Impact of Telemedicine Modality on Quality Metrics in Diverse Settings: Implementation Science-Informed Retrospective Cohort Study

J Med Internet Res. 2023 Jul 26:25:e47670. doi: 10.2196/47670.


Background: Video-based telemedicine (vs audio only) is less frequently used in diverse, low socioeconomic status settings. Few prior studies have evaluated the impact of telemedicine modality (ie, video vs audio-only visits) on clinical quality metrics.

Objective: The aim of this study was to assess telemedicine uptake and impact of visit modality (in-person vs video and phone visits) on primary care quality metrics in diverse, low socioeconomic status settings through an implementation science lens.

Methods: Informed by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework, we evaluated telemedicine uptake, assessed targeted primary care quality metrics by visit modality, and described provider-level qualitative feedback on barriers and facilitators to telemedicine implementation.

Results: We found marginally better quality metrics (ie, blood pressure and depression screening) for in-person care versus video and phone visits; de-adoption of telemedicine was marked within 2 years in our population.

Conclusions: Following the widespread implementation of telemedicine during the COVID-19 pandemic, the impact of visit modality on quality outcomes, provider and patient preferences, as well as technological barriers in historically marginalized settings should be considered.

Keywords: adoption; audio based; diverse; implementation science; quality metrics; screening; socioeconomic; telehealth; telemedicine; video based; video consultation.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Benchmarking
  • COVID-19*
  • Humans
  • Implementation Science
  • Pandemics
  • Retrospective Studies
  • Telemedicine*