Diagnosing at a distance: How telemedicine impacts the diagnostic process

BackgroundThe rapid expansion of telemedicine has reshaped healthcare delivery, offering increased accessibility and convenience. However, its impact on the diagnostic process is still undergoing evaluation. This study explored key stakeholder perspectives to enhance understanding of telemedicine's role in the diagnostic process.MethodsWe conducted semistructured interviews with 34 subject-matter experts (SMEs) in telemedicine and practicing clinicians across various healthcare organizations and 10 patients with prior telemedicine experience. Using inductive qualitative content analysis, we identified themes related to facilitators and challenges in the diagnostic process via telemedicine encounters.ResultsSMEs and clinicians noted telemedicine's potential to improve access and enhance continuity of care, but they raised concerns about diagnostic accuracy due to the absence of hands-on physical exams and challenges in managing diagnostic uncertainty. Specifically, clinicians described relying more on additional testing, patient self-reports, and scheduling in-person follow-ups to compensate. Patients emphasized the convenience and accessibility of telemedicine, particularly for those with disabilities, and valued the ability to communicate with clinicians in a familiar environment. However, few patients had received a new diagnosis via telemedicine; and many preferred in-person visits for new or complex concerns. Additionally, barriers related to digital literacy, technology challenges, and incomplete follow-up on diagnostic testing emerged as critical factors influencing telemedicine's effectiveness in diagnostic decision-making.ConclusionsOur qualitative study of stakeholder perspectives underscores certain limitations of telemedicine in the diagnostic process and outlines the need to consider strategies to enhance the effectiveness of diagnostic decision-making in telemedicine.