Telemedicine and e-Health

This meta-analysis aims to systematically review and synthesize the available evidence comparing telehealth and in-person follow-up after gynecological surgeries, focusing on clinical outcomes related to safety, patient satisfaction, and healthcare utilization.

A systematic search across PubMed, Embase, and Cochrane Central Register of Controlled Trials databases, covering publications from their inception up to October 2025. Studies were selected if they reported outcomes including patient satisfaction measured by the Patient Satisfaction Questionnaire (PSQ-18), incidence of urinary tract infection (UTI), unplanned healthcare visits, and hospitalizations. Seven randomized controlled trials were included, resulting in a total of 692 patients. Data were assessed using Cochrane’s RoB 2 tool and GRADE, with random-effects models applied for statistical analyses.

The analysis revealed higher scores for telehealth in interpersonal manner (MD = 0.19) and time spent with providers (MD = 0.26), while other PSQ-18 domains showed no significant differences. Postoperative complications, including UTI unplanned visits, phone calls, hospitalizations, and emergency care access, were similar between telehealth and in-person follow-up. Sensitivity analysis and quality assessment (using RoB 2 and GRADE) indicated a critical risk of bias and low certainty of evidence.

Telehealth follow-up after gynecological surgery is as safe as in-person care, with similar complication rates and unplanned healthcare utilization. It also improves patient satisfaction, adherence, and cost efficiency, making it a viable, resource-effective alternative for postoperative care.

Health care systems are increasingly pressured by workforce shortages and increasing chronic conditions. Hypertensive disorders of pregnancy (HDP) require frequent monitoring. Telemonitoring of blood pressure (BP) offers a promising alternative for components of hospital care, potentially improving outcomes and reducing costs. Following cost-saving results from the SAFE@home pilot, this study conducts a cost-effectiveness analysis (CEA) of SAFE@home versus care as usual (CAU) at scale.

A CEA was conducted within the SAFE@home II multicenter before–after study. Women with high risk of or established HDP received remote BP monitoring as part of hybrid care. The controls received CAU. Antenatal costs were calculated in euros. Cost-effectiveness was measured as the absolute risk reduction (ARR) in adverse outcome and the incremental cost-effectiveness ratio (ICER) as the cost per adverse outcome prevented.

Mean antenatal costs per patient were €6,756 (standard deviation [SD] €5,144) in the SAFE@home group and €7,142 (SD €5,149) in the CAU group, corresponding with a cost reduction of €368 (5.4%) using telemonitoring. The ARR was 4.3% and resulted in a negative ICER. Health care consumption per adverse outcome revealed cost savings during pregnancy of €765 per participant with an adverse outcome. Fewer HDP-related admissions (12.0% vs. 15.5%, p = 0.039) in the SAFE@home group compared with CAU supported cost-effectiveness.

This CEA demonstrated that at scale, SAFE@home modestly reduces costs. With lower costs per adverse outcome resulting in a negative ICER, SAFE@home dominates CAU. Future research should explore how telemonitoring can optimize use of resources. In conclusion, addressing adoption barriers is essential to sustainably integrate telemonitoring.

Provider-to-provider consultations may improve primary health care (PHC), but empirical data are limited. Hospitalizations for ambulatory care sensitive conditions (ACSC) indicate PHC quality. We aim to address the effects of synchronous telephone-based discussions on ACSC hospitalizations.

We performed an ecological observational temporal series study based on secondary data. All municipalities of Rio Grande do Sul (Brazil’s southernmost state) were eligible; lack of data was the sole exclusion criterion. The main factor explored was the annual rate of consultations per 1,000 inhabitants from 2014 to 2019. Other factors considered included municipality typology (urban or nonurban), poverty, hospital bed rate, PHC coverage, and non-ACSC hospitalizations. The primary outcome was the rate of ACSC hospitalizations per 1,000 inhabitants from 2014 to 2019. Both comparisons between and within municipalities were assessed. The association between the exposure variables and the outcome was explored using a hierarchical multivariable model with a generalized estimating equations (GEE) analysis.

Out of 497 municipalities, one was excluded due to lack of data. Between 2014 and 2019, there was an increase in the usage of consultations and a reduction in ACSC hospitalizations. In the final model, time, poverty, municipality typology, hospital bed rate, non-ACSC hospitalization, and consultations were all associated with ACSC hospitalization. After adjusting for the possible confoundings, the GEE model prediction showed that a higher number of consultations between- and within-municipalities was associated with a lower rate of ACSC hospitalization.

The presented data suggest that increased consultation usage is associated with improved PHC performance.

The COVID-19 pandemic accelerated the integration of telehealth into routine health care, especially within Federally Qualified Health Centers (FQHCs). Few studies have compared patient experiences and/or comments about telehealth versus in-person visits.

We compared patient comments about primary care telehealth versus in-person visits. We examined 3,795 comments from patient experience surveys (1,457 telehealth and 2,338 in-person) collected electronically between April 2023 and March 2024 by a large Southern California FQHC. We coded comment valence, content, and actionability.

Patient comments about telehealth visits were shorter (mean = 13 words) than comments about in-person visits (mean = 30 words) and more positive (85% versus 81%, respectively). Comments about telehealth visits were also less likely to mention specific provider or staff behaviors, resulting in fewer actionable comments: 7% of comments about telehealth and 12% about in-person visits were deemed actionable. Most comments about telehealth and in-person visits focused on overall visit experience, rather than specific aspects of care. References to care setting and staff roles were minimal, particularly in telehealth comments.

While telehealth visits are generally well-received, patient comments about telehealth provide less detail and contain less actionable information compared to comments about in-person visits. The proportion of actionable comments was considerably lower than prior studies (∼30%). This may pose challenges to using comments to improve telehealth. Understanding differences in how patients respond to the same open-ended patient experience survey question about their telehealth versus in-person visit is critical for optimizing telehealth care delivery and addressing patient needs in under-resourced settings.

The use of telemedicine, including direct-to-consumer telemedicine, has increased significantly, yet there are concerns about the quality and safety of care accessed via this model. The current study retrospectively analyzed survey data from individuals about their perceptions of the efficacy, safety, and quality of care they accessed through a telemedicine platform.

An online survey, originally intended for the purposes of quality improvement, was sent to individuals who had accessed treatment via a national telemedicine platform. The survey, made available between June 30, 2025 and July 3, 2025, consisted of 22 questions that queried individuals about their experience with the platform. Data were de-identified and retrospectively analyzed, with descriptive statistics used to report on the number and percentage of participants who indicated agreement with survey items.

The survey was completed by 2,399 participants. Overall, participants (>80%) reported a positive experience pertaining to the quality and safety of care accessed via the platform. The majority (>90%) of participants reported a positive experience with the online clinical intake and with providers on the platform. Participants consistently (>90%) rated their overall experience with the platform as equal to or better than prior in-person health care experiences. There was variability with regard to participants’ awareness of specific safety practices implemented by the platform.

Our findings indicate that the majority of individuals who engaged with the telemedicine platform had positive perceptions of the efficacy, quality, and safety of the care they received and viewed the experience as rivaling care they had previously received in an in-person setting.

Telehealth has emerged as a transformative tool in healthcare delivery, particularly during and after the COVID-19 pandemic. In the field of plastic and reconstructive surgery, telehealth facilitates patient consultations, follow-up visits, and postoperative care, especially for those in remote areas. However, evaluating its usability and patient satisfaction remains essential to guide future implementation. This study aimed to assess the usability of telehealth services and measure patient perceptions in plastic surgery clinics at a tertiary healthcare center in Riyadh, Saudi Arabia.

A cross-sectional study was conducted between September 2024 and May 2025 at King Abdulaziz Medical City. After receiving ethical approval (IRB: NRC23R/515/09), eligible patients who had attended at least one online plastic surgery clinic consultation were contacted by phone and invited to participate. A self-administered questionnaire was distributed via Google Forms. The survey included demographic questions and the validated Telehealth Usability Questionnaire (TUQ), which covers seven domains. Responses were rated on a 7-point Likert scale. Data were analyzed using RStudio; nonparametric tests and multivariable linear regression were performed to identify predictors of usability.

A total of 93 participants completed the survey. Most respondents were female (67.7%), aged between 29–39 and 51–61 years. Overall, TUQ scores indicated high usability, with the highest medians in usefulness, ease of use, and interface quality (median = 7.0). Lower scores were observed in the reliability subscale (median = 6.0). Educational level significantly influenced ease-of-use and reliability scores, while visit type (e.g., craniofacial vs. breast reconstruction) impacted interaction quality. No significant predictors were identified for the overall TUQ score.

Telehealth services in plastic surgery were perceived positively across all domains of usability. While demographic factors such as education influenced specific subscales, the overall experience was favorable. Telehealth presents a viable, efficient, and patient-satisfying alternative for surgical follow-up, with potential for broader integration in clinical practice.

Telehealth has expanded access to health care services, yet its effectiveness relies heavily on access to communication technology, particularly cellphones. People experiencing homelessness (PEH) face significant barriers to technological access, which may limit their ability to engage in telehealth.

This pilot study evaluated cellphone access and barriers to use for telehealth among sheltered and unsheltered PEH at free community clinics in Virginia Beach, Virginia, through an orally administered survey. Differences in the use of telehealth between government-issued cellphone users and nongovernment-issued cellphone users in this population were examined, as well as differences in perceived barriers to cellphone access and telehealth utilization between sheltered PEH and unsheltered PEH.

Of the 74 participants, 53% reported being sheltered PEH and 47% were unsheltered. Of the sheltered PEH, 97% reported having a cellphone, whereas only 74% of the unsheltered PEH reported having one. Significant barriers to utilization included the cost of devices (p = 0.013), inability to charge phones (p = 0.048), and a lack of mobile data (p < 0.001). Nongovernment cellphone users were more likely to use their cellphones for audio-only telehealth than government cellphone users. The study findings provide insights but, given sample size, they cannot be generalized.

PEH may have access to a cellphone; however, utilization for telehealth may be limited due to cost and technological barriers, as well as prioritization of texting and phone calls to preserve data. Overcoming these barriers is crucial to making telehealth an equitable health care tool for PEH.

Although public interest in telemedicine is growing, limited research has examined the necessary conditions for its usage. Therefore, this study aims to identify these conditions in Japan and China.

A self-developed questionnaire was administered between 2022 and 2023, yielding 787 valid responses in Japan and 840 in China. In addition, 241 Japanese and 194 Chinese supplemental responses were collected in 2025. Factor analysis and necessary condition analysis (NCA) were applied.

Based on the initial samples, eight factors were extracted: cost and accessibility, social influence, safety and reliability, adaptive readiness, technology confidence, perceived data security, facilitating conditions, and perceived usefulness. NCA revealed cross-national differences. Japanese participants mainly regarded perceived usefulness (d = 0.12–0.31) and facilitating conditions (d = 0.15–0.29) as necessary conditions, whereas Chinese participants perceived a broader set of prerequisites. Subgroup analyses further indicated that safety and reliability were the most critical necessary conditions for experienced users in both countries (Japan: d = 0.44; China: d = 0.28). Hierarchical clustering analysis further revealed three bottleneck trajectories of constraints: gradual-bottleneck users (progressive constraints), high-bottleneck users (sudden demand surges), and early-bottleneck users (persistent initial constraints). Crucially, the supplemental samples further confirmed the reliability and validity of the eight-factor structure and the temporal consistency of the necessary conditions for sustained usage.

The findings highlight the need for tailored telemedicine strategies. In particular, maintaining safety and reliability represents a nonnegotiable prerequisite for sustained telemedicine usage in both countries. The developed instrument, combined with NCA, offers a transferable approach for identifying constraints and developing more adaptive and equitable telemedicine strategies.

This study analyzed the intention to use military telemental health services and its influencing factors, based on an integrated theoretical framework combining the Unified Theory of Acceptance and Use of Technology and the Health Belief Model.

A questionnaire-based cross-sectional design was employed. Data were collected through an online survey conducted over a 4-week period from July 9 to August 8, 2025.

The mean intention-to-use score, measured on a 7-point Likert scale, was 4.57 (±1.24), indicating a relatively positive level. Intention to use was significantly higher among established patients than new patients. In the multiple regression analysis, social influence and number of visits were identified as statistically significant factors associated with intention to use.

External factors, such as social influence and prior medical experience, were more strongly associated with intention to use than with individual perceptions of service utilization. These results indicate the need for organizations to foster positive awareness of telemental health services. Furthermore, it is essential to address potential barriers related to resources, information, and security in advance. This study will serve as a foundation for system development and for future research on intention to use military telemental health.