The Ergonomics of Telehealth: Physical, Cognitive, and Administrative Strain in Hybrid Clinical Practice

Background: Telehealth saw unprecedented adoption during the COVID-19 pandemic, after which it has remained a steady and expected mode of clinical care delivery. Most ergonomics research has focused on general remote and office-based knowledge workers rather than clinicians providing extended blocks of virtual patient care. This article focuses on the physical, mental, and administrative challenges experienced by clinicians using telehealth; I argue that these challenges constitute an occupational hazard that should not be addressed ad hoc at the individual level. Methods: A narrative literature review was conducted pertaining to occupational ergonomics, the psychology of videoconferencing, and the administration of occupational health. The literature searched was limited to published, peer-reviewed research and included federal guidance on occupational health. Research suggests that telehealth clinicians experience measurable physical strain associated with prolonged computer use, and measurable cognitive and neurophysiological strain associated with prolonged videoconferencing that is distinct from and in addition to strain associated with in-person clinical practice demands. Despite this evidence, the majority of healthcare organizations have not yet adapted their existing occupational health and ergonomics programs to address telehealth practice. Application of the NIOSH Hierarchy of Controls to telehealth provides healthcare administrators, as well as EHS and occupational health leadership, with something tangible to close this gap.