Comparison of Telephone and Video Telehealth Consultations: Systematic Review

Abstract

Background Telehealth has been used for health care delivery for decades, but the COVID-19 pandemic greatly accelerated the uptake of telehealth in many care settings globally. However, few studies have carried out a direct comparison among different telehealth modalities, with very few studies having compared the effectiveness of telephone and video telehealth modalities. Objective This study aimed to identify and synthesize randomized controlled trials (RCTs) comparing synchronous telehealth consultations delivered by telephone and those conducted by video with outcomes such as clinical effectiveness, patient safety, cost-effectiveness, and patient and clinician satisfaction with care. Methods PubMed (MEDLINE), Embase, and CENTRAL were searched via the Cochrane Library from inception until February 10, 2023, for RCTs without any language restriction. Forward and backward citation searches were conducted on included RCTs. The Cochrane Risk of Bias 2 tool was used to assess the quality of the studies. We included studies carried out in any health setting—involving all types of outpatient cohorts and all types of health care providers—that compared synchronous video consultations directly with telephone consultations and reported outcomes specified in the objective. We excluded studies of clinician-to-clinician telehealth consults, hospitalized patients, and asynchronous consultations. Results Sixteen RCTs—10 in the United States, 3 in the United Kingdom, 2 in Canada, and 1 in Australia involving 1719 participants—were included in the qualitative and quantitative analyses. Most of the telehealth interventions were for hospital-based outpatient follow-ups, monitoring, and rehabilitation (n=13). The 3 studies that were conducted in the community all focused on smoking cessation. In half of the studies, nurses delivered the care (n=8). Almost all included studies had high or unclear risk of bias, mainly due to bias in the randomization process and selection of reported results. The trials found no substantial differences between telephone and video telehealth consultations with regard to clinical effectiveness, patient satisfaction, and health care use (cost-effectiveness) outcomes. None of the studies reported on patient safety or adverse events. We did not find any study on telehealth interventions for diagnosis, initiating new treatment, or those conducted in a primary care setting. Conclusions Based on a small set of diverse trials, we found no notable differences between telephone and video consultations for the management of patients with an established diagnosis. There is also a significant lack of telehealth research in primary care settings despite its high uptake.

Factors Explaining the Use of Web-Based Consultations With Physicians by Young and Middle-Aged Individuals in China: Qualitative Comparative Analysis

“…This is in line with previous studies that found that the cost is a barrier influencing the use of the service, even in high-income countries [ 26 ]. Moreover, similar to Germany and the United States, clear regulations about web-based consultations are lacking in China; accordingly, not only do the costs of web-based consultations vary widely, but expenditures on the service are not yet covered by the social health insurance systems [ 5 , 31 ]. Thus, the economic burden on patients may impede their use of web-based consultations.…”

“…The COVID-19 pandemic created a demand for internet health care services at an unprecedented rate [2][3][4], as patients became reluctant to go to hospitals because of the fear of infection [5,6]. Accordingly, an increasing number of hospitals and internet companies started to, and continue to, venture into the internet health care industry.…”

Innovative Applications of Telemedicine and Other Digital Health Solutions in Pain Management: A Literature Review

“…It can be used to assess pain scores, gather valuable information, discuss treatment options, and offer guidance for self-care as well as education. A skilled healthcare provider can provide appropriate guidance over the phone [ 33 , 34 ]. Video Consultations involves conducting virtual visits using video conferencing platforms.…”

Lessons From the Field From a Volunteer Telehealth Ambassador Program to Enhance Video Visits Among Low-Income Patients: Qualitative Improvement Study

“…Reasons for low telehealth video uptake in safety-net systems are multifactorial, including suboptimal infrastructure for implementation as well as challenges faced by their patient populations due to structural and socioeconomic barriers and limited digital literacy [ 4 , 5 ]. There is a paucity of trial data that directly compares different telehealth visit modalities, and both likely have a role to play in primary care delivery [ 6 ]. However, retrospective studies examining data from electronic health records suggest that primary care telehealth video visits are associated with more clinical actions, including more medication prescriptions and diagnostic testing and fewer return in-person visits within 7 days compared to telehealth audio-only visits [ 7 ].…”