Direct-to-Consumer Telemedicine Platforms in China: A National Market Survey and Quality Evaluation
| Autor: | Huipeng Liao, Junzhang Tian, Karishma D’Souza, Sean Sylvia, Weibin Chen, Weiming Tang, Wang Ai Qin, Wenjie Gong, Hao Xue, Winnie Yip, Dong Xu, Yafei Si, Yian Fang |
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| Rok vydání: | 2021 |
| Předmět: |
Protocol (science)
History Telemedicine Polymers and Plastics business.industry media_common.quotation_subject computer.software_genre medicine.disease Digital health Industrial and Manufacturing Engineering Market research Videoconferencing Incentive Ambulatory care medicine Quality (business) Medical emergency Business and International Management business computer media_common |
| Zdroj: | SSRN Electronic Journal. |
| ISSN: | 1556-5068 |
| DOI: | 10.2139/ssrn.3944587 |
| Popis: | Background: Direct to Consumer (DTC) telemedicine platforms are digital platforms that enable patients to match with and initiate online consultations. This growing area of digital health has the potential to expand access to quality outpatient care by extending patient choice of providers and providers’ ability to interact with new patients online. We sought to evaluate the status of DTC telemedicine and the quality of care provided through these platforms in China, the country where DTC telemedicine has expanded most rapidly. Methods: In this cross-sectional study, we first conducted a systematic search of all DTC telemedicine platforms in China providing on-demand consultations through video or SMS/MMS and manually scraped information from each platform. We then evaluated the quality of care provided using unannounced virtual visits by standardized patients (SPs) presenting seven different disease cases. We evaluate the performance of online providers relative to national standards of care and to traditional on-site providers in rural areas. Multiple regressions were used to assess associations between quality and platform characteristics. Findings: The systematic search identified 36 independent platforms providing synchronous or asynchronous consultations via videoconferencing or SMS/MMS text. Platforms varied widely in design, access methods, services, and pricing. The quality of care provided through online-only platforms was superior to platforms that were extensions of physical hospitals in terms of diagnosis and case management. SPs were significantly more likely to be correctly managed through videoconference compared to SMS/MMS consultations, though costs were significantly higher. Both videoconference and SMS/MMS consultations were likely to refer patients unnecessarily. Platform features and the price of consultations were significantly associated with measures of quality. Interpretation: There was substantial variation in the design of DTC telemedicine platforms in China as well as the quality of care provided. Incentives inherent in the design of these platforms may influence care quality and patient costs. The expansion of DTC telemedicine may improve access to high quality care, but could increase unnecessary care and reduce equity in access without thoughtful regulation. Research is needed to inform policies governing DTC telemedicine platforms, particularly in middle-income countries such as China. Funding: Key-Area Research and Development Program of Guangdong Province (No. 2020B0101130020). Declaration of Interest: The authors have no conflicts of interest to declare. Ethical Approval: Approvals were obtained from the institutional review boards (IRBs) of The University of North Carolina (protocol number 257307) and Guangdong Second Provincial General Hospital (protocol number 2019-ITT-1008-02). |
| Databáze: | OpenAIRE |
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