Researchers say ‘essential questions remain’ about telehealth’s diagnostic viability

Researchers from the Society to Improve Diagnosis in Medicine released an issue brief this week aimed at exploring the reach, effectiveness, adoption, implementation and future prospects of telehealth.

By combining literature reviews and interviews with a wide variety of stakeholders, the team sought to identify the most pressing research questions on how to maximize telediagnosis opportunities – while avoiding possible problem areas.  

“We found that telediagnosis has potential, although there is still much to learn about how virtual diagnosis can be done most effectively,” said Suz Schrandt, senior patient engagement advisor at SIDM and principal investigator on the project, in a statement.   

“We found that many patients like the convenience of telemedicine, but we also need more research into who is being left behind in the process, such as small practices or people without access to high-speed Internet,” Schrandt continued.  


As an organization, SIDM focuses on improving diagnosis and eliminating harm from diagnostic error. It partners with stakeholders such as patients, families and members of the healthcare community.  

The researchers noted that the COVID-19 pandemic triggered an enormous paradigm shift when it comes to certain telehealth needs.  

“Most available research on telemedicine is focused on the use of virtual care for maintenance of health, but use of telemedicine for diagnosis – telediagnosis – at this scale is unprecedented, creating more unknowns than knowns about its impact on diagnostic quality and safety,” read SIDM’s issue brief.  

The research team found that published evidence regarding the effectiveness of telemedicine for diagnosis is fairly limited.  

“While some evidence shows high rates of satisfaction among patients, other data shows that such convenience may come at a cost,” they wrote.  

“Generally speaking, there is still much to learn about the effectiveness of telemedicine overall, and even more so within the ambit of diagnostic quality and safety,” they added.  

Some providers flagged the value in being able to see into someone’s home to better understand details about their families and social contexts. At the same time, they said it was harder to evaluate body language and other visual clues.   

Remote patient monitoring devices were also highlighted as one way to enable care continuity and address any unexpected health occurrences.   

“One challenge that emerged within each stakeholder group was the difficulty in measuring or evaluating the true impact of telemedicine on quality and safety, and this remains the key research question that needs to be addressed,” read the brief.   

“Many hospitals and health systems had collected data on patient satisfaction, but those surveys stopped short of assessing diagnostic accuracy,” it continued.

Researchers noted that the industry still lacks ways to measure diagnostic errors in in-person settings, so it’s not an enormous surprise that telemedicine lags in this arena too.  

They highlighted other research questions that still lingered, including what technology obstacles patients still face and how telehealth can make routine evaluations more efficient.  

“Might this virtual care revolution provide a natural starting point for more robust study of diagnostic quality and safety?” they wrote.  


Addressing diagnostic errors is a key concern for many stakeholders.  

In 2017, a report from the National Quality Forum found that 5% or more patients in the U.S are being incorrectly diagnosed, contributing to up to 17% of adverse hospital events.

At that time, the organization said electronic health records are not equipped to assist providers in arriving at an accurate diagnosis.   

But experts have pointed to the roles other health tech, such as AI tools, can play in fixing the issue.  


“Overall, research priorities regarding the effectiveness of telediagnosis must focus on what symptoms require in-person assessments; what the right mix of in-person and virtual care looks like; who is being left behind in the expansion of virtual care; and what determines success or failure in telediagnosis,” said Dr. Mark Graber, founder and president emeritus of SIDM and co-author of the issue brief, in a statement.

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Healthcare IT News is a HIMSS Media publication.

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