Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Nov 1, 2025
Open Peer Review Period: Dec 1, 2025 - Jan 26, 2026
Date Accepted: Apr 28, 2026
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Digital Literacy and Patient Satisfaction in Telemedicine Follow-up After Upper Extremity Surgery: A Randomized Controlled Trial
ABSTRACT
Background:
Telemedicine has rapidly transformed postoperative care, yet the influence of patients’ digital literacy on satisfaction remains underexplored in orthopedic surgery. The purpose of this study was to compare patient satisfaction between telemedicine and in-person (OPD) follow-up after upper-extremity surgery and to examine the association between digital literacy and satisfaction.
Objective:
This study aimed to compare patient satisfaction between telemedicine and traditional in-person outpatient follow-up after upper-extremity surgery, and to investigate the association between patients' digital literacy and satisfaction with their postoperative care.
Methods:
Seventy adults undergoing non-traumatic hand or upper-extremity surgery were randomized 1:1 to telemedicine or OPD follow-up. Satisfaction and digital literacy were assessed using standardized Likert-scale questionnaires at 2 and 6 weeks postoperatively. Between-group comparisons used t-tests, Mann–Whitney U, or chi-square tests as appropriate (p < 0.05).
Results:
Participants in the telemedicine group were younger (mean ± SD = 53.3 ± 11.5 vs. 59.7 ± 14.2 years, p = 0.018) and showed higher digital-literacy scores (mean ± SD = 8.9 ± 1.3 vs. 8.1 ± 1.5, p = 0.041). Overall satisfaction remained high in both groups at 2 and 6 weeks (median = 5 [IQR 5–5]), with no significant differences across any satisfaction domain (p > 0.15). Intra-group analyses revealed stable satisfaction over time (p > 0.3).
Conclusions:
Telemedicine follow-up provides patient satisfaction comparable to traditional visits and is well accepted among digitally literate urban patients. Differences in age and digital literacy suggest the need for targeted digital-skills support when implementing telemedicine at scale. Clinical Trial: Thai Clinical Trials Registry (TCTR20250528008), registered on May 28, 2025.
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