Table 2.
Sample Operational Definitions of Telehealth Implementation Outcomes by Data Source.
| Data Source | Implementation Outcome | Operationalization |
|---|---|---|
| Healthcare administrative data | Sustainability | Reimbursement/revenue generated through telehealth services |
| Are certain diagnostic codes less likely to be reimbursed via telehealth relative to in person visits? | ||
| Cost | Financial investment required to initiate and maintain telehealth service as compared with delivering care in person; healthcare utilization (are patients continuing to seek in-person treatment with other providers, such as ER visits?) | |
| Efficiency | Rates of same day encounter closures/completion of documentation for telehealth versus in person visits | |
| Electronic health record | Acceptability | Number of patients who agreed to receive healthcare via telehealth |
| Adoption | Percentage of daily patient visits conducted via telehealth over time | |
| Cost | Patient zip/postal code data may be extracted to estimate saved appointment transportation costs | |
| Penetration | Assess whether there are differences in telehealth use associated with patient demographics | |
| Does a previously defined risk group (e.g., home bound, complex medical needs, patients in rural area) use telehealth? | ||
| Efficiency | Does treatment length (total number of sessions) differ for services delivered in person relative to remotely? | |
| Sustainability | Rate of no-shows by appointment type | |
| Clinical health registry | Appropriateness | Severity/type of clinical symptoms |
| Feasibility | Change in quality of life and clinical symptoms over time | |
| Penetration | Characterize patients being seen via telehealth | |
| Mixed method stakeholder feedback | Acceptability | Patient, provider and staff self-reported willingness to utilize telehealth |
| Satisfaction | Patient satisfaction with telehealth treatment as delivered | |
| Provider satisfaction with telehealth treatment as implemented | ||
| Cost | Elicit average transportation, lost work time saved by patient attending an appointment in person relative to telehealth | |
| Safety | Assess whether providers felt critical safety concerns could be adequately managed via telehealth | |
| Sustainability | Frequency of technological challenges that result in lost service delivery time | |
| Fidelity | Did providers utilize telehealth as originally envisioned and were additional novel applications discovered? |