Efficiency Potentials of Digital Practice-Patient Communication for Outpatient Medical Practices : Results of a Mixed Methods Systematic Review

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Burkard, Michael ; Weber, David ; Emmert, Martin:
Efficiency Potentials of Digital Practice-Patient Communication for Outpatient Medical Practices : Results of a Mixed Methods Systematic Review.
2025
Veranstaltung: 16th IHEA World Congress , 19.-23.07.2025 , Bali, Indonesia.
(Veranstaltungsbeitrag: Kongress/Konferenz/Symposium/Tagung , Vortrag mit Paper )

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Abstract

Background: The shortage of skilled workers and demographic changes among both patients and healthcare professionals are leading to an increasing workload in outpatient medical practices. These trends are contributing to healthcare professionals burning out and the quality of outpatient medical care being at risk. Medical practice staff craves support, especially with communication-related processes. Digital solutions for practice-patient communication (PPC) have the potential to relieve the practice staff and maintain or even optimize medical quality. As the body of knowledge on digital PPC solutions is growing in terms of their impact on medical quality, research lacks knowledge on their efficiency in outpatient medical care.

Objective: This study aimed to identify and evaluate digital PPC solutions’ efficiency potential for outpatient medical practices.

Method: This mixed methods systematic literature review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The literature search was conducted within PubMed and The Cochrane Library and included international studies that assessed digital PPC solutions’ impacts on medical practice efficiency. Peer-reviewed full texts written in English and published between January 2019 and June 2024 were selected. Data were narratively summarized, categorized in time, staff, material, and cost efficiency, and evaluated regarding their impact. For synthesis of the quantitative and qualitative data, a convergent integrated approach was applied based on the JBI Manual for Evidence Synthesis. Bias assessment was performed using the AXIS (quantitative studies) and CASP (qualitative studies) checklists.

Results: The systematic screening comprised 4,237 articles. Finally, 22 studies (15 quantitative, 7 qualitative) were identified, including 2,670 physicians, 21 non-physician staff, and 301,534 patient appointments. The identified studies assessed efficiency potentials for the following PPC solutions: video consultation (10 studies), video or telephone consultation (not further specified; 8), online messaging (3), SMS (2), patient portal (1), online scheduling (1), and remote patient monitoring (1). Time was the dominant efficiency category with preparation time (15 categorizations) and process duration (17). Interestingly, staff (3) and material (1) were rarely directly mentioned and cost not at all. Summarized, video consultation was rated positively or equally (81%) and online messaging negatively (75%) compared to the standard of communication, whereas SMS, patient portal, online scheduling, and remote patient monitoring were exclusively rated positively or equally. When preparation time was mentioned, most studies (70%) reported positive impacts for all PPC solutions. In terms of process duration, however, the results were indifferent with a positive trend. Regarding staff, there was a tendency that additional non-physician staff were needed for video consultations.

Conclusions: Except online messaging, all other PPC solutions examined were associated with efficiency improvements or equivalent efficiency outcomes. However, video consultation was also associated with some negative efficiency impacts, which is why a differentiated look at individual PPC solutions is necessary. Since the literature has largely focused on video consultation and time efficiency, further research on other PPC solutions and efficiency categories is required. The results can serve as guidance for policy and practice in the further development and implementation of efficient digital PPC solutions.