Impact of telemedicine on continuity of care and patient safety. A systematic review
DOI:
https://doi.org/10.70577/asce.v4i4.564Keywords:
Telemedicine; Continuity Of Care; Patient Safety; Healthcare; Digital Health.Abstract
Telemedicine continues to consolidate itself as an important strategy for addressing continuity of care and patient safety within the challenges faced by healthcare systems. With the objective of analyzing the available scientific evidence on the impact of telemedicine on continuity of care and patient safety across different levels of care, a systematic review of the literature was conducted through a structured process of study identification, selection, eligibility, and inclusion, applying predefined criteria and assessing the methodological quality of the studies using a standardized checklist. A total of 21 studies addressing various telemedicine modalities in primary care, hospital settings, and post-discharge follow-up were included. The results of the review demonstrated improvements in clinical control of chronic diseases, greater therapeutic adherence, reductions in hospitalizations and readmissions, decreased adverse events, and strengthened coordination across levels of care, without compromising clinical safety. In conclusion, telemedicine represents a safe and effective tool to enhance continuity of care, provided that its implementation is supported by clinical protocols, adequate technological infrastructure, and effective training of healthcare personnel.
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References
1. Soltane, H., Lazrak, I., Chelly, S., Khrouf, M., Younes, S., Haddaji, O., Mahjoub, M., & Mezgar, Z. (2024). Place of telemedicine in the organization of emergency care: feasibility and benefits. BMC Emergency Medicine, 24. https://doi.org/10.1186/s12873-024-01074-y DOI: https://doi.org/10.1186/s12873-024-01074-y
2. Tathyane H. N. Teshima, Roddy S. Mcmillan. High diagnostic accuracy of chronic facial pain conditions via remote consultation. Journal of Oral & Facial Pain and Headache. 2025. 39(2);94-100. https://www.jofph.com/articles/10.22514/jofph.2025.028
3. Alansari A, Zaazouee M, Najar S, Elshanbary A, Mesaoud M. Telemedicine applications in pediatric emergency surgery and trauma: a systematic review of diagnostic accuracy and clinical effectiveness. Pediatr Surg Int. 2025;41. doi:10.1007/s00383-025-06023-9 DOI: https://doi.org/10.1007/s00383-025-06023-9
4. Vincent R, Charron M, Lafrance S, Cormier A, Kairy D, Desmeules F. Investigating the use of telemedicine by health care providers to diagnose and manage patients with musculoskeletal disorders: systematic review and meta-analysis. J Med Internet Res. 2024;26:e52964. doi:10.2196/52964 DOI: https://doi.org/10.2196/52964
5. Olsen G, Bastholm M. Artificial intelligence and the future of public health: a qualitative inquiry into ethical, social, and policy scenarios. J Foresight Health Gov. 2024;1(1):42–50. 50. https://www.journalfph.com/index.php/jfph/article/view/19
6. Cruz-Panesso I, Tanoubi I, Drolet P. Telehealth competencies: training physicians for a new reality? Healthcare (Basel). 2024;12(1):93. doi:10.3390/healthcare12010093 DOI: https://doi.org/10.3390/healthcare12010093
7. Leonny S, Bowra J, Davis RA, Zuleta N, Hansen K, Large R, et al. Telehealth in emergency medicine in Australasia: advantages and barriers. Emerg Med Australas. 2024;36(4):498–504. doi:10.1111/1742-6723.14411 DOI: https://doi.org/10.1111/1742-6723.14411
8. Teshima T, McMillan R. High diagnostic accuracy of chronic facial pain conditions via remote consultation. J Oral Facial Pain Headache. 2025;39:94–100. doi:10.22514/jofph.2025.028 DOI: https://doi.org/10.22514/jofph.2025.028
9. Ijaz M. BT01 The effectiveness of telemedicine in dermatology services: a systematic review. Br J Dermatol. 2025. doi:10.1093/bjd/ljaf085.526 DOI: https://doi.org/10.1093/bjd/ljaf085.526
10. Türk E, Karagülle E, Aydoğan C, Oğuz H, Tarım A, Karakayalı H, et al. Use of telemedicine and telephone consultation in decision-making and follow-up of burn patients: initial experience from two burn units. Burns. 2011;37(3):415–9. doi:10.1016/j.burns.2010.10.004 DOI: https://doi.org/10.1016/j.burns.2010.10.004
11. Hoseini F, Ayatollahi H, Salehi SH. A systematized review of telemedicine applications in treating burn patients. Med J Islam Repub Iran. 2016;30(1):458.
12. Roa L, Gómez-Cía T, Acha B, Serrano C. Digital imaging in remote diagnosis of burns. Burns. 1999;25(7):617–23. doi:10.1016/S0305-4179(99)00053-4 DOI: https://doi.org/10.1016/S0305-4179(99)00053-4
13. García-Díaz A, Vilardell-Roig L, Novillo-Ortiz D, Gacto-Sánchez P, Pereyra-Rodríguez JJ, Saigí-Rubió F. Utility of telehealth platforms applied to burns management: a systematic review. Int J Environ Res Public Health. 2023;20(4):3161. doi:10.3390/ijerph20043161 DOI: https://doi.org/10.3390/ijerph20043161
14. Saifan AR, Odeh MS, Oleimat B, AbuRuz ME, Ahmed AM, Razeq NMA, et al. Exploring the impact and challenges of tele-ICU: a qualitative study on nursing perspectives. Appl Nurs Res. 2025;82:151914. doi:10.1016/j.apnr.2025.151914 DOI: https://doi.org/10.1016/j.apnr.2025.151914
15. Gardiner S, Hartzell TL. Telemedicine and plastic surgery: a review of its applications, limitations and legal pitfalls. J Plast Reconstr Aesthet Surg. 2012;65(3):e47–53. https://www.sciencedirect.com/science/article/abs/pii/S1748681511006826 DOI: https://doi.org/10.1016/j.bjps.2011.11.048
16. Vasudevan S. Searching of Literature Through Medical Subject Headings (MeSH): An Update.. International Journal of Medical Sciences and Nursing Research. 2023. https://doi.org/10.55349/ijmsnr.2023331315 DOI: https://doi.org/10.55349/ijmsnr.2023331315
17. Page M, Moher D, Bossuyt P, Boutron I, Hoffmann T, Mulrow C, et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. . The BMJ, 372. 2020. https://doi.org/10.1136/bmj.n160 DOI: https://doi.org/10.31222/osf.io/gwdhk
18. Khan, R., Siddique, R., Ali, A., Tahir, F., Khan, S., & Malik, S. (2024). Randomized Controlled Trials and Consolidated Standards of Reporting Trials “Consort” 2010- 2019, Pakistan. Annals of Punjab Medical College. https://doi.org/10.29054/apmc/2024.1601. DOI: https://doi.org/10.29054/apmc/2024.1601
19. Ma Y, Zhao C, Zhao Y, et al. Telemedicine application in patients with chronic disease: a systematic review and meta-analysis. BMC Med Inform Decis Mak. 2022;22:105. https://doi.org/10.1186/s12911-022-01845-2 DOI: https://doi.org/10.1186/s12911-022-01845-2
20. Tierney AA, Payán DD, Brown TT, Aguilera A, Shortell SM, Rodriguez HP. Telehealth use, care continuity, and quality: diabetes and hypertension care in community health centers before and during the COVID-19 pandemic. Med Care. 2023;61(Suppl):S62-S69. doi:10.1097/MLR.0000000000001811 DOI: https://doi.org/10.1097/MLR.0000000000001811
21. Kuan PX, Chan WK, Ying DKF, Rahman MAA, Peariasamy KM, Lai NM, Anand A. Efficacy of telemedicine for the management of cardiovascular disease: a systematic review and meta-analysis. Lancet Digit Health. 2022;4(9):e676-e691. https://www.thelancet.com/action/showPdf?pii=S2589-7500%2822%2900124-8 DOI: https://doi.org/10.1016/S2589-7500(22)00124-8
22. Lewinski AA, Walsh C, Rushton S, et al. Telehealth for the longitudinal management of chronic conditions: systematic review. J Med Internet Res. 2022;24(8):e37100. doi:10.2196/37100 DOI: https://doi.org/10.2196/37100
23. Ahmed A, Mutahar M, Daghrery AA, et al. A systematic review of publications on perceptions and management of chronic medical conditions using telemedicine remote consultations by primary healthcare professionals April 2020 to December 2021 during the COVID-19 pandemic. Med Sci Monit. 2024;30:e943383. https://medscimonit.com/abstract/full/idArt/943383 DOI: https://doi.org/10.12659/MSM.943383
24. Giansanti D. Joint expedition: exploring telehealth and the digital healthcare landscape as a team integration. Healthcare. 2024;12(5):585. https://doi.org/10.3390/healthcare12050585 DOI: https://doi.org/10.3390/healthcare12050585
25. Menezes LLD, Souza MIDCD, Simas KBDF, et al. Análisis de la percepción de los médicos en el Sistema Único de Salud sobre el uso de la teleconsulta en Campo Grande-MS, Brasil. Ciênc Saúde Coletiva. 2024;29:e03352024. https://doi.org/10.1590/1413-812320242911.03352024ESP DOI: https://doi.org/10.1590/1413-812320242911.03352024esp
26. Xu-Stettner J, Thompson AN, Fitzgerald LJ, Licari T, McMurry KA, Tischer S. Comparison of transplant pharmacist treatment decisions between telehealth and clinic visits. Prog Transplant. 2023;33(2):156-161. doi:10.1177/15269248231164161 DOI: https://doi.org/10.1177/15269248231164161
27. Couto GS, Brasil AB, Gadelha VOS, et al. Os parâmetros da telemedicina direcionada a procedimentos cirúrgicos operatórios: um protocolo de revisão de escopo. Rev Contemp. 2025;5(9):e9178. https://doi.org/10.56083/RCV5N9-104 DOI: https://doi.org/10.56083/RCV5N9-104
28. Colussi CF, Amadigi FR, Petrolini RS, et al. Contribuição das teleconsultorias no fortalecimento da Rede de Atenção à Saúde em Santa Catarina. Saúde Debate. 2025;49:e10008. https://www.scielosp.org/article/sdeb/2025.v49nspe1/e10008/pt/
29. Elsener M, Santana Felipes RC, Sege J, Harmon P, Jafri FN. Telehealth-based transitional care management programme to improve access to care. BMJ Open Qual. 2023;12:e002495. https://doi.org/10.1136/bmjoq-2023-002495 DOI: https://doi.org/10.1136/bmjoq-2023-002495
30. Po HW, Chu YC, Tsai HC, Lin CL, Chen CY, Ma MHM. Efficacy of remote health monitoring in reducing hospital readmissions among high-risk postdischarge patients: prospective cohort study. JMIR Form Res. 2024;8:e53455. doi:10.2196/53455 DOI: https://doi.org/10.2196/53455
31. Amalia I, Said F, Nambiar N. The effect telemonitoring for preventing 30 days re-admission among heart failure patients: a systematic review. Afr J Biomed Res. 2025;28(S1):6395. https://doi.org/10.53555/ajbr.v28i1s.6395 DOI: https://doi.org/10.53555/AJBR.v28i1S.6395
32. Bourkas A, Barone N, Bourkas M, et al. Diagnostic reliability in teledermatology: a systematic review and a meta-analysis. BMJ Open. 2023;13:e068207. https://doi.org/10.1136/bmjopen-2022-068207 DOI: https://doi.org/10.1136/bmjopen-2022-068207
33. Kruse, C. S., Molina-Nava, A., Kapoor, Y., Anerobi, C., & Maddukuri, H. (2023). Analyzing the effect of telemedicine on domains of quality through facilitators and barriers to adoption: systematic review. Journal of Medical Internet Research, 25, e43601. DOI: https://doi.org/10.2196/43601
34. Eberly LA, Kallan MJ, Julien HM, Haynes N, Khatana SAM, Nathan AS, Snider C, Chokshi NP, Eneanya ND, Takvorian SU, Anastos-Wallen R, Chaiyachati K, Ambrose M, O'Quinn R, Seigerman M, Goldberg LR, Leri D, Choi K, Gitelman Y, Kolansky DM, Cappola TP, Ferrari VA, Hanson CW, Deleener ME, Adusumalli S. Patient Characteristics Associated With Telemedicine Access for Primary and Specialty Ambulatory Care During the COVID-19 Pandemic. JAMA Netw Open. 2020 Dec 1;3(12):e2031640. doi: 10.1001/jamanetworkopen.2020.31640. Erratum in: JAMA Netw Open. 2021 Feb 1;4(2):e211913. doi: 10.1001/jamanetworkopen.2021.1913. PMID: 33372974; PMCID: PMC7772717. DOI: https://doi.org/10.1001/jamanetworkopen.2020.31640
35. Greenhalgh T, Wherton J, Shaw S, Morrison C. Video consultations for COVID-19 and beyond: an evidence review. BMJ. 2020;368:m998. doi:10.1136/bmj.m998 DOI: https://doi.org/10.1136/bmj.m998
36. Lobato, S. D., Spiaggi, E., Lahuerta, I. V., Arechabala, I. M., Alcobé, E. O., Sanz, J. R. P., ... & Aranda, J. C. (2022). Guía de telemedicina para pacientes con terapias respiratorias domiciliarias (tele-TRD). Open Respiratory Archives, 4(4), 100193. https://www.sciencedirect.com/science/article/pii/S265966362200039X DOI: https://doi.org/10.1016/j.opresp.2022.100193
37. Totten, A. M., Womack, D. M., Eden, K. B., McDonagh, M. S., Griffin, J. C., Grusing, S., & Hersh, W. R. (2019). Telehealth for Acute and Chronic Care Consultations. Agency for Healthcare Research and Quality (US). https://doi.org/10.23970/AHRQEPCCER216 DOI: https://doi.org/10.23970/AHRQEPCCER216
38. Bhatia, R. S., & Falk, W. (2018). Modernizing Canada's Healthcare System through the virtualization of services. CD Howe Institute e-Brief, 277. https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3184876 DOI: https://doi.org/10.2139/ssrn.3184876
39. Bashshur RL, Doarn CR, Frenk JM, Kvedar JC, Woolliscroft JO. Telemedicine and the COVID-19 pandemic: lessons for the future of healthcare delivery. Telemed J E Health. 2020;26(5):571–573. doi:10.1089/tmj.2020.29040.rb DOI: https://doi.org/10.1089/tmj.2020.29040.rb
40. Islam MR, Kabir MM, Mridha MF, et al. Deep learning-based IoT system for remote monitoring and early detection of health issues in real-time. Sensors. 2023;23(11):5204. https://www.mdpi.com/1424-8220/23/11/5204 DOI: https://doi.org/10.3390/s23115204
41. Anma A, Komori M. The efficacy of a wearable device-based vital sign monitoring system in a Japanese home medical care clinic. Intern Med. 2025;5213-24. https://doi.org/10.2169/internalmedicine.5213-24 DOI: https://doi.org/10.2169/internalmedicine.5213-24
42. Hussain A, Dayo KA, Kumari V, et al. Role of telemedicine in rural areas for providing doorstep medical treatment to the elderly and chronic disease patients. Pak J Med Health Sci. 2025;19(5):18-23. https://doi.org/10.53350/pjmhs02025195.4 DOI: https://doi.org/10.53350/pjmhs02025195.4
43. Sahu RK, Jena H, Chakraborty D, et al. Advancing public health: a comprehensive analysis of telemedicine in chronic disease management, access improvement, and health promotion programs. Int J Health Sci Res. 2024;14(2):125-136. DOI: https://doi.org/10.52403/ijhsr.20240216
44. Toktas E. The future of e-health: opportunities and challenges in public health systems. J Foresight Health Gov. 2024;1(1):1-14. https://www.journalfph.com/index.php/jfph/article/view/15
45. Saadatzadeh R. The future of public health: integrating artificial intelligence in disease surveillance and prevention. Foresight Public Health. 2024;1(2):1-15. https://doi.org/10.61838/jfph.1.2.1
46. Ahmed S, Sanghvi K, Yeo D. Telemedicine takes centre stage during COVID-19 pandemic. BMJ Innov. 2024;10(1):1–7. doi:10.1136/bmjinnov-2023-000889
47. Giansanti D. The digital transformation of healthcare: telemedicine and integrated care ecosystems. Front Digit Health. 2024;6:1298745. doi:10.3389/fdgth.2024.1298745
48. Kuan WS, Ibrahim I, Lim TK, et al. Effectiveness of telemonitoring interventions in cardiovascular disease: a multinational cohort study. Int J Cardiol. 2022;358:72–79. doi:10.1016/j.ijcard.2022.03.041 DOI: https://doi.org/10.1016/j.ijcard.2022.03.041
49. Lewinski AA, Patel UD, Diamond M, et al. Addressing chronic disease management through synchronous telehealth: a comparative effectiveness study. BMC Health Serv Res. 2022;22:1045. doi:10.1186/s12913-022-08452-9
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