Medical Teleconsultation Research Articles

The Role of Self-Determination Theory in Explaining Patients' Motivation to Continue Using Telemedicine in a Post-Pandemic World

COVID-19 has led to a considerable increase in telemedicine use by physicians and patients. However, usage is expected to decline post-pandemic despite the benefits in terms of convenience, reachability, accessibility, and cost. We are investigating antidotes to this supposed decline from the patient’s perspective: Which psychological needs and motivations may increase the patient’s satisfaction with telemedicine and her or his continuance intention? Our research combines the well-known Expectation-Confirmation Model (ECM) from satisfaction research with motivation antecedents and outcomes according to Self-Determination Theory (SDT). We developed and shared a self-administered questionnaire in online health communities. A patient sample (n = 464) participated in the survey. A subsample (n = 151) had experiences with medical teleconsultation or similar medical applications, whereas other patients (n = 313) with teleconsultations in administration, business, or education only. Overall, both subsamples reveal almost the same results. Perceived usefulness (e.g., time-saving and quick access to healthcare treatment) is the most important continuance intention predictor. However, psychological needs from SDT (e.g., perceived competence and perceived relatedness) also determine motivation, satisfaction, and continuance intention. The combination of ECM and SDT appears to lay the foundation for improved research for digitalized healthcare delivery. Further, both subsamples demonstrate high satisfaction with telemedicine. Nevertheless, telemedicine providers and marketers should carefully optimize the patient journey while minimizing patient waiting time and focus on understanding users’ health needs to differentiate their services in the market.

National emergency medical teleconsultation: A novel system applied during the COVID-19 pandemic in Taiwan.

Telemedicine can facilitate social distancing during an infectious disease pandemic and reduce the burden on health-care resources. Moreover, telemedicine can be utilized for medical care in remote island regions, in home health care, and during isolated major disasters such as regional earthquakes. However, the effectiveness of telemedicine for emergency consultation remains unclear. This study introduced and analyzed the national emergency medical teleconsultation (NEMTC) established in Taiwan in 2022 during the COVID-19 pandemic. In response to the COVID-19 pandemic, Taiwan's Centers for Disease Control established a temporary 24-h NEMTC contingency system. Patient information was collected from consultations through the NEMTC from April 28 to June 28, 2022. After successful consultation, physicians made recommendations for home observation, emergency department (ED) visit, or outpatient follow-up. ED visits were divided into two categories, namely self-transport and transport, by the emergency medical service system (EMSS). During the aforementioned period, 20,902 consultation requests were made through the NEMTC, and 11,804 consultations (56.5% of 20,902) were successful. Consultation success rates were significantly higher for those who had a consultation between 08:00 and 16:00, had a waiting time of less than 10 min, and were not aged between 18 and 45 years. Moreover, 8.2% of the analyzed patients were advised to visit the ED, and only 0.4% required ambulance transportation. Children and older individuals and patients with cardiovascular symptoms, shortness of breath, or neurological or abdominal symptoms had a significantly higher chance of being referred to the ED than did other individuals. The NEMTC response system can enhance the efficiency of the EMSS and can reduce the burden of patients with mild conditions overloading the EMSS and EDs. The NEMTC could serve as an effective rapid response system during future pandemics.

Pathway for medical tele-consultation between Diabetes Unit and Community House

L’obiettivo di questo progetto è quello di strutturare un percorso ideale di teleconsulto e di teleconsulenza sanitaria, all’interno di quanto previsto dal DM 77/2022, tra il personale sanitario che fa capo a una Casa di Comunità (CdC) e la struttura Diabetologica Hub di riferimento per facilitare la comunicazione e l’integrazione dei percorsi terapeutici e assistenziali per i pazienti diabetici. Il progetto prevede l’utilizzo di due modalità di teleconsulto: il teleconsulto medico-medico in modalità asincrona tra medico specialista della struttura Hub e medico di medicina generale (MMG), la teleconsulenza medico-sanitaria tra Infermiere di Famiglia e Comunità (IFeC) e uno o più componenti del team diabetologico. L’obiettivo di tale progetto è quello di riuscire a supportare il percorso decisionale del MMG e l’attività dell’IFeC che gravitano su una stessa CdC, favorire l’empowerment dei pazienti attraverso l’accesso a prestazioni del team multiprofessionale diabetologico e migliorare l’appropriatezza degli invii in presenza alle strutture di diabetologia. Il progetto parte dall’ipotesi di adottare un investimento iniziale di 8 ore lavorative a settimana, per una media di 48 teleconsulti al mese, da destinare nel 50% dei casi a urgenze/richieste su pazienti che ordinariamente non utilizzano la telemedicina e nel restante 50% a pazienti che utilizzano già la telemedicina per presenza di condizioni di fragilità e/o difficoltà a raggiungere la struttura. Considerando un efficientamento delle prestazioni del 15% annuo, in circa cinque anni, l’investimento prestato potrebbe consentire una copertura del target fino al 62%. La strutturazione di un progetto pilota consentirebbe di comprendere la reale accessibilità delle cure ai pazienti nel tempo e dunque valutare il potenziale beneficio in termini organizzativi, di produttività per la struttura e di stato di benessere dei pazienti. PAROLE CHIAVE teleconsulto; pazienti diabetici ambulatoriali; cura del paziente diabetico.

Real-Time 3D Reconstruction Pipeline for Room-Scale, Immersive, Medical Teleconsultation

Medical teleconsultation was among the initial use cases for early telepresence research projects since medical treatment often requires timely intervention by highly specialized experts. When remote medical experts support interventions, a holistic view of the surgical site can increase situation awareness and improve team communication. A possible solution is the concept of immersive telepresence, where remote users virtually join the operating theater that is transmitted based on a real-time reconstruction of the local site. Enabled by the availability of RGB-D sensors and sufficient computing capability, it becomes possible to capture such a site in real time using multiple stationary sensors. The 3D reconstruction and simplification of textured surface meshes from the point clouds of a dynamic scene in real time is challenging and becomes infeasible for increasing capture volumes. This work presents a tightly integrated, stateless 3D reconstruction pipeline for dynamic, room-scale environments that generates simplified surface meshes from multiple RGB-D sensors in real time. Our algorithm operates directly on the fused, voxelized point cloud instead of populating signed-distance volumes per frame and using a marching cube variant for surface reconstruction. We extend the formulation of the dual contouring algorithm to work for point cloud data stored in an octree and interleave a vertex-clustering-based simplification before extracting the surface geometry. Our 3D reconstruction pipeline can perform a live reconstruction of six incoming depth videos at their native frame rate of 30 frames per second, enabling the reconstruction of smooth movement. Arbitrarily complex scene changes are possible since we do not store persistent information between frames. In terms of mesh quality and hole filling, our method falls between the direct mesh reconstruction and expensive global fitting of implicit functions.

ATA2023Annual Conference & ExpoMarch 4–6, 2023San Antonio, Texas

ATA2023Annual Conference & ExpoMarch 4–6, 2023San Antonio, Texas

Health professionals’ views of medical teleconsultation uptake in the Brazilian Unified Health System: A description using the NASSS framework

BackgroundThe COVID-19 pandemic accelerated efforts to deploy and regulate medical teleconsultation in Brazil. Studying the Brazilian Unified Public Health System (SUS) experiences in implementing teleconsultations can help to inform their sustainability. This study identifies the changes required to integrate specialized teleconsultation in local workflows in SUS. MethodsA case study of teleconsultation performed by a University Hospital and a Municipal Specialty Outpatient Clinic in the south of Brazil collected information from two focus groups with specialised doctors, two key informant interviews and associated documents. The Non-adoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework domains of condition, technology, proposal value, users and organization informed a qualitative thematic analysis of this data. ResultsSeveral forms of teleconsultation were used to manage paediatrics and endocrine conditions including instant messaging, WhatsApp, telephone calls and video consultations which were also used for dermatology. In Brazil, telephone interactions are not considered teleconsultation. In contrast, video consultations were longer than face-to-face appointments, facilitate the understanding and evaluation of conditions, and offered continuity of care, comfort, and safety, without the need for patients to travel, reducing the risk of infection. Patients accepted video consultations to varying degrees but some found it difficult to use the technology. The willingness of doctors to provide any form of teleconsultation was important. Management support was key to defining workflows, coordinating care pathways, and providing technical support. ConclusionsThis study highlights particularities of teleconsultation uptake for the included specialities. The NASSS framework provides a useful means of identifying the changes to enable teleconsultation continuity for specialised care in SUS.

Perception and Attitude toward Teleconsultations among Different Healthcare Professionals in the Era of the COVID-19 Pandemic.

Teleconsultation has become one of the most important and sometimes the only possible forms of communication between healthcare professionals (HCPs) and their patients during the COVID-19 pandemic. The perceptions and attitudes of HCPs to teleconsultations may affect the quality of the therapeutic process provided using them. Therefore, this study aimed to understand the attitudes to and perceptions of medical teleconsultation among various HCPs during the COVID-19 pandemic. We analyzed data from a dedicated questionnaire on preferences, attitudes, and opinions about teleconsultation, which was filled by 780 Polish HCPs. Most of the HCPs were doctors and nurses (69% and 19%, respectively); most of the doctors were family physicians (50.1%). During the pandemic, teleconsultation and face-to-face contact were reported as the preferred methods of providing medical services with similar frequency. Doctors and nurses displayed the most positive attitude toward teleconsultation while the paramedics and physiotherapists took the least positive view of it. The most frequently indicated ratio of the optimal number of teleconsultations to in-person visits in primary health facilities care was 20%:80%. Most HCPs appreciate the value of teleconsultation, and more than half of them are willing to continue this form of communication with the patient when necessary or desirable.

Teleconsultation at Sea and Acute Wound Management Onboard.

Introduction: The French Tele-Medical Assistance Service (TMAS) provides medical teleconsultation for any ship at sea. At the end of the consultation, the doctor decides whether the problem can be taken care of onboard or not. In this study, we determined the factors associated with the decision for disembarkation or evacuation in case of wounds. Methods: We conducted a retrospective epidemiological study between 2011 and 2019 from consultations with the French TMAS. The inclusion criterion was the presence of an acute wound. Results: One thousand six patients (n = 1,006) were analyzed and 586 (58%) patients were disembarked or evacuated. Factors associated with disembarkation or evacuation are wound characteristics (severity and location), the onboard staff's medical training, the availability of photography, and the ship's location. Wound severity is a risk factor for disembarkation or evacuation. The availability of photography, staff with advanced training, and being at >1 day of navigation from a harbor are protective factors against being disembarked or evacuated. Conclusion: The added value of photography and an update of medium medical training could increase the number of wounds taken care of onboard.

Kewajiban BPJS Kesehatan dalam Pemberian Pelayanan Telekonsultasi Klinis yang Dilakukan Antara Dokter dan Pasien BPJS

BPJS Health Obligations in Providing Clinical Teleconsultation Services Performed between Doctor and BPJS’ Patients By the decree of the minister of health of the Republic of Indonesia HK.01.07/MENKES/4829/2021 on guidelines of telemedicine utilization to prevent coronavirus disease 2019 (Covid-19). Telemedicine provided by doctors in medical teleconsultation form has been widely considered in this pandemic era. This research uses normative legal research. The approach used in this research is applying the law and the conceptual approach. The result showed various legal norms for BPJS healthcare medical teleconsultation in terms of service. However, BPJS healthcare users are said to be burdened by medical teleconsultation fees, which is different from the initial legal norms. Therefore, it can be said that BPJS has done unlawful acts and is an opening chance for BPJS healthcare users to sue BPJS. Therefore, the researcher recommends that the government make rules regarding the clinical teleconsultation system so that it can run according to its function when needed, for example, during the current covid-19 pandemic. Thus, the task of BPJS in organizing national health insurance for all Indonesian people can be realized. In addition, BPJS Health is required to guarantee the legal protection of patients in clinical teleconsultation services so that the rights and obligations of BPJS participants can be fulfilled. If the rights of the BPJS participants are not fulfilled, the BPJS participants can make mediation efforts. If the mediation mechanism cannot be implemented, the settlement can be submitted to the District Court in the area where the participant lives.

Assessing the Quality of Direct-to-Consumer Teleconsultation Services in Canada.

The objective of this study was to describe and assess the quality of the direct-to-consumer medical teleconsultation landscape in three Canadian provinces. An environmental scan of primary care teleconsultation platforms was conducted in January 2022 to identify medical teleconsultation platforms in Quebec (Qc), Ontario, and British Columbia (BC). The quality of each teleconsultation platform was assessed using a modified version of the HONcode principles. Nineteen different direct-to-consumer medical teleconsultation platforms were identified across the three provinces. The quality of these teleconsultation platforms was very heterogeneous. The landscape of virtual primary care is changing rapidly in the Canadian ecosystem, and the transparency of current teleconsultation platforms could be improved.

Teleconsultations Quality During the COVID-19 Pandemic in Poland in the Opinions of Generation Z Adults.

Introduction: The aim of the study was to collect and evaluate the opinions of representatives of Generation Z on their satisfaction with medical teleconsultation services during the COVID-19 pandemic in Poland. Methods: An online survey was conducted from April to June 2021. We received replies from 424 students. The research tools used comprised a validated Doctor-Patient Communication (DPC) questionnaire, the Telehealth Satisfaction Scale (TeSS), and a self-authored questionnaire. Results: About 60% of the respondents rated communication with a doctor during the remote visit as medium, with a DPC score value in the intermediate range (36-50). Only 7.5% of students rated DPC as high (DPC score over 50). Also, satisfaction with telemedicine measured by the modified Telehealth Satisfaction Scale was assessed as intermediate by 61.3% of respondents. DPC and satisfaction with telemedicine services are better assessed by students living in large cities and those who used paid telemedicine services. Conclusions: The need to improve the quality of DPC has been observed. Also, the functioning of telemedicine platforms, with the possibility of using images in teleconsultations would be welcome, with the concomitant leveling out of the disproportions in the quality of telemedicine services and DPC between urban and rural areas, as well as between commercial and noncommercial services. This could improve the service delivery process and, consequently, be beneficial for the competitiveness of telemedicine, which will be based on medical rather than organizational aspects.

Enabling Cost-Effective and Secure Minor Medical Teleconsultation Using Artificial Intelligence and Blockchain

While the onset of the COVID-19 pandemic has increased the popularity of home-based consultations, worries over privacy, high consultations costs, slow response times, and the burden on doctors due to the overwhelming number of COVID-19 cases have made current in-person and online models ineffective. In this study, we present an advanced, privacy-protected, artificial intelligence and blockchain-based consultation framework for minor medical conditions. Patients can post their medical queries anonymously on the blockchain network, which may be answered by any available medical professionals. The queries are sorted into their respective domains using naive Bayes and logistic regression. The consultations provided by medical specialists are evaluated based on their reputation, expertise, detail orientation, and the use of supporting documents, and rewards are given in accordance with the evaluation scheme. This fair and incentivized system provides cheaper and more accessible healthcare to patients, which is the need of the hour.

The Impact of the COVID-19 Outbreak on Patients' Adherence to PCSK9 Inhibitors Therapy.

PCSK9 inhibitors (PCSK9i) are monoclonal antibodies that have been shown to be effective in reducing both LDL cholesterol (LDL-C) values and major cardiovascular events in patients at high cardiovascular risk. Adherence to PCSK9i is critical for the success of the treatment. The aim of the present study is to evaluate patients’ adherence to PCSK9i during the COVID-19 pandemic. Patients referred to the Cardiac Diagnostic Unit of the University of Campania “Luigi Vanvitelli” Naples, taking PCSK9i, and who missed the cardiological follow-up visit during the first national COVID-19 lockdown (9 March–17 May 2020), were included. Each patient underwent medical teleconsultation to collect current clinical conditions, adherence to drug treatments, and lipid profile laboratory tests. Among 151 eligible patients, 20 were excluded for missing or untraceable telephone numbers and one for refusing to join the interview. The selected study population consisted of 130 patients (64 ± 9 years, 68% males), of whom 11 (8.5%) reported a temporary interruption of the PCSK-9 therapy for a mean period of 65 ± 1.5 days. The non-adherent patients showed a marked increase in LDL-C than in the pre-pandemic period (90.8 ± 6.0 vs. 54.4 ± 7.7 mg/dL, p < 0.0001), and 82% of patients moved out of the LDL-C therapeutic range. The non-adherent group was more likely to have a very high cardiovascular risk compared to the adherent group (81.8 vs. 33.6%, p < 0.001). Causes of interruption included drug prescription failure (63.6%) due to temporary interruption of the non-urgent outpatient visits and failure in drug withdrawal (36.4%) due to patients’ fear of becoming infected during the pandemic. The COVID-19 lockdown caused a remarkable lack of adherence to PCSK9i therapy, risking negative implications for the health status of patients at high cardiovascular risk. Facilitating patients’ access to PCSK9i and enhancing telemedicine seem to be effective strategies to ensure the continuity of care and appropriate management of these patients.

Medical Teleconsultation Uptake for Specialized Care in the Brazilian Unified Health System: A Description Using the NASSS Framework

Medical Teleconsultation Uptake for Specialized Care in the Brazilian Unified Health System: A Description Using the NASSS Framework

Impact of the COVID-19 Pandemic Crisis on the Health Care System in Less Developed Regions of Poland

Purpose: The aim of the study was to develop a model for assessing the satisfaction of patients of GP practice with access to health services in the Lubelskie Voivodeship, in terms of eliminating inequalities in the quality of these services and developing a scenario for the revitalization of the health care system in relation to the inhabitants of the underdeveloped region in the period after the cessation of pandemic. Design/Methodology/Approach: The research method included developing a research tool in the form of a survey questionnaire, validating the tool, conducting Phase I and II of the survey, and evaluating the performance of the outpatient specialty care subsystem. The analysis of the research results was directed at developing the assumptions of a model for restoring functionality and increasing resilience of the healthcare system. Findings: It was found that the level ofpatient satisfaction with the functioning of the health care system during a pandemic, both in the form of medical tele-consultation and in the form of direct contact with personnel in a health care facility, depends on the age and the level of education. There were no differences in terms of sex and place of residence (town, village). It was also found that the very limited availability of advanced diagnostic methods, showing an unfavorable trend in the period preceding the outbreak of the pandemic, deteriorated further and poses a critical threat to the functioning of the health care system for patients with chronic diseases (oncological, neurodegenerative etc.). Practical Implications: The results of the research will be used to construct a model for the reconstruction and revitalization of the health care system in the Lubelskie Voivodeship after the pandemic. Originality/Value: The study presents results of the current research. The development of the research results will be continued in order to construct a comprehensive model.

SINERGI HALODOC DALAM MUTU PELAYANAN RUMAH SAKIT DI MASA PANDEMI COVID 19

One of the developments in information system technology in the health sector via the internet is E-health. The Medical Teleconsultation solution offered is very helpful for the Indonesian health system in screening patients with a risk of Covid 19. Halodoc is the number 1 health application in Indonesia. The purpose of this study was to determine the Halodoc synergy in the quality of hospital services on patient satisfaction, trust, and loyalty. This research was conducted in a type c hospital in collaboration with Halodoc in Denpasar, namely Surya Husada Hospital and Bali Royal Hospital. Taken a sample of 50 respondents at each hospital. Data collection techniques using a questionnaire. This study uses data analysis methods using Smart PLS software. The results of this study were Halodoc Medical teleconsultation proved to have a positive and significant effect on patient satisfaction, patient confidence and patient loyalty. The quality of hospital services is proven to have a positive and significant effect on patient satisfaction and patient confidence. Halodoc Medical Teleconsultation proved to have a positive and significant effect on the quality of hospital services. Related to the research results, it was found that some people still trust their health fully by consulting directly with medical personnel at the hospital. This research will become an illustration to see the development of medical teleconsultation in Indonesia. As well as indirectly seeing to what extent the role of Halodoc Medical Telecosultation is able to provide optimal health services in the midst of the Covid 19 pandemic.

Teleconsultation Apps in the COVID-19 Pandemic: The Case of Guayaquil City, Ecuador

The new coronavirus disease (COVID-19) has affected a large part of the worldwide population, causing more than a million deaths between the end of 2019 until now. Technological development and digital tools arise to carry out activities remotely, either for monitoring or diagnosis. Medical teleconsultation activities are not new, but due to the pandemic situation that the COVID-19 originated, it has become a popular option to avoid going to consultations physically due to the risk of contagion. This article presents an analysis of different teleconsultation services implemented during the spread of the COVID-19 in the city of Guayaquil, Ecuador, as a case study. The methodology includes a performance assessment of the teleconsultation apps used during the critical periods of the pandemic. We detailed the fundamental stages deemed to verify that the fulfillment and knowledge about telemedicine in this city are not extensive enough in terms of remote health benefits. Throughout this article, we evidenced that the population is not prepared to manage remote-care systems due to the low use of technology and the lack of support from public or private agencies for providing technological development for medical services that satisfy the needs of the inhabitants.

Structure and work process for implementing medical teleconsultation in the Brazilian National Health System, a cross-sectional study using 2017-2018 data.

To compare the structure and the work process in Primary Care for implementing medical teleconsultation in municipalities in different regions and with different population sizes (<25,000; 25,000-100,000; >100,000 inhabitants). Cross-sectional study, with descriptive and bivariate analysis, using data from 2017-2018 to assess the availability of computers with internet access, webcam, microphone, speaker, as well as to assess the work processes (use of Telehealth, service supply and demand control center, and communication flow). 30,346 primary health centers and 38,865 teams were evaluated. Presence of teleconsultation equipment in the health centers ranged from 1.2% in large northern municipalities to 26.7% in small southern municipalities. Established work process ranged from 10.7% in small northern municipalities to 39.5% in large southern municipalities. Compared to the South, medium-sized municipalities in the North (OR=0.14 - 95%CI 0.11;0.17) and Northeast (OR=0.21 - 95%CI 0.18;0.25) regions were less likely to have the necessary equipment. Significant regional inequalities call for investments in Digital Health.

Designing a novel hybrid healthcare teleconsultation network: a benchtop study of telepathology in Iran and a systematic review

BackgroundGrowing demand for medical services has increased patient waiting time due to the limited number or unbalanced distribution of healthcare centers. Healthcare teleconsultation networks are one of the potentially powerful systems to overcome this problem. Medical pathology can hugely benefit from teleconsultation networks because having second opinions is precious for many cases; however, resource planning (i.e., assignment and distribution of pathology consultation requests) is challenging due to bulky medical images of patients. This results in high setup and operational costs. The aim of this study is to design an optimal teleconsultation network for pathology labs under the supervision of medical sciences universities in Tehran, Iran.MethodsTo avoid the setup cost, we first propose a modified hybrid peer-to-peer (P2P) overlay architecture for our telepathology network, using Iran’s National Healthcare Information Network (SHAMS) as the underlying infrastructure. Then we apply optimization techniques to solve the request assignment and distribution problems in the network. Finally, we present a novel mathematical model with the objective of minimizing the variable operational costs of the system.ResultsThe efficiency of the proposed method was evaluated by a set of practical-sized network instances simulated based on the characteristics of SHAMS. The results show that the presented model and architecture can obtain optimal solutions for network instances up to 350 nodes, which covers our target network.ConclusionsWe believe that the proposed method can be beneficial for designing large-scale medical teleconsultation networks by adjusting the constraints according to the rules and conditions of each country. Our findings showed that teleconsultation networks in countries with strong information technology (IT) infrastructures are under the influence of consultation fees, while in countries with weak IT infrastructure, the transmission costs are more critical. To the best of our knowledge, no research has so far addressed resource planning in medical teleconsultation networks using optimization techniques. Besides, the target network, i.e., pathology labs under the supervision of medical sciences universities in Tehran and the SHAMS network, are discussed for the first time in this work.

Teleconsultation: an Integrative Review of the Doctor-Patient Interaction Mediated by Technology

Abstract: Medical teleconsultation can apply different technologies to mediate the communication between doctors and patients located in different geographic spaces. Its implementation has been encouraged in several countries, under the assumption of its potential to overcome distances, offering health care in a shorter time, reducing costs and workload. The scarcity of evidence about these allegations, in addition to the need of clarifying the situations in which teleconsultation can be adequate, safe and effective, have generated debates, intensified after the publication of Resolution N. 2.227/2018 by the Federal Council of Medicine, which allowed medical teleconsultation, containing principles and recommendations. This article aims to analyze the international experience of medical teleconsultation, including the media and technologies employed, their use, benefits and limitations, highlighting and associating the controversial points of the resolution recently published by the Federal Council of Medicine. An integrative review of the literature was carried out to identify these experiences from January 2013 to February 2019. Of the 1912 identified references, 42 were analyzed after applying the exclusion and inclusion criteria. Data collection and analysis indicated that telephone, e-mail, e-consulting systems, video or a combination of those have been used in several countries to mediate the doctor-patient relationship. Its use goes ranges from diagnosis to treatment, monitoring, management and prescription, both in acute and chronic conditions. The main benefits include less demand for face-to-face consultations, with the possibility of doctors’ workload management, allowing systems’ reorganization. Moreover, the teleconsultation allows overcoming distance barriers, in a flexible and convenient way for patients, possibly contributing to continuity of care, patient autonomy and resource savings, in the latter case, when it avoids work absenteeism due to face-to-face consultation. Some limitations of the teleconsultation include the inability to perform the physical examination, so it is not recommended for the first consultation. Technical and communication difficulties for each media, as well as its inadequacy for some groups of patients, are other important barriers. Data security regarding diagnosis and clinical precision, patients’ and professionals’ acceptance and the need for organizational adjustments are also considered limitations of the teleconsultation. The success of the teleconsultation depends on the integration of different organizations and professionals, aiming to maximize its potential and improve service design, encompassing clinical, technical, organizational and context issues. Therefore, it is important to investigate in which contexts, situations and conditions the teleconsultation can be beneficial, safe and effective for patient care, as well as the most appropriate means of communication.