BMJ 2000;320:1517-1520 ( 3 June )

Information in practice

Systematic review of studies of patient satisfaction with telemedicine

Frances Mair, senior lecturer in general practice, ^a Pamela Whitten, assistant professor. ^b

^a Department of Primary Care, Whelan Building, Quadrangle, University of Liverpool, Liverpool L69 3GB, ^b Department of Telecommunication, Michigan State University, 409 Communication Arts and Sciences Building, East Lansing, MI 48824-1212, USA

Correspondence to: F Mair f.s.mair{at}liv.ac.uk

Objective: To review research into patient satisfaction with teleconsultation, specifically clinical consultations between healthcare providers and patients involving real time interactive video.
Design: Systematic review of telemedicine satisfaction studies. Electronic databases searched include Medline, Embase, Science Citation Index, Social Sciences Citation Index, Arts and Humanities Citation Index, and the TIE (Telemedicine Information Exchange) database.
Subjects: Studies conducted worldwide and published between 1966 and 1998.
Main outcome measures: Quality of evidence about patient satisfaction.
Results: 32 studies were identified. Study methods used were simple survey instruments (26 studies), exact methods not specified (5), and qualitative methods (1). Study designs were randomised controlled trial (1 trial); random patient selection (2); case-control (1); and selection criteria not specified or participants represented consecutive referrals, convenience samples, or volunteers (28). Sample sizes were 20 (10 trials), 100 (14), >100 (7), and not specified (1). All studies reported good levels of patient satisfaction. Qualitative analysis revealed methodological problems with all the published work. Even so, important issues were highlighted that merit further investigation. There is a paucity of data examining patients' perceptions or the effects of this mode of healthcare delivery on the interaction between providers and clients.
Conclusions: Methodological deficiencies (low sample sizes, context, and study designs) of the published research limit the generalisability of the findings. The studies suggest that teleconsultation is acceptable to patients in a variety of circumstances, but issues relating to patient satisfaction require further exploration from the perspective of both clients and providers.

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