Comprehensiveness of the Telemedicine Assessment Toolkit for the Assessment of Audiovisual Telemedicine Encounters

Background: The use of telemedicine for continuity of care during disruptions in health care delivery and routine primary care is now well known. Insufficient scientific evidence from assessing telemedicine persists, with widespread use of nonvalidated questionnaires resulting in the inability to pool data on the quality of telemedicine encounters from numerous small-sample studies. This study examines the comprehensiveness of the recently developed Telemedicine Assessment Toolkit (TAT), among articles published after the toolkit was created. Methods: We conducted a PubMed search for articles that used questionnaires to assess telemedicine encounters, published between November 1, 2021, and July 31, 2023. We extracted individual questions from nonvalidated questionnaires and analyzed them to determine their similarity with TAT items. We used a statistical proportion test to see if rates of inclusion were similar across the initial TAT questionnaires and the follow-up set. We calculated p-values for proportions. Results: The database search had an initial yield of 277 articles in which there were 21 articles each with its nonvalidated questionnaire and 348 individual questions. Test of proportions revealed no statistical difference between initial and follow-up articles tested, adjusted for multiple tests. Further analysis found that 85.6% (298 of 348) of the questions used in the follow-up articles match items in the TAT. Conclusion: These results provide insight into the comprehensiveness and potential suitability of the TAT as a toolkit for telemedicine assessment. Future work to standardize TAT involving expert, cognitive testing, and weighting toward a single score would improve telemedicine encounter assessment.