Telemedicine and the assessment of clinician time. A scoping review

• Introduction: Telemedicine may improve healthcare access and efficiency if demanding less clinician time than usual care. We sought to describe the degree to which telemedicine trials assess the effect of telemedicine on clinicians' time and to discuss how including the Time Needed to Treat (TNT) in HTA of telemedicine could affect 33 the design of telemedicine services and studies. Methods: We conducted a scoping review by searching clinicaltrials.gov using the search term "telemedicine"and limiting results to randomized trials or observational studies with a comparison group registered between January 2012 and October 2023. We then reviewed trial registration data to determine if any of the outcomes assessed in the trials measured effect on clinicians' time. Results: We found 113 studies and of these 78 studies of telemedicine met the inclusion criteria and were included. Nine (12 percent) of the 78 studies had some measure of clinician time as a primary outcome, and 11 (14 percent) as secondary outcome. Four studies compared direct measures of TNT with telemedicine vs. usual care, but no statistically significant difference was found. Of the sixteen studies including indirect measures of clinician time, thirteen found no significant effects, two found a statistically significant reduction and one found a statistically significant increase. Discussion: This scoping review found that clinician time is not commonly measured in studies of telemedicine interventions. Attention to telemedicine's TNT in clinical studies and HTAs of telemedicine in practice may bring 48 attention to the organization of workflows and increase the value of telemedicine.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Health Care Service and Management, Health Policy and Services and Health Economy (hsv//eng)

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