Videoconference compared to telephone in healthcare delivery: A systematic review

Introduction: Telehealth is an important tool for ensuring accessible healthcare access particularly over geographical distances. Videoconference and telephone are two common telehealth modalities, yet little is known as to the relative advantage of these modalities. Synthesizing evidence as to the impact of these modalities is important to optimize patient, provider, and health system outcomes.

Objectives: To conduct a review comparing the effectiveness of videoconference versus telephone in the delivery of healthcare.

Methods: This systematic review examined citations from three databases - EMBASE, CINAHL, PUBMED - using the search words telehealth, videoconference, and telephone. From 150 records published between 2000 and 2018, eight high to moderate quality studies were selected for review.

Results: Videoconference and telephone were compared in adults and children across a range of contexts, and health challenges. Overall, videoconference was comparable or better than telephone in reducing healthcare utilization, but healthcare costs were highly variable across studies. Consultations done by videoconference typically took longer than by telephone, however activities included in the consultations differed across studies. Provider-related outcomes using videoconference were superior compared to telephone, particularly with the stroke sub-population. Videoconference resulted in fewer medication errors, greater diagnostic accuracy, and improved decision-making accuracy when compared to telephone. Patient outcomes were generally comparable between videoconference and telephone with no consistent differences in patient mortality or patient satisfaction.

Conclusions: Videoconference appears to offer advantages over telephone particularly improved provider diagnostic accuracy and reduced readmission rates. Evidence showed little differences between the two modalities in terms of patient outcomes. However, the small heterogeneous sample prevents generalizability of the findings. More research is needed in this area to determine the circumstances under which videoconference is superior to telephone as a telehealth modality.