Article

Limitations of Patient Satisfaction Studies in Telehealthcare: A Systematic Review of the Literature

School of Primary Care, University of Manchester, United Kingdom.
Telemedicine and e-Health (Impact Factor: 1.54). 02/2001; 7(4):293-316. DOI: 10.1089/15305620152814700
Source: PubMed

ABSTRACT The objective of this study is to provide a systematic review of studies on patient satisfaction with telemedicine. The review included empirical studies that investigated patient satisfaction with that telemedicine service. The search strategy involved matching at least one of 11 'telemedicine' terms with one of 5 'satisfaction' terms. The following databases were searched: Telemedicine Information Exchange (TIE) database, MEDLINE, Science Citation Index (SCI), Social Science Citation Index (SSCI), Psycinfo, and Citation Index of Nursing and Allied Health (CINAHL). A highly structured instrument was used for data extraction. The review included 93 studies. Telepsychiatry represents the largest portion of these studies (25%), followed by multispecialty care (14%), nursing (11%), and dermatology (8%). Real-time videoconferencing was used in 88% of these studies. Only 19 (20%) included an independent control group, including 9 (10%) randomized control trial (RCT) studies. One third of studies were based on samples of less than 20 patients, and only 21% had samples of over 100 patients. Aspects of patient satisfaction most commonly assessed were: professional-patient interaction, the patient's feeling about the consultation, and technical aspects of the consultation. Only 33% of the studies included a measure of preference between telemedicine and face-to-face consultation. Almost half the studies measured only 1 or 2 dimensions of satisfaction. Reported levels of satisfaction with telemedicine are consistently greater than 80%, and frequently reported at 100%. Progression of telemedicine services from "trial" status to routine health service must be supported by improved research into patients' satisfaction with telemedicine. Further investigation of factors that influence patient acceptance of telemedicine is indicated.

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    • "Reported benefits include reduced waiting times, less need for travel and time off work, and greater overall convenience. However, the methodology of many patient satisfaction studies has been weak (Williams et al. 2001), in keeping with patient satisfaction research more generally (Sitzia 1999). "
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    ABSTRACT: Many Australians have limited access to health-care services due to a range of barriers, including geographic distance and restricted mobility, which telehealth can potentially address. This paper reviews the current and potential use of video consultation in primary health care in Australia, drawing on international literature. There is substantial evidence of high patient satisfaction, but many studies have methodological limitations. Overall, evidence of effectiveness and cost-effectiveness is weak. There is reasonable evidence for diagnosis, home care and specialist consultations by GPs with patients present. Two telehealth initiatives using video consultation are briefly presented. Both provide evidence that video consultation has a valuable role to play, but does not obviate the need for face-to-face consultations. Video consultation challenges traditional professional roles, particularly those of nurses, and can improve health workers' skills and job satisfaction. More fundamentally, telehealth challenges the traditional distinction between primary and secondary care. This can be a source of resistance but may ultimately be one of its strengths. Appropriately targeted video consultation has much potential to improve the delivery of primary health care in Australia, particularly in rural and remote regions.
    Australian Journal of Primary Health 10/2013; 19(4). DOI:10.1071/PY13032 · 1.22 Impact Factor
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    • "Some of the studies included in the reviews did not report power calculations, placing them at risk of Type II errors [66]. Often reviews contained studies that were not randomised or that were designed as observational studies, pilot studies or pre-post studies, limiting the weight that can be given to their conclusions [21], [22], [23], [24], [26], [28], [29], [31], [33], [34], [35], [36], [38], [40], [41], [42], [43], [48], [49], [52], [58], [67], [68], [69], [70], [71], [72], [73], [74], [75], [76], [77]. A number of reviews did not clearly detail the study designs of all the included studies [20], [30], [32], [51], [60], [78], [79], [80], [81], [82], [83], [84], [85], [86]. "
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    PLoS ONE 08/2013; 8(8):e71238. DOI:10.1371/journal.pone.0071238 · 3.23 Impact Factor
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    • "Patient preferences and satisfaction are important for implementing a new examination technique such as teleophthalmology, as these opinions will help shape and improve the model. Currently there are a handful of studies comparing patient satisfaction between face-to-face consultations and telemedicine.616 In 2006, Kumari Rani and colleagues,6 noted that 99% of their patients were satisfied with their teleophthalmology screening. "
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