Changes in diagnosis, treatment, and clinical improvement among patients receiving telemedicine consultations

James P Marcin, Thomas S Nesbitt, Stacey L. Cole, Robin M. Knuttel, Donald M. Hilty, Pamela T Prescott, Martha M. Daschbach

Research output: Contribution to journalArticlepeer-review

53 Scopus citations


The aim of this study was to determine whether outpatient telemedicine specialty consultations to primary care clinicians result in changes in a patient's diagnosis, treatment management, and clinical outcomes. Medical records of patients who received two or more clinical telemedicine consultations in dermatology, psychiatry, and endocrinology were evaluated in a nonconcurrent retrospective analysis. Three indicators were used to measure changes in the processes of care and clinical outcomes: change in diagnosis, change in treatment, and patient clinical improvement. A retrospective review of 223 individual telemedicine patient medical records was conducted. Specialty telemedicine consultations were found to result in changes in diagnoses in 48% of the cases, changes in treatment therapy in 81.6% of the cases, and clinical improvement in 60.1%. These results are consistent with previous literature that has assessed changes in processes of care and outcomes from face-to-face specialty consultations in outpatient clinics. Changes in diagnosis and treatment therapy were found to be associated with clinical improvement with odds ratios (ORs) of 2.66 (95% confidence interval [CI]: 1.47-4.83) and 11.22 (95% CI: 4.49-31.48), respectively. This study found that telemedicine consultations resulted in changes in diagnosis and treatment regimens and also are associated with clinical improvements.

Original languageEnglish (US)
Pages (from-to)36-43
Number of pages8
JournalTelemedicine Journal and e-Health
Issue number1
StatePublished - Feb 2005

ASJC Scopus subject areas

  • Medicine(all)
  • Bioengineering
  • Media Technology
  • Nursing(all)


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