Management of quality of care in telehealth services offered by European hospitals

Abstract

Telehealth services are now part of modern healthcare systems. Their adoption, accelerated by the COVID-19 pandemic and the increasing need for accessible and flexible care models, revealed gaps in systematic approaches to quality management in telehealth. This study explores the perspectives of quality managers and telehealth leads in European hospitals, focusing on telehealth adoption, integration, quality assessment, and the utility of structured tools like the WHO Europe Telehealth Quality of Care Tool (TQoCT; 2024). This study employed semi-structured interviews with healthcare professionals from European hospitals to assess the management of telehealth quality and evaluate the applicability of the WHO TQoCT. Thematic analysis was used to identify key barriers, perceptions, and implementation challenges. Institutional disparities in telehealth adoption reveal fragmented practices, with teleradiology leading integration. Barriers to telehealth adoption and quality assurance include financial constraints, interoperability issues, and regulatory misalignment, underscoring the need for scalable quality management. The TQoCT (2024) offers guidance highlighting telehealth quality indicators but is criticized as a management tool for its resource intensity and inflexibility for diverse needs. This study emphasizes the need to address financial, technical, regulatory, and organizational barriers while advancing systematic quality assessment, hybrid systems, and technical device therapy. It endorses the WHO (2024) quality dimensions - patient-centeredness, clinical effectiveness, and safety - and promotes scalable, high-quality telehealth integration across diverse European institutions.

Date of Award	27 Jan 2025
Original language	English
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Henrique Martins (Supervisor)