Bridging Policy and Practice in Telemedicine Follow-Up Identification: Multicenter Mixed Methods Study in Beijing

Area of Science:

• Health Services Research
• Digital Health
• Healthcare Policy

Background:

• Telemedicine services have seen rapid global development, gaining popularity in China after a 2018 policy change.
• Implementation and effectiveness of telemedicine, particularly for follow-up patients, require further understanding across diverse medical institutions.

Purpose of the Study:

• To investigate patient eligibility assessment processes for telemedicine in Beijing's medical institutions.
• To understand institutional rationales for telemedicine adoption and analyze policy-practice discrepancies.
• To provide insights for future telemedicine service development.

Main Methods:

• A mixed-methods study involving 36 top-ranking medical institutions in Beijing.
• Quantitative phase: Questionnaires on assessment processes and patient prerequisites.
• Qualitative phase: Thematic analysis of semi-structured interviews with institutional contacts.

Main Results:

• 36 institutions handled nearly 1 million telemedicine visits, with most using a two-stage eligibility assessment.
• Nonprofit hospitals predominantly used automatic assessments, often with stricter location criteria than policy required.
• Key discrepancies stemmed from distrust in other institutions and difficulties with interinstitutional disputes.

Conclusions:

• This study highlights significant discrepancies between telemedicine policy and practice in Beijing's patient eligibility assessments.
• Policy ambiguity and institutional priorities contribute to these variations.
• Recommendations include enhancing policy clarity, easing regulations for new patients, and improving service oversight.