Assessing the Quality of Telehealth Services in Latin America Using ISO/TS 13131:2021

Telehealth has emerged as a fundamental component for improving health efficiency and access in Latin America. In this regard, it is essential to investigate the quality of the services offered and structure best practices for their implementation, monitoring, and evaluation. This study aims to evaluate the quality of 15 telehealth services from 4 Latin American countries across 3 dimensions.

An instrument for evaluating the quality of telehealth services was developed and validated by Latin American experts, based on the Service Planning, Risk Management, and Technology Management domains of ISO/TS 13131:2021. After validation, data from 15 services in Brazil, Mexico, Chile, and Peru were analyzed. The following tests were applied: Content Validation Index, Shapiro-Wilk, Analysis of Variance, Kruskal-Wallis, and Fisher to validate content and verify associations between countries and service quality, classified into low, medium, and high levels.

The instrument showed S-CVI for Relevance = 0.96; Clarity = 0.86; General = 0.91. There was no statistically significant association between countries and service quality. Overall, 60% of services were classified as low (46.67%) or medium quality (13.33%), while 40% presented high quality. Mean scores were 9.8/15 for Service Planning, 8.5/12 for Risk Management, and 21.5/35 for Technology Management, resulting in a general mean of 39.8/62 points.

The results highlight gaps in the quality of the evaluated telehealth services. The instrument's validation confirms its applicability as a tool for telehealth quality assessment.