Reducing outpatient wait times through telemedicine: a systematic review and quantitative analysis
Objectives Population ageing and the rise in chronic diseases place continual stress on healthcare systems. Scarce resources often impede equitable access to healthcare, particularly in rural areas, resulting in prolonged waiting times and heightened risks of morbidity and mortality. Telemedicine ha...
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BMJ Publishing Group
2025-01-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/1/e088153.full |
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| author | Tina Hernandez-Boussard Claudio Passino Michele Emdin Sabina Nuti Alberto Giannoni Angelo Capodici Francesca Noci Stefano Dalmiani |
| author_facet | Tina Hernandez-Boussard Claudio Passino Michele Emdin Sabina Nuti Alberto Giannoni Angelo Capodici Francesca Noci Stefano Dalmiani |
| author_sort | Tina Hernandez-Boussard |
| collection | DOAJ |
| description | Objectives Population ageing and the rise in chronic diseases place continual stress on healthcare systems. Scarce resources often impede equitable access to healthcare, particularly in rural areas, resulting in prolonged waiting times and heightened risks of morbidity and mortality. Telemedicine has emerged as a promising solution, offering remote and equitable care that could potentially bridge access gaps and enhance health outcomes. This systematic review aims to quantitatively examine the impact of telemedicine implementation on waiting times, defined as the time passed from the booking of a visit for an outpatient to the administration of the service.Design A systematic review was conducted using studies on telemedicine interventions that specifically addressed waiting times. Bias assessment was performed with three tools: ROBINS-I ('Risk of Bias In Non-Randomized Studies of Interventions'), AXIS ('Appraisal tool for Cross-Sectional Studies') and RoB-2 ('Risk of Bias-2'). A weighted mean approach was used to synthesise results, with medians synthesised using a median approach.Data sources Articles in English were retrieved from the PubMed and Scopus databases.Eligibility criteria Studies were excluded if they did not specifically address waiting times related to telemedicine interventions. Only studies that considered waiting times defined as the time passed from the booking of a visit for an outpatient to the administration of the service and any telemedicine intervention were included.Data extraction and synthesis A total of 53 records were included, encompassing 270 388 patients in both the experimental and control groups. The weighted mean reduction in waiting times was calculated, and bias was assessed. No record was evaluated to be at high risk of bias, with 69.8% of studies evaluated at low risk and 26.4% at moderate risk (3.8% were surveys). Results were synthesised using a weighted mean approach for studies reporting means, and a median approach for studies reporting medians.Results Overall, a weighted mean reduction of 25.4 days in waiting times was observed. Focusing on clinical specialties (n=114 042), the weighted mean reduction amounted to 34.7 days, while in surgical patients (n=156 346), telemedicine was associated with a weighted mean of 17.3 days saved.Conclusions The implementation of telemedicine solutions may significantly improve waiting times, potentially leading to more efficient and equitable healthcare systems.PROSPERO registration number CRD42023490822. |
| format | Article |
| id | doaj-art-7113fb758f7b451685e23a944e9cbd4b |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-7113fb758f7b451685e23a944e9cbd4b2025-08-20T01:53:26ZengBMJ Publishing GroupBMJ Open2044-60552025-01-0115110.1136/bmjopen-2024-088153Reducing outpatient wait times through telemedicine: a systematic review and quantitative analysisTina Hernandez-Boussard0Claudio Passino1Michele Emdin2Sabina Nuti3Alberto Giannoni4Angelo Capodici5Francesca Noci6Stefano Dalmiani7Department of Medicine, Stanford University, Stanford, California, USAInterdisciplinary Research Center for Health Science, Sant’Anna School of Advanced Studies, Pisa, Italy5 Health Science Interdisciplinary Center, Scuola Superiore Sant’Anna, Pisa, ItalyInterdisciplinary Research Center for Health Science, Sant’Anna School of Advanced Studies, Pisa, ItalyInterdisciplinary Research Center for Health Science, Sant’Anna School of Advanced Studies, Pisa, ItalyDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, ItalyInterdisciplinary Research Center for Health Science, Sant’Anna School of Advanced Studies, Pisa, ItalyCardiology and Cardiovascular Medicine Department, Fondazione Monasterio, Pisa, ItalyObjectives Population ageing and the rise in chronic diseases place continual stress on healthcare systems. Scarce resources often impede equitable access to healthcare, particularly in rural areas, resulting in prolonged waiting times and heightened risks of morbidity and mortality. Telemedicine has emerged as a promising solution, offering remote and equitable care that could potentially bridge access gaps and enhance health outcomes. This systematic review aims to quantitatively examine the impact of telemedicine implementation on waiting times, defined as the time passed from the booking of a visit for an outpatient to the administration of the service.Design A systematic review was conducted using studies on telemedicine interventions that specifically addressed waiting times. Bias assessment was performed with three tools: ROBINS-I ('Risk of Bias In Non-Randomized Studies of Interventions'), AXIS ('Appraisal tool for Cross-Sectional Studies') and RoB-2 ('Risk of Bias-2'). A weighted mean approach was used to synthesise results, with medians synthesised using a median approach.Data sources Articles in English were retrieved from the PubMed and Scopus databases.Eligibility criteria Studies were excluded if they did not specifically address waiting times related to telemedicine interventions. Only studies that considered waiting times defined as the time passed from the booking of a visit for an outpatient to the administration of the service and any telemedicine intervention were included.Data extraction and synthesis A total of 53 records were included, encompassing 270 388 patients in both the experimental and control groups. The weighted mean reduction in waiting times was calculated, and bias was assessed. No record was evaluated to be at high risk of bias, with 69.8% of studies evaluated at low risk and 26.4% at moderate risk (3.8% were surveys). Results were synthesised using a weighted mean approach for studies reporting means, and a median approach for studies reporting medians.Results Overall, a weighted mean reduction of 25.4 days in waiting times was observed. Focusing on clinical specialties (n=114 042), the weighted mean reduction amounted to 34.7 days, while in surgical patients (n=156 346), telemedicine was associated with a weighted mean of 17.3 days saved.Conclusions The implementation of telemedicine solutions may significantly improve waiting times, potentially leading to more efficient and equitable healthcare systems.PROSPERO registration number CRD42023490822.https://bmjopen.bmj.com/content/15/1/e088153.full |
| spellingShingle | Tina Hernandez-Boussard Claudio Passino Michele Emdin Sabina Nuti Alberto Giannoni Angelo Capodici Francesca Noci Stefano Dalmiani Reducing outpatient wait times through telemedicine: a systematic review and quantitative analysis BMJ Open |
| title | Reducing outpatient wait times through telemedicine: a systematic review and quantitative analysis |
| title_full | Reducing outpatient wait times through telemedicine: a systematic review and quantitative analysis |
| title_fullStr | Reducing outpatient wait times through telemedicine: a systematic review and quantitative analysis |
| title_full_unstemmed | Reducing outpatient wait times through telemedicine: a systematic review and quantitative analysis |
| title_short | Reducing outpatient wait times through telemedicine: a systematic review and quantitative analysis |
| title_sort | reducing outpatient wait times through telemedicine a systematic review and quantitative analysis |
| url | https://bmjopen.bmj.com/content/15/1/e088153.full |
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