JMIR Publications

ABSTRACT

Background:

Telemedicine has a long history, but its efficacy has been reported with mixed reviews.

Objective:

To analyze the effectiveness of telemedicine through the six domains of quality through an analysis of RCTs in the literature published in 2022.

Methods:

Four databases were queried with a standard Boolean string. The 882,420 results were reduced to 33 for analysis. The systematic literature review was conducted in accordance with the Kruse Protocol and reported in accordance with PRISMA (2020).

Results:

A kappa statistic was calculated to show agreement between reviewers (k=0.90, strong). Medical outcomes associated with the telemedicine modality were 100% effective with a weighted average effect size of 0.21 (small effect). Many medical outcomes were positive but not statistically better than treatment as usual. RCTs reported positive outcomes for physical and mental health, medical engagement, behavior change, increased quality of life, increased self-efficacy, increased social support, and reduces costs. All six domains of quality were identified in the RCTs, but four were identified in 100% of the studies. Telemedicine is highly patient-centered because it meets a digital preference, is convenient, avoids a stigma, and enables education at ones’ own pace. A few barriers exist to its wide adoption such as staff training, cost, and it may not be the preferred modality for all.

Conclusions:

Telemedicine’s effectiveness is equal to or above traditional care across a wide spectrum of services studied in this systematic literature review. Providers should feel comfortable offering this modality of care as a standard option to patients where it makes sense to do so. While barriers do exist for wide adoption, the facilitators are all patient facing.