Telehealth Evaluation

Original Editor - Simisola Ajeyalemi

Top Contributors - Simisola Ajeyalemi and Kim Jackson  

Introduction

Telehealth is the delivery of health-related services and information via electronic communication. As with any process or intervention, it is essential to continually evaluate the efficacy of digital solutions for healthcare delivery. Healthcare professional can assess telehealth visits based on service user's satisfaction, experience, technical quality, usefulness, effect on interaction and effectiveness.

[1] [2]  [3]  [4]

Satisfaction

The focus here should be on service user's expectation; if the expectation were met. Overall satisfaction and willingness to reuse telehealth to receive healthcare services should be measured.Satisfaction questionnaire typically show ceiling effects e.g.most report 80‐100% satisfaction[5] however they are not designed to be sensitive to variations in quality of services. Validated measures to measure patient satisfaction specific to telehealth include Telemedicine Satisfaction Questionnaire[6], Telemedicne Satisfaction and Usefulness Questionnaire, generic tools including Patient Satisfaction Questionnaire.

Experience

The focus here is on service user's experience of telehealth service which could be subjective or objective. The following dimensions should be evaluated- comfort, safety, values, equity, needs and preferences, participation in decisions, treated with compassion and respect.

Technical Quality

Technology is a key aspect of telehealth service delivery and the focus of the evaluation here is technical quality of the platform used for telehealth. The visual and audio quality, reliability, ease of use and security should be evaluated.

Usefulness

The focus here is on evaluating if the service user found the service useful and/or benefits. Convenience, time & cost, accessibility, efficiency, acceptability, intent to use again and appropriateness are all measured in this domain.

Effect on Interaction

The focus here is to evaluate the effect of telehealth as a mode of healthcare delivery on the clinician-patient interaction. Effect on communication, ability to do assessment; effect of visual & non‐verbal cues has to be evaluated.

Effectiveness

The focus here is to assess the effect on the service user's health service and/or well being. Change in knowledge, quality of life, health status, wellbeing, function etc. In addition, clinician confidence in diagnosis should be measured.

Evaluating Telehealth Visits

The following outcome measures can be used in evaluating the effectiveness of telehealth visits.

  • Functional Observation
    1. Bed mobility
    2. Transfers
    3. Gait
    4. Functional ROM
  • Impairment Measures
    1. Range of motion
    2. Pain- Numerical Pain Scale
    3. Strength
  • Activity – independence, time, frequency
    1. Walking distance, duration, frequency
    2. Duration to complete a task e.g. dress

Resources and Further Reading

Download Evaluating Telehealth Visits PDF

Physiotherapy Specific Evaluation Tools Non-Physiotherapy Specific Evaluation Tools
MedRisk: Patient Satisfaction with Physical Therapy Care Telemedicine Satisfaction Questionnaire
Physical Therapy Outpatient Satisfaction Survey Telemedicine Satisfaction and Usefulness Questionnaire
Physical Therapy Patient Satisfaction Survey Telemedicine Perception Questionnaire
Patient Satisfaction with Physical Therapy Patient Assessment of Communication during Telemedicine
Patient Satisfaction with Outpatient Physiotherapy Telehealth Usability Questionnaire
Treatment Outcome Satisfaction Questionnaire

References

  1. Gutiérrez‐Sánchez D et al. Instruments for measuring satisfaction with physical therapy care: A systematic review. American Journal of Physical Therapy. E‐publication ahead of print. June 2020.
  2. Langbecker D et al. Using survey methods in telehealth research: A practical guide. Journal of Telemedicine and Telecare. 2017, Vol. 23(9) 770–779.
  3. Patient‐reported outcome measures may be integrated into virtual orthopedic care
  4. BC Quality Matrix
  5. Williams TL, May CR and Esmail A. Limitations of patient satisfaction studies in telehealthcare: A systematic review of the literature. Telemed J E Health 2001; 7: 293–316.
  6. Yip MP, Chang AM, Chan J, et al. Development of the Telemedicine Satisfaction Questionnaire to evaluate patient satisfaction with telemedicine: A preliminary study. J Telemed Telecare 2003; 9: 46–50.