Study Overview
The adoption of telemedicine by medical care organizations has been on the rise. Although telemedicine may increase access to health care, little is known about how the medium changes providers’ medical decision making. To understand the degree to which telemedicine differs from in-person care, we compare the quality and cost of care between in-person clinic care and care provided remotely over the phone for common health conditions in Rwanda. To control for patient selection, we collected data from 2,541 standardized patient visits, where locally recruited individuals portraying real patients presented standardized cases for malaria and upper respiratory infection (URI) remotely or in person. Outcomes will include condition-specific correct case management definitions benchmarked to clinical practice guidelines, time spent, medical history questions asked, medicines prescribed, lab tests ordered, and patient costs. We will also explore whether telemedicine shifts the patient-provider dynamic by testing how providers respond to patient requests for unnecessary antibiotics and suggested diagnoses. We will control for a rich set of provider training, experience, and personality covariates as measured by a survey of providers.
Study Results
Pending