Bridging the Gaps: Strengthening Patient Engagement and Interprofessional Telehealth in Primary Care: Response to Your Insightful Commentary on Our Scoping Review

Dear Editor,

We would like to thank the person who wrote the letter to the editor and gives thoughtful and constructive feedback on our scoping review concerning the engagement of patients with chronic conditions in interprofessional telehealth within primary care settings.

Several of the comments raised in the letter such as the diversity of telehealth modalities, interprofessional collaboration, and strategies to enhance accessibility, are central to our broader research project. While our initial publication focuses on a specific subset of findings, these key dimensions will be more thoroughly addressed in our forthcoming results papers. The variability in telehealth modalities significantly influences both patient engagement and interprofessional collaboration; however, the effective involvement of diverse team members often remains limited and poorly coordinated.^{1 -3} Moreover, the integration of interprofessional collaboration within telehealth settings has been shown to improve patient outcomes, provider satisfaction, and care coordination especially for individuals living with chronic conditions.^1,2 Finally, ensuring accessibility requires deliberate attention to technological infrastructure, digital literacy, and social determinants of health that may either unable or hinder equitable participation in virtual care. ⁴ These themes are fundamental to advancing a more inclusive and effective model of primary care delivery in the digital age.

Moreover, our findings underscore the crucial role patients can play not only as care users, but as active partners in the design, implementation, and ongoing refinement of telehealth services. We believe that meaningful patient integration is essential to building more equitable, contextually grounded, and culturally responsive models of care.

The commentary raises critical points, particularly regarding access inequities in rural and underserved communities, and the importance of culturally safe approaches, critical points, particularly regarding access inequities in rural and underserved communities, and the importance of culturally safe approaches especially in relation to Indigenous populations. While these important dimensions are not directly represented in our forthcoming results papers given that they were not the specific populations targeted in this study, particularly as my research sites are in urban areas. With a background in research involving Indigenous communities, ⁵ I am acutely aware of these gaps, ⁶ and I fully agree that future research must explore them more explicitly and rigorously. The absence of their voices in this study underscores a broader systemic issue in the literature: the underrepresentation of these communities in primary care and telehealth research.^7,8 I fully agree that future research must aim to address these gaps more explicitly and rigorously, not only to ensure inclusivity but also to improve the relevance, cultural safety, and effectiveness of interventions across diverse population.^2,3 This necessitates the adoption of research approaches that are participatory, decolonizing, and grounded in principles of cultural humility. ⁸ Your suggestion to highlight cultural aspects is particularly relevant. It aligns with some of the future projects we are considering and helps reaffirm our belief that we are on a path toward system transformation.

One striking observation that emerged during the review and analysis phases was the limited attention given to primary care settings in the literature. Despite the central role that primary care plays in chronic disease follow-up and interprofessional collaboration, particularly in rural and semi-urban contexts, very few studies examined the nuances and systemic barriers within these settings in a telehealth context. For example, several articles emphasized hospital-based or specialist-driven models of care, often overlooking the longitudinal, community-anchored nature of primary care services. This gap reinforced the importance and originality of our study, which seeks to document and better understand collaboration dynamics where patients most often initiate and sustain their care trajectories in a telehealth context.

However, we maintain that any such transformation must place the patient voice at its core. Integrating patients as active partners not merely as sources of data but as co-creators of knowledge is essential for the development of health policies and governmental decision-making processes that are truly responsive, inclusive, and effective.^9,10

Thank you once again to this person and your Journal for contributing to this important dialogue.

Warm regards

Monica McGraw, M.Sc.inf, B.Sc.inf, II, CCNEDepartment of Family Medecine and Emergency Medecine, Université de Sherbrooke Saguenay, CanadaCRMUS Research Chair on Optimal Professional Practices in Primary Care, Saguenay, Canada Anaëlle Morin, RN, M.ScDepartment of Family Medecine and Emergency Medecine, Université de Sherbrooke Saguenay, CanadaCentre intégré universitaire de santé et de services sociaux du Saguenay–Lac-St-Jean, Saguenay, CanadaCRMUS Research Chair on Optimal Professional Practices in Primary Care, Saguenay, Canada Vanessa Tremblay-Vaillancourt, M.ScDepartment of Family Medecine and Emergency Medecine, Université de Sherbrooke Saguenay, CanadaCentre intégré universitaire de santé et de services sociaux du Saguenay–Lac-St-Jean, Saguenay, CanadaCRMUS Research Chair on Optimal Professional Practices in Primary Care, Saguenay, Canada Marie-Eve Poitras, PhDDepartment of Family Medecine and Emergency Medecine, Université de Sherbrooke Saguenay, CanadaCentre intégré universitaire de santé et de services sociaux du Saguenay–Lac-St-Jean, Saguenay, CanadaCRMUS Research Chair on Optimal Professional Practices in Primary Care, Saguenay, Canada Prof. Yves Couturier, PhDDepartment of Social Work, Université de Sherbrooke, Sherbrooke, Canada Pre Isabelle Gaboury, PhDDepartment of Family Medecine and Emergency Medecine, Université de Sherbrooke Saguenay, Canada Marie-Dominique PoirierDepartment of Family Medecine and Emergency Medecine, Université de Sherbrooke Saguenay, CanadaCRMUS Research Chair on Optimal Professional Practices in Primary Care, Saguenay, Canada