Physicians' views on optimal use and payment system for telemedicine: a qualitative study

Area of Science:

• Healthcare Policy
• Digital Health
• Medical Economics

Background:

• Telemedicine adoption is widespread, yet reimbursement and physician payment models lag globally.
• Limited research exists on optimal telemedicine payment structures, hindering equitable access and physician participation.

Purpose of the Study:

• To investigate physicians' perspectives on the optimal utilization of telemedicine.
• To identify essential components for effective telemedicine reimbursement and payment systems.

Main Methods:

• Conducted 61 semi-structured interviews with physicians across 19 medical disciplines.
• Employed thematic analysis for encoding interview data to identify key themes and requirements.

Main Results:

• Physicians generally use telemedicine for triage, not initial patient contact, except in urgent situations.
• Identified key payment modalities for televisits: equitable remuneration, comparable fees to in-person visits, discipline-specific rates, and quality mandates.
• Key payment modalities for telemonitoring include alternative schemes beyond fee-for-service, remuneration for all health professionals, designated coordinator roles, and distinction between sporadic and continuous follow-up.

Conclusions:

• Physician usage patterns highlight the need for supportive payment structures for telemedicine.
• Developed a framework of minimum required modalities for a physician-supported telemedicine payment system.
• Emphasized the necessity of adapting healthcare payment systems to accommodate telemedicine innovations.