, yet evaluations of its services and programs often lack comprehensive frameworks, resulting in unclear standards for quality assurance. To address this gap, we conducted a scoping review of telehealth evaluation frameworks applicable to the United States healthcare system, following the Joanna Briggs Institute methodology and a published protocol. Twelve telehealth evaluation frameworks published between 2019 and 2023 were identified, focusing on four key themes: program implementation, clinical impact, economic impact, and equity. Guided through two auxiliary frameworks, we further developed a stakeholder-driven multi-stage adaptive real-world theme-oriented (SMART) conceptual framework for telehealth evaluation. We illustrated this framework through a use case on a remote patient monitoring program. This comprehensive telehealth evaluation framework not only facilitates stakeholders in developing tailored evaluation plans but also contributes to the standardization and enhancement of telehealth services, ultimately improving health outcomes and promoting greater equity across society.