The transition from pandemic-era telehealth to permanent hybrid care models requires evidence-based implementation strategies. We conducted a 24-month prospective evaluation of eight primary care systems across five countries using the RE-AIM framework. Three distinct implementation approaches were compared: parallel track (n=2), sequential integration (n=3), and unified platform (n=3) models. Analysis of 147,892 patient encounters and surveys from 4,847 patients and 124 clinicians revealed that unified platform models achieved superior reach (78.3% vs 52.4%), implementation fidelity (91.2% vs 72.4%), and 24-month sustainability (87.5% vs 68.2%) compared to parallel track approaches. Unified platforms demonstrated 23% cost reduction and 94.2% revenue coverage despite requiring higher initial investment. Statistical modeling identified technology integration, training investment, and organizational culture as critical success determinants. These findings establish that sustainable hybrid care requires unified platforms with comprehensive workflow integration rather than incremental telehealth additions.Full Text Available: Sustainable Implementation of Hybrid Primary Care Models Through Unified Technology Platforms
Nakamura et al. (Fri,) studied this question.