Online Medical Services Research Articles

Factors associated with successful implementation of telehealth abortion in 4 United States clinical practice settings

ObjectiveTo overcome obstacles to delivering medication abortion services during the COVID-19 pandemic, clinics and providers implemented new medication abortion service models not requiring in-person care. This study identifies organizational factors that promoted successful implementation of telehealth and adoption of “no test” medication abortion protocols. Study designWe conducted 21 semi-structured, in-depth interviews with health care providers and clinic administrators implementing clinician-supported telehealth abortion during the COVID pandemic. We selected 15 clinical sites to represent 4 different practice settings: independent primary care practices, online medical services, specialty family planning clinics, and primary care clinics within multispecialty health systems. The Consolidated Framework for Implementation Research guided our thematic analysis. ResultsSuccessful implementation of telehealth abortion included access to formal and informal inter-organizational networks, including professional organizations and informal mentorship relationships with innovators in the field; organizational readiness for implementation, such as having clinic resources available for telehealth services like functional electronic health records and options for easy-to-use virtual patient-provider interactions; and motivated and effective clinic champions. ConclusionsIn response to the need to offer remote clinical services, 4 different practice settings types leveraged key operational factors to facilitate successful implementation of telehealth abortion. Information from this study can inform implementation strategies to support the dissemination and adoption of this model. ImplicationsExamples of successfully implemented telehealth medication abortion services provide a framework that can be used to inform and implement similar patient-centered telehealth models in diverse practice settings.

TANGGUNG JAWAB HUKUM DOKTER TERHADAP KONSULTASI VIA ONLINE APABILA PASIEN MENGALAMI KERUGIAN

Health is the need of every human being in living his life. Health is also very important because without good health, it will be difficult for every human being to carry out his daily activities. Entering an era of rapid development, the world is faced with the emergence of new technologies in the medical field that allow doctors to practice in a virtual space. The legal basis of online medical services as well as to analyze the legal responsibility of doctors in providing online medical services if a patient experiences a loss. Type of research is a normative juridical research and analysis of legal materials. The approach used in this study is a statutory approach and a conceptual approach. Until now, there have been no detailed regulations regarding online-based medical services, both in statutory provisions and in the provisions of the medical code of ethics. Law Number 36 of 2009 concerning Health and Law Number 29 of 2004 concerning Medical Practice have so far not been used as a reference for the implementation of medical practice using online-based medical services. Furthermore, Law Number 11 of 2008 concerning Electronic Information and Transactions also cannot be used as a reference.

Health Information System's Responses to COVID-19 Pandemic in China: A National Cross-sectional Study.

After the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, Chinese hospitals and health information technology (HIT) vendors collaborated to provide comprehensive information technology support for pandemic prevention and control. This study aims to describe the responses from the health information systems (HIS) to the COVID-19 pandemic and provide empirical evidence in the application of emerging health technologies in China. This observational descriptive study utilized a nationally representative, cross-sectional survey of hospitals in China (N = 1,014) from 30 provincial administrative regions across the country. Participants include hospital managers, hospital information workers, and health care providers. Among all the responses, the most popular interventions and applications include expert question-and-answer sessions and science popularization (61.74%) in online medical consultation, online appointment registration (58.97%) in online medical service, and remote consultation (75.15%) in telehealth service. A total of 63.71% of the participating hospitals expanded their fever clinics during the pandemic, 15.38% hospitals used new or upgraded mobile ward rounds systems, and 44.68% hospitals applied online self-service systems. Challenges and barriers include protecting network information security (57.00%) since some hospitals experienced cybersecurity incidents. 71.79% participants hope to shorten wait time and optimize the treatment process. Health care workers experienced increased amount of work during the pandemic, while hospital information departments did not experience significant changes in their workload. In the process of fighting against the COVID-19, hospitals have widely used traditional and emerging novel HITs. These technologies have strengthened the capacity of prevention and control of the pandemic and provided comprehensive information technology support while also improving accessibility and efficiency of health care delivery.

An internet-based multidisciplinary online medical consultation system to help cope with pediatric medical needs during the COVID-19 outbreak: a cross-sectional study.

BackgroundTelemedicine is becoming an emerging innovative supplement to the traditional medical system in China. In the present study, we described the rapid implementation of the telemedicine in pediatrics during the coronavirus disease 2019 (COVID-19) outbreak and explored its value in response to the demand for pediatric medical services during the epidemic.MethodsAn Internet-based platform for multidisciplinary online medical consultation was established on February 8, 2020, by a national children’s medical center in China. The medical data of the traditional hospital visits and novel online visits from the first two months (February 8 to March 31) after the establishment of the platform were collected and analyzed. The demographic features, changes in the disease spectrum and characteristics of online medical services were described.ResultsThe total number of visits was significantly lower (by 75.3%) than that of in the same period in the previous year. The disease spectrum was different with a significant decrease of >95% in the number of patients with infectious or contagious diseases. The online visits accounted for 14.7% of all visits. Online patients came from all over the country, covering 91% of the administrative regions of China, and the largest proportion of inquiries were for infants (33.7%) (P<0.01). The response rate of experts to requests for online consultations was 100%. During the study period, 266 experts from 25 pediatric specialties completed 12,318 effective consultations, proving different degrees of online supplementation for various specialties (4.3–168.4%). Online consultations mainly addressed two types of problems: (I) accessibility of the traditional hospital visits and (II) consultations regarding an illness. Data from pediatric nephrology showed that 96% of the patients with stable chronic kidney disease successfully received follow-up medication adjustment guidance through the online platform.ConclusionsThe traditional hospital medical services have been affected by the COVID-19 outbreak. The multidisciplinary online medical consultation system is a strategy to actively respond to the medical needs of children during unique periods.

Privacy Concerns Over the Use of Webcams in Online Medical Education During the COVID-19 Pandemic.

The emergence of the coronavirus diseases 2019 (COVID-19) pandemic has transformed traditional classroom education to online learning worldwide. Challenges to this sudden transformation include protecting student privacy while using online medical education services. Consequently, dealing with challenges to online medical education became a heated debate at Alfaisal University. This study aimed to determine the challenges of using webcams during online classes and the ensuing implications for medical education during the COVID-19 pandemic. A cross-sectional study was conducted during the 2020-2021 academic year. The study investigators developed and validated a self-administered online questionnaire that targeted preclinical and clinical medical students at Alfaisal University, which is a private not-for-profit academic institution that was founded in 2008. Alfaisal University consists of five colleges: Medicine, Business, Engineering, Pharmacy, and Science. A total of 319 medical students completed the study questionnaire, with a response rate of 25%. The median age of the study sample was 21 years, with 63.3% females; 78.1% were in preclinical (first to third) years and 21.9% were in clinical (fourth to fifth) years. Of the respondents, 76.5% reported not using webcams when communicating via social media and 64.3% preferred blended learning, i.e., a combination of face-to-face and online learning. An overwhelming majority (91.5%) of study respondents were against using webcams in online classes for reasons including privacy (88.4%) and anxiety (64.4%). Privacy was the main concern of study respondents. Information about online privacy, including information being collected and how it will be used, should be provided to the students. Effective strategies to improve online learning experiences and protect the privacy of students should be explored.

Exploring the freemium business model for online medical consultation services in China

Online medical consultation (OMC) is an emerging form of e-health service that is gaining popularity both within China and worldwide. Among the various issues facing OMC, patients’ sustained participation and payment remain challenging. This study seeks to understand the relationship between patients’ initial and subsequent OMC participation and their payment behaviors using an established OMC platform in China (i.e., Haodf.com). By drawing on a goal-directed perspective, this study explores patients’ OMC participation (i.e., information provision quantity, reply time, and payment) at two stages of the goal pursuit process (i.e., initial versus subsequent). Moreover, we investigate the potential differences between the freemium (i.e., try-before-you-buy) and direct pay patients. Hierarchical linear modeling analysis of 34,706 OMC service records reveals that initial patient information provision (as measured by quantity and reply time) significantly impacts the patient's subsequent information provision and payment. However, a timely reply from the doctor facilitates the patient's subsequent information provision but does not influence payment decisions. Freemium patients and direct pay patients do not differ significantly in most participation measures. These findings offer insight to OMC platforms and service providers who wish to enhance sustained patient participation.

The Construction and Practice of Internet Hospital in Hospital J

Background With the increasing demand for diversified health of the public and the increasingly mature technology of "Internet + medical treatment", the online business of hospitals continues to extend and expand. Under this background, Internet hospitals have witnessed rapid development in China in recent years. Objective In order to provide better patient services and improve the accessibility of quality medical services, Hospital J created Internet hospital to provide online diagnosis and treatment services. Methods Relying on Internet technology, Hospital J built hospital Internet online medical services, such as online registration, real-time consultation, message consultation, revisit prescription, drug distribution, pharmacist online, nursing consultation, appointment nurse home care and other services, supported by the offline hospital medical resources. Results Internet hospitals can help save the cost and time of patients' medical treatment, optimize the process of patients' medical treatment, avoid delay of illness and cross-infection, effectively alleviate the difficulty of patients' medical treatment, and improve the quality and level of hospital services. Conclusion In practice, Hospital J has explored a way to develop an Internet hospital in line with the characteristics of the hospital. Fundamentally, the development of Internet + medical treatment is fundamentally a change in the mode of doctor-patient service. With the advantages of convenience, efficiency and timeliness, it has become the trend of The Times. It is of positive practical significance to research on and solve the problems with the Internet hospital.

SeekDoc: Seeking eligible doctors from electronic health record.

With the development of online medical service platform, patients can find more medical information resources and obtain better medical treatment. However, it is difficult for patients to discover the most suitable doctors from the complex information resources. Therefore, the analysis and mining of Electronic Health Record(EHR) is very important for patients' timely and accurate treatment. Discovering the most suitable doctor is actually predicting the exact performance of the doctor for a specific disease. We believe that "a curative/bad treatment is likely to be caused by a good/bad doctor, and a good/bad doctor has a higher/lower evaluation by the patient(s)". In this paper, we propose a novel approach named SeekDoc, which is to seek the most effective doctor for a specific disease. Specifically, we build a doctor-disease heterogeneous information network and collect patients reviews and rating records for doctors. Then, we embed the comprehensive comment data for doctors and the constructed heterogeneous information network. Next, we use the autoencoder mechanism to learn the embedded features, which is an effective learning algorithm for constructing the latent feature representation in an unsupervised manner. After this learning, the latent features are input into the extreme gradient boosting (XGBoost) algorithm to improve their detection capabilities. Finally, extensive experiments show that our method can effectively and efficiently predict the doctor's experience score for specific diseases and has good performance compared with other algorithms.

Матрица оценки качества телемедицинского консультирования «пациент-врач»

Introduction. The growing demand for online medical services, the active inclusion of telemedicine consultations in state health insurance programs, and the general intensive development of telemedicine require a methodology for quality assurance and control. Objective is to develop a methodological basis for a comprehensive assessment of the quality and effectiveness of direct-to-consumer telemedicine consultations. Material and methods. There are sources of primary data: systematizing scientific publications (descriptions of models and methodologies for telemedicine quality assessing); own theoretical researches, accumulated practical experience with of directto-consumer telemedicine. Methods of analysis and synthesis have been use. Results and discussion. The matrix for for direct-to-consumer telemedicine quality assessing has formed. It includes four domains «Accessibility», «Efficiency», «Safety» and «Responsibility» from the standpoint of all participants of the distant interaction processes: patient and/or legal representative; medical consultant; operator of a telemedicine information system; medical organization; health care system (society). The matrix takes into account the aspects of goal-setting and the interests of each participant. There are structured metrics in frame of each domain. Conclusions. The matrix can be used as a basis for scientific research and as a methodology for internal and departmental quality control of medical care provided via telemedicine technologies.

Impact of early Coronavirus Disease 2019 pandemic on pediatric cardiac surgery in China

ObjectiveThis study aimed to provide an insight into the impact of the early outbreak of the novel Coronavirus Disease 2019 on the care management for patients with congenital heart disease. MethodsThis study respectively enrolled a cohort of surgical patients who underwent surgery in 2018 (group I), 2019 (group II), and 2020 (group III) and a cohort of follow-up patients who had follow-up in 2017 (group A), 2018 (group B), and 2019 (group C) in 13 children hospitals. ResultsDuring the Coronavirus Disease 2019 era, there was a significant decrease in total surgical volume and a change in case mix in terms of an increase in the proportion of emergency operations. Decrease in migration scale index was correlated to the decrease in both surgical volume (r = 0.64, P = .02) and outpatient visit volume (r = 0.61, P = .03). There was a significantly higher proportion of patients who had follow-up through the internet or phone in group C (26.4% vs 9.6% in group B and 8.9% in group A; P < .0001). There was no statistical difference in death or rehospitalization among the 3 follow-up groups (P = .49). There was higher parents' anxiety score (P < .0001) and more use of telemedicine (P = .004) in group C compared with groups A and B. ConclusionsThe Coronavirus Disease 2019 pandemic has resulted in a considerable decrease in total surgical volume and a change of case mix, which seems to be related to the strict traffic ban. Follow-up through the online medical service appears to be an effective alternative to the conventional method.

Analysis of Online Medical Services Availability during Covid-19 Pandemic In Nepal

After the first case of COVID-19 reported from Wuhan City in China, the WHO declared it as a ‘pandemic’ on 11th March 2020. The first case of COVID-19 was officially announced in Nepal on 24th January 2020. The lockdown of the entire nation was implemented by the government of Nepal from 24th March 2020 following the announcement of the second positive case of COVID-19. The aims of the study to find out the available online services understand and analyze them to implement in Nepal.&#x0D; There are 10 online medical services operating to facilitate medical services and 13 Covid-19 related mobile apps to use by common public and medical surveillance within Nepal. These are online mobile application and online services dedicated to make life easy during Covid – 19 Pandemic in Nepal. It is better to apply single or minimize duplication of similar work for Covid-19 Pandemic in Nepal by different concerned authorities.

The design and research of a new pharmaceuticals-vending machine based on online medical service

Under the pressure of fast-paced life, people’s demand for pharmaceuticals increases, and 24-h pharmacies begin to increase. But these pharmacies cannot really provide pharmaceuticals anytime and anywhere, and at the same time, the existing pharmaceuticals-vending machine (PM) has only single function and imperfect management. The mature automated medicine distribution equipment is only used in hospitals, and the cost is higher. In order to solve the above problems, a new pharmaceuticals-vending machine (NPM) based on mobile terminal machine combines body temperature, pulse detection with pharmaceuticals purchase was designed, which breaks the traditional manual retail mode and realizes 24 h safe and efficient pharmaceuticals purchase. The new pharmaceuticals-vending machine (NPM) has some functions such as self-detecting body temperature and pulse, remote doctor consultation, accurate positioning of pharmaceuticals machine location and rapid search and purchase. Users can purchase pharmaceuticals efficiently, accurately and safely by it. The new pharmaceuticals-vending machine (NPM) can connect with the hospitals, communities and patients through APP, which can not only meet the personalized needs of users, but also manage the machine effectively.

PNS14 Investigation of Physicians’ Digital Activities on Mitigating the IMPACT of Covid-19 in China

COVID-19 outbreak caused a global health crisis and posed public health challenges. During the outbreak, digital technologies were widely used to enhance prevention measures. Kantar in association with CphMRA, conducted a survey to understand the use and role of digital health tools among Chinese physicians during the epidemic. A cross-sectional online survey was conducted from February 29th to March 5th in 2020, using convenience sampling to collect physician behaviour in terms of digital activity and participation in internet hospitals. Logistic regression was used to analyse the digital activity data, and mixed model was used to analyse the internet hospital practice including online diagnosis and treatment before and during the outbreak. This study included 28.3% residents, 35.5% doctors-in-charge and 36.2% chief/vice-chief physicians from 30 provinces (n=3691). In total, 79.5% of respondents engaged in digital activities to enhance public health/medical education and communication such as webcasting, case sharing, and patient management. The results also show that physicians practising in higher level hospitals (p<0.001) as well as those working in fever clinics (p<0.05) were significantly more likely to use digital tools. Moreover, 66.1% respondents registered with internet hospitals and 22.8% of whom had registered new accounts during the outbreak. The number of online medical service during the outbreak was significantly higher (29.1 patients/week, 95% CI: 7.5∼50.6) than that before the outbreak. The physicians in lower level hospitals and those registered more internet hospital accounts were significantly more likely to conduct online medical services (p<0.05). Additionally, 75.1% of the online prescriptions were delivered to patients’ doorsteps, with higher incidence in more serious epidemic regions (P<0.01). Digital technology was extensively used to enhance public health strategies and mitigate the impact of COVID-19 by improving medical education, communication, and ensuring continuity of health services for patients while preventing unnecessary hospital visits.

A NOVEL ONLINE SYSTEM LINKING AT-HOME SMARTPHONE SEMEN TESTS WITH EMBRYOLOGISTS

Infertility is a serious disease requiring timely treatment. If treatment is delayed, the condition of patients may deteriorate over time. The coronavirus (COVID-19) pandemic has seriously affected couples in need of immediate infertility treatment. Because of stay-at-home guidance, fewer people are visiting medical facilities, and thus it may become necessary to provide online medical services, including infertility treatment. Male-factor infertility contributes to about 50% of the incidence of infertility in couples.

Medical speciality classification system based on binary particle swarms and ensemble of one vs. rest support vector machines.

Nowadays, artificial intelligence plays an integral role in medical and healthcare informatics. Developing an automatic question classification and answering system is essential for coping with constant advancements in science and technology. However, efficient online medical services are required to promote offline medical services. This article proposes a system that automatically classifies medical questions of patients into medical specialities and supports the Arabic language in the MENA region. Text classification is not trivial, especially when dealing with a highly morphologically complex language, the dialectical form of which is the dominant form on the Internet. This work utilizes 15,000 medical questions asked by the clients of Altibbi telemedicine company. The questions are classified into 15 medical specialities. As the number of medical questions received daily by the company has increased, a need has arisen for an automatic classification system that can save the medical personnel much time and effort. Therefore, this article presents an efficient medical speciality classification system based on swarm intelligence (SI) and an ensemble of support vector machines (SVMs). Particle swarm optimization (PSO) is an SI-based and stochastic metaheuristic algorithm that is adopted to search for the optimal number of features and tune the hyperparameters of the SVM classifiers, which are deployed as one-versus-rest for multi-class classification. In addition, PSO is integrated with various binarization techniques to boost its performance. The experimental results show that the proposed approach accomplished remarkable performance as it achieved an accuracy of 85% and a features reduction rate of 95.9%.

The Internet Hospital as a Telehealth Model in China: Systematic Search and Content Analysis.

BackgroundThe internet hospital is an innovative organizational form and service mode under the tide of internet plus in the Chinese medical industry. It is the product of the interaction between consumer health needs and supply-side reform. However, there has still been no systematic summary of its establishment and definition, nor has there been an analysis of its service content.ObjectiveThe primary purpose of this study was to understand the definition, establishment, and development status of internet hospitals.MethodsData on internet hospitals were obtained via the Baidu search engine for results up until January 1, 2019. Based on the results of the search, we obtained more detailed information from the official websites and apps of 130 online hospitals and formed a database for descriptive analysis.ResultsBy January 2019, the number of registered internet hospitals had expanded to approximately 130 in 25 provinces, accounting for 73.5% of all provinces or province-level municipalities in China. Internet hospitals, as a new telehealth model, are distinct but overlap with online health, telemedicine, and mobile medical. They offer four kinds of services—convenience services, online medical services, telemedicine, and related industries. In general, there is an underlying common treatment flowchart of care in ordinary and internet hospitals. There are three different sponsors—government-led integration, hospital-led, and enterprise-led internet hospitals—for which stakeholders have different supporting content and responsibilities.ConclusionsInternet hospitals are booming in China, and it is the joint effort of the government and the market to alleviate the coexistence of shortages of medical resources and wasted medical supplies. The origin of internet hospitals in the eastern and western regions, the purpose of the establishment initiator, and the content of online and offline services are different. Only further standardized management and reasonable industry freedom can realize the original intention of the internet hospital of meeting various health needs.

Phrase-level pairwise topic modeling to uncover helpful peer responses to online suicidal crises

Suicide is a serious public health problem; however, suicides are preventable with timely, evidence-based interventions. Social media platforms have been serving users who are experiencing real-time suicidal crises with hopes of receiving peer support. To better understand the helpfulness of peer support occurring online, this study characterizes the content of both a user’s post and corresponding peer comments occurring on a social media platform and present an empirical example for comparison. It introduces an approach that uses pairwise topic models to transform large corpora of discussion into associated topics of user and peer posts. The key advantages of this approach include: (i) modeling both the generative process of each type of the corpora (i.e., user posts and peer comments) and the associations between them, and (ii) using phrases, which are more informative and less ambiguous than words, in addition to words, to represent social media posts and topics. The study evaluated the method using data from Reddit r/SuicideWatch. It examined how the topics of user and peer posts were associated and how this information influenced the peer perceived helpfulness of the peer support. Then, this study applied structural topic modeling to data collected from individuals with a history of suicidal crisis as a means to validate findings. The observations suggest that effective modeling of the association between the two lines of topics can uncover helpful peer responses to online suicidal crises, notably providing the suggestion of professional help. The proposed technology can be applied to “paired” corpora in many applications, such as technical support forums, question-answering sites, and online medical services.

Consumer behavior and customer relationship management in mental health services

Mental health services are perceived differently in different socio-cultural settings. The connotations accorded to mental health, especially in terms of need awareness and evaluation of alternatives, vary from culture to culture. Understanding these differences is critical to attract and retain patients suffering from mental conditions. Generic literature on consumer behavior does not provide direct answers to many of the problems in this regard, primarily because such literature does not take into account the deviant mental states of these patients. In this paper, we review findings from mental health specific studies conducted in both Western and Asian countries, evaluate the importance of decision-making factors for both public and private service providers, and offer directions for future research. Interdisciplinary literature on customer relationship management, consumer behavior, mental health, and healthcare marketing, guided by the principles of systematic literature review constituted the methodology of this study. The research methods are analysis, synthesis, classification and grouping. The empirical base included about 250 peer-reviewed articles on the topic under consideration. We find that doctor-led service provision is still the most prevalent form of relationship building in the Eastern societies, especially in the less developed countries of South East Asia. Consumer-initiated mental health treatment schemes are more common in more developed Western economies. We also observe that, among the innovative set of providers, there is a trend of increased use of telehealth. Among other things, this includes more proactive and digitally-savvy identification, acquisition, and retention of patients. The results of the study can be used as the basis for marketing strategies of drug manufacturers and mobile application designers in the field of online medical services.

A Systematic Literature Review on Online Medical Services in Malaysia

The aim of the study reviews online medical services in Malaysia. The paper reviews the improvement in Malaysian Medical services in the past five years. In this paper, we systematically reviewed literature from the year 2014 to 2018. We selected the web of science database for the literature search to make the process more transparent and clearer, every process is recorded on the excel sheets and all studies were screened through rigorous inclusion and exclusion criteria. Final 48 papers were selected for this systematic literature review and all irrelevant papers are excluded from the study. For the selection and exclusion process, PRISMA 2009 is used. The results revealed that Literature is heavily focusing on the medical services towards the urban areas, but rural areas were largely neglected. Many studies are discussing the importance of online medical services; However, implementation mechanisms have not been discussed. The systematic review recommends that future research should be focused more on holistic patterns of implementations of the online medical services in Malaysia.

Analysis of Massive Online Medical Consultation Service Data to Understand Physicians' Economic Return: Observational Data Mining Study.

BackgroundOnline health care consultation has become increasingly popular and is considered a potential solution to health care resource shortages and inefficient resource distribution. However, many online medical consultation platforms are struggling to attract and retain patients who are willing to pay, and health care providers on the platform have the additional challenge of standing out in a crowd of physicians who can provide comparable services.ObjectiveThis study used machine learning (ML) approaches to mine massive service data to (1) identify the important features that are associated with patient payment, as opposed to free trial–only appointments; (2) explore the relative importance of these features; and (3) understand how these features interact, linearly or nonlinearly, in relation to payment.MethodsThe dataset is from the largest China-based online medical consultation platform, which covers 1,582,564 consultation records between patient-physician pairs from 2009 to 2018. ML techniques (ie, hyperparameter tuning, model training, and validation) were applied with four classifiers—logistic regression, decision tree (DT), random forest, and gradient boost—to identify the most important features and their relative importance for predicting paid vs free-only appointments.ResultsAfter applying the ML feature selection procedures, we identified 11 key features on the platform, which are potentially useful to predict payment. For the binary ML classification task (paid vs free services), the 11 features as a whole system achieved very good prediction performance across all four classifiers. DT analysis further identified five distinct subgroups of patients delineated by five top-ranked features: previous offline connection, total dialog, physician response rate, patient privacy concern, and social return. These subgroups interact with the physician differently, resulting in different payment outcomes.ConclusionsThe results show that, compared with features related to physician reputation, service-related features, such as service delivery quality (eg, consultation dialog intensity and physician response rate), patient source (eg, online vs offline returning patients), and patient involvement (eg, provide social returns and reveal previous treatment), appear to contribute more to the patient’s payment decision. Promoting multiple timely responses in patient-provider interactions is essential to encourage payment.