Remote shared decision making through telemedicine: A systematic review of the literature

Sandra A Hartasanchez; Anja Fog Heen; Marleen Kunneman; Andrea García-Bautista; Ian G Hargraves; Larry J Prokop; Carl R May; Victor M Montori

doi:10.1016/j.pec.2021.06.012

Remote shared decision making through telemedicine: A systematic review of the literature

Patient Educ Couns. 2022 Feb;105(2):356-365. doi: 10.1016/j.pec.2021.06.012. Epub 2021 Jun 11.

Authors

Sandra A Hartasanchez¹, Anja Fog Heen², Marleen Kunneman³, Andrea García-Bautista¹, Ian G Hargraves¹, Larry J Prokop⁴, Carl R May⁵, Victor M Montori⁶

Affiliations

¹ Knowledge and Evaluation Research Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
² Knowledge and Evaluation Research Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA; Department of Medicine, Lovisenberg Diaconal Hospital, Oslo, Norway.
³ Knowledge and Evaluation Research Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA; Medical Decision Making, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands.
⁴ Mayo Clinic Libraries, Rochester, MN, USA.
⁵ Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
⁶ Knowledge and Evaluation Research Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA. Electronic address: montori.victor@mayo.edu.

PMID: 34147314
DOI: 10.1016/j.pec.2021.06.012

Abstract

Objectives: To assess the extent to which shared decision making (SDM) can take place in telemedicine (remote SDM).

Methods: We searched Medline, Cochrane, and Scopus from 2010 until August 7th, 2020 for articles on remote SDM in the care of any patient using any technology. We also conducted a search for telemedicine articles citing key reports on SDM outcome measures. Two reviewers independently screened titles and abstracts, reviewed full text eligible studies, and synthesized their content using thematic analysis.

Results: Of the 12 eligible articles, most were European with patients with chronic disease or mental and behavioral health. 8 articles used synchronous remote SDM and 1 used asynchronous remote SDM. Themes related to interactional workability of both telemedicine technologies and SDM emerged, namely access to broadband, digital literacy, and satisfaction with the convenience of remote visits.

Conclusions: Telemedicine technologies may foster virtual interactions that support remote SDM, which, in turn, may promote productive patient-clinician interactions and patient-centered care.

Practice implications: Digitally-mediated consultations surged amidst the COVID-19 pandemic. The extent to which SDM frameworks developed for in-person use need any adaptation for remote SDM remains unclear. Investment in innovation, design, implementation, and effectiveness research to advance remote SDM are needed.

Keywords: Patient centered care; Shared decision making; Telemedicine.

Publication types

Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

COVID-19*
Decision Making
Decision Making, Shared
Humans
Pandemics
Patient Participation
SARS-CoV-2
Telemedicine*