Patient perspectives of telemedicine quality

Abstract

BackgroundThe purpose of this study was to explore the quality attributes required for effective telemedicine encounters from the perspective of the patient.MethodsWe used a multi-method (direct observation, focus groups, survey) field study to collect data from patients who had experienced telemedicine encounters. Multi-perspectives (researcher and provider) were used to interpret a rich set of data from both a research and practice perspective.ResultsThe result of this field study is a taxonomy of quality attributes for telemedicine service encounters that prioritizes the attributes from the patient perspective. We identify opportunities to control the level of quality for each attribute (ie, who is responsible for control of each attribute and when control can be exerted in relation to the encounter process). This analysis reveals that many quality attributes are in the hands of various stakeholders, and all attributes can be addressed proactively to some degree before the encounter begins.ConclusionIdentification of the quality attributes important to a telemedicine encounter from a patient perspective enables one to better design telemedicine encounters. This preliminary work not only identifies such attributes, but also ascertains who is best able to address quality issues prior to an encounter. For practitioners, explicit representation of the quality attributes of technology-based systems and processes and insight on controlling key attributes are essential to implementation, utilization, management, and common understanding.

Providing Comprehensive Medication Management in Telehealth

“…Proper lighting must also be ensured, and camera placement and angle must provide clear visibility of the patient's face and allow for adequate eye contact . Regardless of the technical challenges involved, patients express satisfaction with telehealth when the health care professional is focused on providing care rather than technology …”

Perspectives of Nurses Toward Telehealth Efficacy and Quality of Health Care: Pilot Study (Preprint)

“…The "type of technology" has a direct effect on barrier reduction, attitudes, quality and quantity of communication [16]. There is a link between potential service quality facets and health care organizations adoption of healthcare information technologies and telehealth [17,18]. SERVQUAL and its improved versions are still widely used for measuring service quality in various sectors including health care, justifying SERVQUAL as an appropriate tool for TNSQ [6,11].…”

“…The gap analysis method based on SERVQUAL has been used to calculate patient perceptions related to hospital service quality [19,20].However, published research is lacking with the instrument being used to measure nurse perspectives toward telehealth quality. Past studies have been conducted to determine the quality attributes for telemedicine services from the patient and physician perspective [18,19]. There is a need to further investigate the quality attributes for telemedicine services from the nurse perspective, which hasn't been clearly defined before [5,12].TNSQ survey contains questions belonging to the five dimensions [9,11][Multimedia Appendix A].The gap method of subtracting nurses' expectations from perceptions, in each of the dimensions (using the survey),helps in assessing the TNSQ [9].The dimensions having the negative gap score indicate that there is a barrier or an inhibitor present in that dimension, in the same manner a positive value indicates that there is a facilitator in that dimension.…”

“…The modified SERVQUAL instrument consisted of 25 items, which included the five original dimensions. The first seven questions belonged to the tangibles dimension (1-7), questions eight to twelve belonged to the reliability dimension (8)(9)(10)(11)(12), questions thirteen to sixteen belonged to the responsiveness dimension (13)(14)(15)(16), questions seventeen to twenty belonged to the assurance dimension (17)(18)(19)(20), and the last five questions belonged to the empathy dimension (21-25).…”

“…The distribution scale values obtained for the average telehealth service expectation scores, service performance scores and service quality scores are presented [ Table 2,3,4].The gap scores are negative in the tangibles (1-7), responsiveness (13)(14)(15)(16) and assurance dimensions (17)(18)(19)(20). These values demonstrate that the expectations (E) of telehealth nursing service are higher than the actual perception (P) of the service [ Table 3].…”