Readiness for telehealth integration in primary healthcare centers: a pilot mixed‑methods assessment from Lebanon’s REMOTE project

BACKGROUND: The healthcare system in Lebanon has faced numerous challenges due to recent crises, significantly impacting its ability to meet population health needs. One of the primary obstacles is the reduced capacity of individuals to seek healthcare services due to financial difficulties, transportation challenges, and the limited availability of providers in certain specialties or geographical areas. This is especially true for vulnerable groups and those living in rural areas where healthcare services are scarce and socioeconomic status is lower. AIM: This study aims to assess the readiness of primary healthcare centers (PHCs) in Lebanon to integrate telehealth (TH) services to inform an evidence-based model for telehealth integration in resource-limited settings. METHODOLOGY: The research assessed, from August to September of 2022, five PHCs managed by the Order of Malta, an organization that provides humanitarian and medical assistance across the country, serving vulnerable populations of all backgrounds, across 5 Lebanese governorates. This mixed-methods assessment involved a quantitative cross-sectional survey targeting beneficiaries and a directed content analysis of qualitative interviews conducted with PHC-affiliated healthcare providers, PHC personnel, and beneficiaries. RESULTS: Findings indicate that telehealth can reduce costs, improve accessibility, and decrease waiting time, addressing key barriers in the current healthcare system. Challenges such as power and internet outages, limited digital literacy, and infrastructural constraints were identified. Despite these obstacles, patients and staff demonstrated a positive reception to telehealth, especially for telemental health services. CONCLUSION: Telehealth presents a scalable solution to enhance primary care in Lebanon's low-resource settings. Future efforts should prioritize infrastructure upgrades, digital literacy training, and policy support to ensure sustainable implementation.