EC Gastroenterology and Digestive System

Online medical consultations (OMC) are becoming increasingly popular among patients seeking information for diagnosis and treatment. The mandatory quarantine measures enforced during the COVID-19 pandemic increased the use of OMCs for different healthcare conditions among different patient groups. Telemedicine effectuates benefits for both physicians and patients and, thus, has a growing potential for use. OMC is an effective healthcare innovation since it provides potential benefits to patients and physicians through improved delivery of patient-centered healthcare services at reduced costs.

OMCs offer benefits to all stakeholders in the healthcare systems. The purpose of this article is to discuss the benefits of OMCs to the patients, healthcare systems, and individual physicians. Firstly, OMC reduces the time gap to gain consultation through a high physician response rate and consultation dialogue intensity. Second, OMCs reduce patients' discomfort from positive physician-patient relationships over traditional, powerful-powerless hierarchical relationships. Third, OMCs reduce the overall costs of the systems by reducing administrative costs. Fourth, OMCs increase the ease for physicians through increased convenience, service flexibility, and strong physician-patient relationships. Healthcare systems and individual physicians look forward to integrating state-of-the-art technology, including artificial intelligence, to leverage OMC benefits.

 Keywords: Online Medical Consultations (OMC); Paradigm Shift; Healthcare

1. Yang M., et al. “Re-examining the impact of multidimensional trust on patients’ online medical consultation service continuance decision”. Information Systems Frontiers3 (2021): 983-1007.
2. Donaghy E., et al. “Acceptability, benefits, and challenges of video consulting: a qualitative study in primary care”. British Journal of General Practice 686 (2019): e586-e594.
3. Jiang X., et al. “Characteristics of online health care services from China's largest online medical platform: Cross-sectional survey study”. Journal of Medical Internet Research 4 (2021): e25817.
4. Jiang J., et al. “Analysis of massive online medical consultation service data to understand physicians’ economic return: Data mining study”. JMIR Medical Informatics2 (2020): e16765.
5. Zhou F., et al. “Online clinical consultation as a utility tool for managing medical crisis during a pandemic: Retrospective analysis on the characteristics of online clinical consultations during the COVID-19 pandemic”. Journal of Primary Care and Community Health 11 (2020).
6. Wan Y., et al. “Influencing factors and mechanism of doctor consultation volume on online medical consultation platforms based on physician review analysis”. Internet Research6 (2021): 2055-2075.
7. College of Family Physicians of Canada. Improving Access to Care for Patients in Canada.
8. Bennett KJ and Baxley EG. “The effect of a carve-out advanced access scheduling system on no-show rates”. Family Medicine 1 (2009): 51-56.
9. Michael M., et al. “Improving wait times and patient satisfaction in primary care”. Journal for Healthcare Quality2 (2013): 50-60.
10. Chang YW., et al. “Integration of online and offline health services: The role of doctor-patient online interaction”. Patient Education and Counseling10 (2019): 1905-1910.
11. Zanaboni P and Fagerlund AJ. “Patients' use and experiences with e-consultation and other digital health services with their general practitioner in Norway: results from an online survey”. BMJ Open6 (2020): e034773.
12. Hsiao JL and Oh DH. “The impact of store-and-forward teledermatology on skin cancer diagnosis and treatment”. Journal of the American Academy of Dermatology 2 (2008): 260-267.
13. Kahn E., et al. “Evaluation of skin cancer in Northern California Kaiser Permanente’s store-and-forward teledermatology referral program”. Telemedicine Journal and e-Health 10 (2013): 780-785.
14. Edwards HB., et al. “Use of a primary care online consultation system, by whom, when and why: evaluation of a pilot observational study in 36 general practices in South West England”. BMJ Open11 (2017): e016901.
15. Chen M., et al. “Characteristics of online medical care consultation for pregnant women during the COVID-19 outbreak: cross-sectional study”. BMJ Open11 (2020): e043461.
16. Salazar-Fernandez CI., et al. “Telemedicine as an effective tool for the management of temporomandibular joint disorders”. Journal of Oral and Maxillofacial Surgery 2 (2012): 295-301.
17. Viers BR., et al. “Efficiency, satisfaction, and costs for remote video visits following radical prostatectomy: A randomized controlled trial”. European Urology4 (2015): 729-735.
18. Paul M., et al. “Digitization of healthcare sector: A study on privacy and security concerns”. ICT Express 4 (2023): 571-588.
19. Wang RH., et al. “Clinical effectiveness and cost-effectiveness of teledermatology: Where are we now and what are the barriers to adoption?” Journal of the American Academy of Dermatology 1 (2020): 299-307.
20. Bansal M., et al. “Satisfaction level among patients visiting a rural dental institution toward rendered dental treatment in Haryana, North India”. Journal of Education and Health Promotion 7 (2018): 81.
21. Armfield NR., et al. “The clinical use of Skype—for which patients, with which problems and in which settings? A snapshot review of the literature”. International Journal of Medical Informatics 10 (2015): 737-742.
22. Marsh J., et al. “Economic evaluation of web-based compared with in-person follow-up after total joint arthroplasty”. Journal of Bone and Joint Surgery, American Volume 22 (2014): 1910-1916.
23. Harno K., et al. “Patient referral by telemedicine: effectiveness and cost analysis of an Intranet system”. Journal of Telemedicine and Telecare 6 (2000): 320-329.
24. Moreno-Ramirez D., et al. “Teledermatology as a filtering system in pigmented lesion clinics”. Journal of Telemedicine and Telecare 6 (2005): 298-303.
25. Ohinmaa A., et al. “A cost-minimization analysis of orthopaedic consultations using videoconferencing in comparison with conventional consulting”. Journal of Telemedicine and Telecare 5 (2002): 283-289.
26. Holmner A., et al. “Carbon footprint of telemedicine solutions--unexplored opportunity for reducing carbon emissions in the health sector”. PLoS One9 (2014): e105040.
27. World Health Organization. Telemedicine: Opportunities and developments in member states: Report on the second global survey on eHealth: Global Observatory for eHealth series - Volume 2. WHO (2010).
28. Gilbert AW., et al. “Rapid implementation of virtual clinics due to COVID-19: report and early evaluation of a quality improvement initiative”. BMJ Open Quality 2 (2020): e000985.
29. Ferguson T. “From Doc-Providers to Coach-Consultants: Type 1 Vs. Type 2 Provider-Patient Relationships” (2001).
30. Wiederhold BK., et al. “Future directions: advances and implications of virtual environments designed for pain management”. Cyberpsychology, Behavior, and Social Networking6 (2014): 414-422.
31. Bakhai M and Atherton H. “How to conduct written online consultations with patients in primary care”. British Medical Journal 372 (2021): n264.
32. Hao J., et al. “Research on the use of online health community in tertiary hospitals: A case of Beijing”. Chinese Journal of Health Policy 13 (2020): 31-36.
33. Johns G., et al. “Remote mental health services: a mixed-methods survey and interview study on the use, value, benefits and challenges of a national video consulting service in NHS Wales, UK”. BMJ Open9 (2021): e053014.
34. Bolle SR., et al. “Video conferencing versus telephone calls for team work across hospitals: A qualitative study on simulated emergencies”. BMC Emergency Medicine 9 (2009): 22.
35. Capampangan DJ., et al. “Telemedicine versus telephone for remote emergency stroke consultations: A critically appraised topic”. Neurologist 3 (2009): 163-166.
36. Seuren LM., et al. “Physical examinations via video for patients with heart failure: qualitative study using conversation analysis”. Journal of Medical Internet Research 2 (2020): e16694.
37. McKinstry B., et al. “The quality, safety and content of telephone and face-to-face consultations: a comparative study”. Quality and Safety in Health Care 4 (2010): 298-303.
38. Parsons J., et al. “Use of a pharmacy-based GP video consultation service: a mixed methods study”. Family Practice2 (2023): 241-247.
39. Björndell C and Premberg Å. “Physicians' experiences of video consultation with patients at a public virtual primary care clinic: a qualitative interview study”. Scandinavian Journal of Primary Health Care 1 (2021): 67-76.
40. Yan M., et al. “The roles of trust and its antecedent variables in healthcare consumers’ acceptance of online medical consultation during the COVID-19 pandemic in China”. Healthcare9 (2023): 1232.
41. Shaw S., et al. “Advantages and limitations of virtual online consultations in an NHS acute trust: The VOCAL mixed-methods study”. Health Services and Delivery Research21 (2018): 1-136.
42. Nyoni T., et al. “Perceived barriers and facilitators to adopting telemedicine infectious diseases consultations in southeastern Missouri hospitals”. Journal of Telemedicine and Telecare (2023): 1357633X2211494.
43. Jung C and Padman R. “Virtualized healthcare delivery: Understanding users and their usage patterns of online medical consultations”. International Journal of Medical Informatics12 (2014): 901-914.
44. Stevenson F., et al. “General practitioner's use of online resources during medical visits: Managing the boundary between inside and outside the clinic”. Sociology of Health and IllnessS1 (2019): 65-81.
45. Gong K., et al. “Internet hospitals help prevent and control the epidemic of COVID-19 in China: Multicenter user profiling study”. Journal of Medical Internet Research 4 (2020): e18908.
46. Zhang Y. “Dynamic power relations in online medical consultation in China: Disrupting traditional roles through discursive positioning”. Chinese Journal of Communication4 (2021): 369-385.
47. Almathami HKY., et al. “Barriers and facilitators that influence telemedicine-based, real-time, online consultation at patients’ homes: systematic literature review”. Journal of Medical Internet Research2 (2020): e16407.
48. Pandey S. “Toll-like receptors-autophagy immuno-inflammatory “molecular cross-talks” in hypoxic tumor microenvironment in complex neurological diseases primarily glioblastoma: translational research impact in genetically susceptible population-pools in Covid-19/omicron pandemic era”. Advance Research in Sciences 2 (2023): 1009.